Hoffmann, K., Schober, J., Schäfer, W., Maier, M.
Tackling the reasons for GP shortage: the workload of GPs in rural and urban areas in Austria. A cross-sectional study within the framework of QUALICOPC.
European Journal of Public Health, 23 (2013) Suppl. 1, p. 126. Abstract. 6th European Public Health Conference: Health in Europe: are we there yet? Learning from the past, building the future. 13-16 November 2013, Brussel.ls..
Background: In the near future Austria like many other European countries will face a shortage of GPs, especially in rural regions. The interest of young doctors to work in this profession is decreasing steadily. According to the literature, working in rural areas is often associated with a higher number of working hours and a higher number of patients, especially in singlehanded practices. It was the aim of this analysis to assess the workload of rural and urban GPs in Austria and to illustrate the infrastructure for their profession. Additionally, factors influencing the workload were analyzed and compared. Methods: The data collection took place between October 2011 and May 2012 within the context of the European QUALICOPC-study by using a standardized GP questionnaire with 60 questions. Via email and personal contacts, a stratified sample of 3.050 general practitioners was invited to participate in the study. Statistical analyses included descriptive statistics and tests as well as correlations. Results: Data from 174 out of 184 returned GP questionnaires could be used. Their analysis shows that GPs in rural areas spent (excluding additional jobs) 5.1 hours per week more on direct patient care (33.6 h vs. 38.7 h; p = 0.010), 3.1 hours more on administrative issues (7.6 h vs. 10.7 h; p = 0.026), and had more than twice as much on-call duties (10.2 vs. 22.7; p < 0.001) within three months than their colleagues from urban areas. The average consultation length is similar in both groups with approx. 9 min per patient as well as the high self-rated workload-feeling. The number of patients, of home visits and of patient contacts is directly proportional to the weekly working hours. 91.7% of the urban and 87.6% of the rural offices were single-handed. Discussion: There is a significant difference between the workload of Austrian GPs in rural and in urban areas. In order to raise the attractiveness of primary care practice in rural areas and the interest of young doctors to work there, substantial changes in both working conditions and organizational structure for primary care services appear to be necessary; possibilities include shared duties in group practices consisting of primary health care teams, incentives, and adequate under- and postgraduate education and training. Key messages:
There is a significant and alarming difference between the workload of Austrian GPs in rural and in urban areas. Substantial changes in both working conditions and organizational structure for primary care services appear to be necessary in Austria.