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General Practice Activity in Australia 2010–11

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General Practice Activity in Australia 2010–11 General practice activityGeneral Australia in General practice activity The book provides a summary of results from the 13th year of the BEACH program, a continuing national study of general practice activity in Australia. in Australia From April 2010 to March 2011, 958 general practitioners recorded details about 95,800 GP-patient encounters, at which patients presented 149,005 reasons for encounter and 146,141 problems were managed. For 2010 –11 an ‘average’ 100 problems managed, GPs recorded: 69 medications (including 56 prescribed, seven supplied Family Medicine Research Centre to the patient and six advised for over-the-counter purchase); 11 procedures; 23 clinical treatments (advice Helena Britt, Graeme C Miller, Janice Charles, Joan Henderson, and counselling); six referrals to specialists and three to Clare Bayram, Lisa Valenti, Christopher Harrison, Ying Pan, Julie allied health services; orders for 30 pathology tests and 2010–11 O’Halloran, Carmen Zhang, Salma Fahridin six imaging tests. A subsample study of more than 31,000 patients suggests prevalence of measured risk factors in the attending adult (18 years and over) patient population were: obese—27%; overweight—35%; daily smoking—15%; at-risk alcohol consumption—25%. One in five people in the attending population had at least two of these risk factors. N°29 ISBN: 978-1-920899-86-8 9 781920 899868 GENERAL PRACTICE SERIES N°29 BEACH annual report.indd 1 25/10/11 11:04 AM GENERAL PRACTICE SERIES Number 29 General practice activity in Australia 2010–11 BEACH Bettering the Evaluation and Care of Health Helena Britt, Graeme C Miller, Janice Charles, Joan Henderson, Clare Bayram, Lisa Valenti, Christopher Harrison, Ying Pan, Julie O’Halloran, Carmen Zhang, Salma Fahridin November 2011 Sydney University Press Published 2011 by Sydney University Press SYDNEY UNIVERSITY PRESS University of Sydney Library sydney.edu.au/sup © Sydney University Press 2011 Reproduction and Communication for other purposes Except as permitted under the Act, no part of this edition may be reproduced, stored in a retrieval system, or communicated in any form or by any means without prior written permission. All requests for reproduction or communication should be made to Sydney University Press at the address below: Sydney University Press Fisher Library F03 University of Sydney NSW 2006 AUSTRALIA Email: [email protected] Any enquiries about or comments on this publication should be directed to: The Family Medicine Research Centre Sydney School of Public Health, University of Sydney Level 7, 16–18 Wentworth Street, Parramatta NSW 2150 Phone: +61 2 9845 8151; Fax: +61 2 9845 8155 Email: [email protected] This publication is part of the General practice series based on results from the BEACH program conducted by the Family Medicine Research Centre. A complete list of the Centre’s publications is available from the FMRC’s website <www.fmrc.org.au>. ISSN 1442-3022 ISBN 978-1920899-86-8 pbk ISBN 978-1920899-92-9 online Suggested citation Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, O’Halloran J, Zhang C, Fahridin S. General practice activity in Australia 2010–11. General practice series no.29. Sydney: Sydney University Press, 2011. Keywords Australia, delivery of health care/statistics and numerical data, family practice/statistics and numerical data, health care surveys/methods. Companion publication Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L, Harrison C, Pan Y, O’Halloran J, Zhang C, Chambers T, Fahridin S. A decade of Australian general practice activity 2001–02 to 2010–11. General practice series no. 30. Sydney: Sydney University Press, 2011. Cover design by Miguel Yamin, the University Publishing Service Printed in Australia Foreword It is a truth universally acknowledged that general practice, subsidised at the point of delivery through Medicare, is at the epicentre of Australian healthcare. General practitioners manage most peoples’ immediate health concerns or refer patients to specialist or hospital care when deemed necessary. The magnitude of this primary care service is reflected in the singular statistic that from April 2010 to March 2011, Medicare paid rebates for about 118.1 million general practice services amounting to an average of 5.3 GP visits per head of population Undoubtedly, the question that most occupies users of this service is its quality and safety. International comparative surveys of general practice reveal that Australia consistently falls in the upper echelon of participating first world nations; but rigorous studies of its safety are sparse. Be that as it may, the overriding concern of most public health practitioners and funders of the service is what actually transpires in these numerous primary care consultations. The answer to this question is provided by a unique program—the BEACH—Bettering the Evaluation and Care of Health – program conducted by the Family Medicine Research Centre, of the University of Sydney. Since 1998 the BEACH program has conducted an ongoing national, cross-sectional study of Australian general practice. Every year about 1000 randomly selected general practitioners record details of 100 consecutive patient encounters on a structured questionnaire. Through this activity BEACH has accumulated and published a comprehensive and sequential record of general practice activities. The most recent significant movement in medicine is evidence- based practice and this requires accurate and relevant data. No one could deny that the BEACH program is a jewel in the crown of evidence-based medicine for general practice— other clinical disciplines do not have such a valuable asset. The latest addition in this series is Number 29: General practice activity in Australia 2010–11, which compiles, an array of data on: general practitioners, practice encounters, the patients, the clinical problems, management actions including medications and other interventions such as preventive counselling, referrals to hospitals and admissions, referrals to specialists and allied health professionals, tests and investigations, practice nurse activity and patient risk factors. Accompanying this publication is the 30th book in the General Practice Series A decade of Australian general practice activity 2001–02 to 2010 –11, which highlights the many changes that have occurred over the decade in GP clinical activity. All outcomes in General practice activity in Australia 2010–11 are succinctly outlined, accessible and prove to be interesting reading. Importantly, this report also suggests how BEACH data may be integrated and aligned with other national data such as from the Pharmaceuticals Benefits Scheme, pathology and imaging MBS data and the National Health Survey. However, in these times of evidence-based medicine, one thing that might frustrate attuned readers is that the availability of such a volume of data, necessary as it is, may well hinder attempts to draw meta-analyses effectively signposting possible future directions in primary healthcare delivery. iii Crucially, neither here nor from other sources, is there systematic or extensive analysis of what is appropriate in general practice, or identification of the leading health care cost centres. Answers to these questions are becoming more relevant as health expenditure swallows increasing proportions of the national gross domestic product. Perhaps the BEACH team might consider how these indices could be serially evaluated in future reports. Another future direction would be to focus on the activities of recent players in general practice, such as the autonomous nurse practitioner clinics. These are simply suggestions for consideration of future lines of enquiry. With these issues in mind, the Family Medicine Research Centre is actively planning the development of a longitudinal general practice patient cohort study to complement the current BEACH data collection. This program will provide data from a stratified random sample of patients, which is collected via GP desktop computer systems. This program will allow the tracking of patient outcomes over time and will enhance the capacity of the BEACH team to comprehensively describe the management of patients in both primary and secondary care. In the meantime, it must be categorically stated that this assiduous and painstaking assembling of the BEACH data is a credit to Australian medicine, providing the definitive snapshot of activities of general practice in Australia. Martin B Van Der Weyden MD Emeritus Editor Medical Journal of Australia iv Acknowledgments The BEACH program 2010–11 was conducted by the Family Medicine Research Centre, University of Sydney in collaboration with the Australian Institute of Health and Welfare (AIHW), under the AIHW Act. The Family Medicine Research Centre thanks the 958 general practitioners who participated in BEACH between April 2010 and March 2011. This report would not have been possible without their valued cooperation and effort in providing the data. We thank the following organisations for their financial support and their contribution to the ongoing development of the BEACH program in 2010–11. • Australian Government Department of Health and Ageing • AstraZeneca Pty Ltd (Australia) • Merck, Sharp and Dohme (Australia) Pty Ltd • Pfizer Australia Pty Ltd • Sanofi-Aventis Australia Pty Ltd • Novartis Pharmaceuticals Australia Pty Ltd • GlaxoSmithKline Australia Pty Ltd • CSL Biotherapies Pty Ltd • Bayer Australia Ltd. Some financial support for the program
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