Spatial variations in attendance at general practitioner services

The general practitioner is the initial point of entry to the health service for the majority of persons in the United Kingdom. This paper presents an analysis of results from a behavioural survey of attendance patterns at general practitioner services in West Glamorgan. Respondents in six selected survey sites were questioned regarding a range of surgery attendance behaviour. In many cases, respondents were not attending their nearest general practitioner and hence were not conforming to the nearest-centre hypothesis. A number of features distinguished the attendance patterns of higher and lower social status respondents and these were analysed using knowledge of variables which have been found to influence consumer behaviour in other spheres. Personal mobility, age of respondent, pre-school age children in households and place of former residence were included to examine their influence on attendance patterns. Personal mobility of respondents did to some extent influence distance travelled to general practitioner surgeries, although this was status-related also. Age of respondent did not appear to influence significantly distances travelled. More importantly, "place of previous residence" appeared to produce a type of "inertia" in that certain respondents were maintaining links with general practitioners in areas where they formerly lived and the resulting flows were termed "relict patterns of travel" to surgery. The implications of these findings for the planning of primary health care services are considered.