Improving general practitioner involvement in urban hospitals: Departments or divisions of general practice

Abstract

Objective To discover what measures have been taken in urban Australian hospitals to involve general practitioners (GPs) in public hospital services. Design A descriptive study. Data were collected by postal survey. Setting Hospitals in urban areas. Main outcome measures Appointment of GP affiliates or associates, existence of departments or divisions of general practice, appointed GP liaison positions and formal arrangements for GP shared care and discharge planning. Results Ninety‐five of 102 hospitals (93%) responded to a postal survey. Sixty‐five per cent of respondent hospitals had appointed GP affiliates or associates, 32% had a division or department of general practice and 41% had a designated GP liaison position. Forty per cent had formal GP shared care programs and 14% had formal GP involvement in discharge planning. Conclusion There was a high level of adoption of measures to involve GPs in urban hospitals. However, only a minority of hospitals had comprehensive measures in place and sufficient support for this to occur.

Shared care: a review of the literature

“…6463 In Australia, nearly half of the surveyed hospitals employed such a person whose roles include education, organization of shared care/discharge and optimizing communication. 66 Whichever planning process is used, the importance of including the patient (where appropriate) in all discussions has already been mentioned. The emphasis of one shared care unit in Canada was to encourage the patient to become responsible for their own care.…”

Recent Advances:General practice

“…Governments elsewhere have been experimenting with new organisational and financial structures for general practice 9. For example, the federal government in Australia provided funding during 1993 to establish 104 independent, locally based networks of general practitioners around the country.…”

Australian health policy research and development: where is it?

“…Before dismissing such a judgement as being too harsh, it might be helpful to revisit health policies that have had a major impact on our health system in the final quarter of the 20th century. Most will acknowledge that these include Medibank (1975) and its progeny, Medicare (1984); 5 casemix funding (1993) that accelerated the drive for efficiency and effectiveness in the hospital sector; 6 , 7 the evidence‐based medicine movement (early 1990s) 8 that, among other things, augmented the growth of evidence‐based guidelines; 9 and finally the development of an organisational structure for general practice — the Divisions (early 1990s) 10 . While not wishing to downplay the contributions of many Australians to these health policies, is it not significant that all but one were imported ideas?…”