Common general practice presentations and publication frequency

Australian journal of primary health, 2014

Significant gaps remain between recommendations of evidence-based guidelines and primary health care practice in Australia. This paper aims to evaluate factors associated with the use of guidelines reported by Australian GPs. Secondary analysis was performed on a survey of primary care practitioners which was conducted by the Commonwealth Fund in 2009: 1016 general practitioners responded in Australia (response rate 52%). Two-thirds of Australian GPs reported that they routinely used evidence-based treatment guidelines for the management of four conditions: diabetes, depression, asthma or chronic obstructive pulmonary disease and hypertensiona higher proportion than in most other countries. Having non-medical staff educating patients about self-management, and a system of GP reminders to provide patients with test results or guideline-based intervention or screening tests, were associated with a higher probability of guidelines use. Older GP age was associated with lower probability of guideline usage. The negative association with age of the doctor may reflect a tendency to rely on experience rather than evidence-based guidelines. The association with greater use of reminders and selfmanagement is consistent with the chronic illness model.

Family Practice, 1996

1992

It is responsible for the provision of a comprehensive range of health promotion services and preventative and reactive primary health care. When it operates smoothly there is no better example of multidisciplinary teamwork. But patient expectations are rising all the time and the pressure on doctors to become more patient or consumer orientated has never been greater. General practice is no longer just a vehicle to enable doctors to practice medicine. Increasingly practices are becoming community health resources that need pro-active management. The quality of patient care and service is a major issue for doctors, their patients and the Family Health Service Authority (FHSA). The quality depends on the whole practice team. Recent changes in the National Health Service have made it imperative that good medical care is linked closely to sound management of all the resources of the practice. At the same time General Practice is becoming more competitive. GPs now have a monetary incentive to increase the size of their patient list. Patients are being encouraged to "shop around" when they move to a new area. They are being encouraged to expect more from their doctor and, if the level of service is not forthcoming, to complain or change doctors. FHSAs not only undertake medical audits, they also undertake surveys of patient service. Those who cannot deliver the appropriate quality of patient care and service will find it increasingly difficult to survive. Those who can will find many opportunities for expansion. Excellence of patient care and service does not happen by chance, it needs careful planning and continuous management. It needs to be properly organised at all levels of the practice and requires committed team work. It is not a one-off activity but an ongoing process that heeds continuous monitoring. This selection of articles published in the professional medical journals reflects the increasing interest in general practice as a small business. In the past GPs have never needed to develop their skills in managing their professional and support staff. What is more their "style" of management, whilst appropriate to the consulting room, may well be inappropriate when it comes to developing and controlling an effective practice team. These articles reflect the need of doctors to acquire "basic" management skills across a spectrum of disciplines, but particularly in the area of people management. They reflect a statement of best management practice applied to the general practice situation.

2013

Background: In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000–2002, using a normative model of primary health care and data from a descriptive study to evaluate

Australia and New …, 2006

There was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be ...

Quality and Safety in Health Care, 2001

Objectives-Little is known about the quality of clinical care provided outside the hospital sector, despite the increasingly important role of clinical generalists working in primary care. In this study we aimed to summarise published evaluations of the quality of clinical care provided in general practice in the UK, Australia, and New Zealand. Design-A systematic review of published studies assessing the quality of clinical care in general practice for the period 1995-9. Setting-General practice based care in the UK, Australia, and New Zealand. Main outcome measures-Study design, sampling strategy and size, clinical conditions studied, quality of care attained for each condition (compared with explicit or implicit standards for the process of care), and country of origin for each study. Results-Ninety papers fulfilled the entry criteria for the review, 80 from the UK, six from Australia, and four from New Zealand. Two thirds of the studies assessed care in self-selected practices and 20% of the studies were based in single practices. The majority (85.5%) examined the quality of care provided for chronic conditions including cardiovascular disease (22%), hypertension (14%), diabetes (14%), and asthma (13%). A further 12% and 2% examined preventive care and acute conditions, respectively. In almost all studies the processes of care did not attain the standards set out in national guidelines or those set by the researchers themselves. For example, in the highest achieving practices 49% of diabetic patients had had their fundii examined in the previous year and 47% of eligible patients had been prescribed beta blockers after an acute myocardial infarction. Conclusions-This study adopts an overview of the magnitude and the nature of clinical quality problems in general practice in three countries. Most of the studies in the systematic review come from the UK and the small number of papers from Australia and New Zealand make it more diYcult to draw conclusions about the quality of care in these two countries. The review helps to identify deficiencies in the research, clinical and policy agendas in a part of the health care system where quality of care has been largely ignored to date. Further work is required to evaluate the quality of clinical care in a representative sample of the population, to identify the reasons for substandard care, and to test strategies to improve the clinical care provided in general practice.

Population health, 2007

The purpose of this report is to provide evidence-based information to the 14 South Australian Divisions of General Practice and the South Australian Divisions of General Practice Inc (SADI) about the self-reported health status of, and related issues for, their communities using a representative epidemiologically-sound sample of the South Australian population. It will assist the general practitioners in advocating for health issues specific to their Divisions and to form policy to achieve valuable change for the general practitioners ...

Family Practice, 2002

agreement on aspects of general practice care. Family Practice 2002; 19: 339-343.

Canadian Family Physician, 2018

To identify the most commonly presenting conditions in primary care globally, and to compare common reasons for visits (RFVs) as reported by clinicians and patients, as well as among countries of different economic classifications.