Characteristics of general practitioner referrals to podiatrists in Australia, 2000–2016

Menz, Hylton B.; Harrison, Christopher; Bayram, Clare

doi:10.1016/j.puhe.2021.01.015

Cited by 5 publications

(6 citation statements)

References 33 publications

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“…The share of participants reporting a longer duration of diabetes and the use of insulin or other injectable was substantially higher in the “GP & podiatrist” profile than in the “GP only” one, which could explain the involvement of the diabetologist concomitantly with the GP. Additionally, the older age of participants in the “GP & podiatrist” profile is congruent with findings from a recent study, which showed that patients referred to the podiatrist by their GP were more likely to be aged ≥85 years ( 35 ). Moreover, older age and a longer duration of diabetes are known risk factors for foot ulceration and the higher use of podiatry may also reflect an increased risk of diabetic foot in this profile ( 36 ).…”

Section: Discussionsupporting

confidence: 84%

Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study

et al. 2022

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BackgroundDespite the growing burden of diabetes worldwide, evidence regarding the optimal models of care to improve the quality of diabetes care remains equivocal. This study aimed to identify profiles of patients with distinct ambulatory care use patterns and to examine the association of these profiles with the quality of diabetes care.MethodsWe performed a cross-sectional study of the baseline data of 550 non-institutionalized adults included in a prospective, community-based, cohort study on diabetes care conducted in Switzerland. Clusters of participants with distinct patterns of ambulatory healthcare use were identified using discrete mixture models. To measure the quality of diabetes care, we used both processes of care indicators (eye and foot examination, microalbuminuria screening, blood cholesterol and glycated hemoglobin measurement [HbA1c], influenza immunization, blood pressure measurement, physical activity and diet advice) and outcome indicators (12-Item Short-Form Health Survey [SF-12], Audit of Diabetes-Dependent Quality of Life [ADDQoL], Patient Assessment of Chronic Illness Care [PACIC], Diabetes Self-Efficacy Scale, HbA1c value, and blood pressure <140/90 mmHg). For each profile of ambulatory healthcare use, we calculated adjusted probabilities of receiving processes of care and estimated adjusted outcomes of care using logistic and linear regression models, respectively.ResultsFour profiles of ambulatory healthcare use were identified: participants with more visits to the general practitioner [GP] than to the diabetologist and receiving concomitant podiatry care (“GP & podiatrist”, n=86); participants visiting almost exclusively their GP (“GP only”, n=195); participants with a substantially higher use of all ambulatory services (“High users”, n=96); and participants reporting more visits to the diabetologist and less visits to the GP than other profiles (“Diabetologist first”, n=173). Whereas participants belonging to the “GP only” profile were less likely to report most processes related to the quality of diabetes care, outcomes of care were relatively comparable across all ambulatory healthcare use profiles.ConclusionsSlight differences in quality of diabetes care appear across the four ambulatory healthcare use profiles identified in this study. Overall, however, results suggest that room for improvement exists in all profiles, and further investigation is necessary to determine whether individual characteristics (like diabetes-related factors) and/or healthcare factors contribute to the differences observed between profiles.

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Section: Discussionsupporting

confidence: 84%

Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study

et al. 2022

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“…Working with older people is a significant part of podiatry practice and previously identified as a major source of occupational stress amongst Australian podiatrists [ 21 , 52 ]. Tinley [ 52 ] reported that Australian podiatrists describe their work with older people as repetitive and insufficiently challenging with perceived limited clinical gains, akin to a palliative approach to care, and that this contributed to stress.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst literature on podiatry practice in reablement is limited, evidence suggests that older people represent the largest proportion of care provided by podiatrists in Australia and their attendance at podiatrists tends to be recurrent [20,21]. The link between foot problems in older age which reduce mobility and decrease quality of life has been well established [22][23][24][25][26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Australian podiatrists’ understanding and current practices of reablement for older people: a qualitative exploratory study

Mulquiny

Oakman

2022

Journal of Foot and Ankle Research

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Background The ageing of Australia's population is placing significant pressure on health and social aged care services due to increasing demand for the provision and a relative decrease in the healthcare workforce. Reablement has been introduced by the Australian Commonwealth Government and is aimed at increasing older people's independence to age in place and decreasing dependency on aged care services. To date, research on reablement practice has focussed on interventions from physiotherapists, occupational therapists, and nurses, with no data available on podiatrist involvement. The aim of this research was to explore Australian podiatrists' understanding and current practice of implementing a reablement approach to older clients. Methods A qualitative exploratory study was conducted with Australian podiatrists who had experience working with older people and were familiar with the reablement model. Podiatrists were recruited after completing a prior web-based survey. Promotion of the web-based survey was via professional networks and Twitter. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's approach to thematic analysis. Results Fourteen podiatrists were interviewed. Using thematic analysis, three themes were generated: (i) Thinking and practicing differently, (ii) Reconciling practice with competing pressures, (ii) Funding influences on podiatry practice and reablement. Rather than identifying practice examples that demonstrate involvement by podiatrists in older peoples reablement, our analysis identified system level barriers which gave negative influence on podiatrists' ability to implement the reablement model. Conclusions The participants in this study considered their role in reablement for older people was limited. While some participants felt unskilled to implement the reablement model, it is factors such as inadequate funding arrangements and clients' perceptions of podiatrists' roles have a more significant impact on current practice and are seemingly more intractable.

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“…Items were scored on a seven-point Likert scale (1 = everyday, 2 = a few times a week, 3 = once a week, 4 = a few times a month, 5 = once a month or less, 6 = a few times a year, 7 = never). Higher scores for emotional exhaustion [10][11][12][13][14][15][16][17][18] and depersonalisation [10][11][12][13][14][15][16][17][18] and lower scores for personal accomplishment (0-9) and job satisfaction (0-9) indicated greater burnout [27].…”

Section: Data Collectionmentioning

confidence: 99%

“…Podiatrists play a fundamental role in the provision of primary health care in different settings including acute hospitals, sub-acute rehabilitation services, aged care, private practice and with participants of the National Disability Insurance Scheme [ 11 ]. General practitioners increasingly rely on podiatrists for the management of patients with foot problems and the introduction of Medicare funding has been effective in increasing access for patients with chronic diseases to podiatry services [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Describing the factors related to rural podiatry work and retention in the podiatry workforce: a national survey

Couch

Menz

O’Sullivan

et al. 2023

Journal of Foot and Ankle Research

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Background Maldistribution of podiatrists limits capacity to address the footcare needs of the population. Understanding factors that impact recruitment and retention of Australian podiatrists is a key solution. The primary aim of this study was to describe factors related to rural podiatry work, and overall professional retention amongst Australian podiatrists. Methods We used data collected from the most recent relevant response of a cohort of Australian podiatrists between 2017 and 2020 of four online surveys. Person and job role variables known to impact current work and retention were collected. Logistic regression models were used to determine factors associated with rural work and intent to leave direct patient care or the profession entirely. Results There were 1129 podiatrists (21% of 5429) who participated in at least one of the survey waves. Podiatrists who had a rural background (30%) were less likely to work in a metropolitan location (OR = 0.20, 95%CI = 0.11,0.37). Podiatrists who undertook a regional/rural placement during their undergraduate education (43%) were more likely to work in a metropolitan location (OR = 1.86, 95%CI = 1.38,2.51). Podiatrists who indicated they were planning to leave direct patient care within 5 years (n = 282, 26%), were less satisfied with working conditions (OR = 0.77, 95% CI = 0.66, 0.92), less satisfied with opportunities to use their abilities (OR = 0.83, 95% CI = 0.69, 0.99), perceived less personal accomplishment (OR = 0.94, 95% CI 0.86, 0.94) and less job satisfaction (OR = 0.92, 95% CI = 0.91, 0.98). Podiatrists who indicated that they were planning to leave podiatry work entirely within 5 years (n = 223, 21%), were less satisfied with opportunities to use their abilities (OR = 0.74, 95% CI = 0.62, 0.88), agreed they had a poor support network from other podiatrists (OR = 1.35, 95% CI = 1.13, 1.61), had less job satisfaction (OR = 0.89, 95% CI = 0.86, 0.94), and did not have access to paid annual leave (OR = 0.62, 95% CI = 0.38, 0.99). Conclusion Findings suggest ways to promote rural work, including selecting university students with rural backgrounds, and optimising the experience of rural placements which currently predict metropolitan practice. To retain podiatrists, it is important to ensure access to leave, professional support, and appropriate physical working conditions. Further research is required to understand why intention to leave is so high.

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Characteristics of general practitioner referrals to podiatrists in Australia, 2000–2016

Cited by 5 publications

References 33 publications

Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study

Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study

Australian podiatrists’ understanding and current practices of reablement for older people: a qualitative exploratory study

Describing the factors related to rural podiatry work and retention in the podiatry workforce: a national survey

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