General practitioners' views and experiences of providing services in Adelaide residential aged care homes.

Abstract

Aim: To explore general practitioners' (GPs') views and experiences of providing services in Adelaide residential aged care homes (RACHs) and identify barriers, enablers, and suitable models of care (MoC).

Background: National reports describe persistent challenges with GP access in RACHs. Residents often have limited choice of visiting GPs, and fee-for-service payments incentivise episodic rather than proactive care.

Methods: A qualitative study comprising semi-structured interviews was conducted with Adelaide-based GPs. Interviews were audio-recorded, transcribed, and analysed using reflexive thematic analysis. The i-PARIHS framework informed interview questions and interpretation.

Results: Twelve GPs participated, with a median interview time of 24 minutes (range, 18-49 minutes). Five themes were generated: 1. Poor remuneration and work-life balance, 2. Growing demands, operational inefficiencies and limited support, 3. Regulatory and administrative burdens detracting from care, 4. Small and diminishing cohort of GPs, and 5. Strengths and limitations across MoC. To improve care coverage, some GPs proposed a shared roster, with GPs rotating on-site to see their own residents and provide interim reviews for others.

Conclusions: GP engagement in Adelaide RACHs remains constrained by inadequate remuneration, growing demands, system inefficiencies, and limited support. Addressing these challenges requires improved remuneration reflecting care complexity, more streamlined information systems, and adjustments to prescribing and administrative requirements. Regular scheduled in-hours visits and strong relationships with staff and residents were key facilitators. A shared GP roster may improve access, continuity, and coordination while reducing on-call burden and inefficiencies in RACH work, thereby supporting more proactive, timely care. This warrants future implementation research.