Monitoring the prevalence and management of chronic conditions is of increasing importance. This study provided evidence for multifaceted definitions of chronicity. While all characteristics examined could be used by those interested in chronicity, the list has been designed to identify chronic conditions managed in Australian general practice, and is therefore not a nomenclature of all chronic conditions. Subsequent analysis of chronic conditions using pre-existing data sets will provide a baseline measure of chronic condition prevalence and management in general practice.
Objectives: To describe the patients seen and the clinical activity undertaken by general practitioners during encounters at residential aged‐care facilities (RACFs), and to ascertain how these differ from all GP encounters in Australia as a whole. Design and participants: A secondary analysis of encounter data from the Bettering the Evaluation and Care of Health (BEACH) study, April 2004 to March 2006, comparing RACF consultations (identified by Medicare item numbers) with all BEACH study encounters in Australia. Participants were a random sample of GPs who had claimed at least 375 general practice Medicare items in the 3 months prior to the study. Main outcome measures: Differences in the characteristics of GPs and patients at RACF consultations, morbidities managed, and treatments provided to patients. Results: Over the study period there were 2310 RACF encounters out of a total of 197 000 BEACH encounters; 360/1970 GPs (18.4%) recorded at least one RACF consultation. GPs aged ≥ 45 years were more likely to record at least one RACF consultation than those aged < 45 years. Patients were predominantly women (70.7%), and 83.4% were aged ≥ 75 years. At RACF consultations, problems managed significantly more often included chronic problems, as well as psychological, neurological, urological, circulatory, eye and musculoskeletal problems. Dementia was the most common problem managed, at 33 times the usual management rate in everyday practice. Significantly fewer medications, non‐pharmacological treatments, referrals, pathology and imaging tests were recorded at RACF consultations. Conclusion: GP encounters at RACFs involve the management of chronic and complex conditions, including some not frequently seen in everyday general practice. The provision of additional education and resources where required may assist with workforce shortages in this setting.
Objectives: To describe the content of general practitioners’ (GP) encounters with patients aged 65 years or more, and to determine any differences in the way problems are managed between the 65–74 and 75 years and over age groups. Method: A secondary analysis of data collected through the Bettering the Evaluation and Care of Health (BEACH) program was carried out. Results: Encounters with older patients accounted for 25.0% of a GP's total workload. Circulatory conditions, in particular hypertension, were the most frequently managed, with cardiovascular medications the most frequently prescribed. Numerous differences exist in the characteristics and management of older patients when divided into those aged 65–74 and 75 years and over, with patients aged 75 years or more receiving investigations and non‐pharmacological treatments significantly less often. Conclusion: The present study provides a baseline measure of the management of older patients in general practice.
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