scholarly journals Characteristics of patients receiving health assessments, care plans or case conferences by general practitioners, as part of the Enhanced Primary Care program between November 1999 and October 2001

2002 ◽  
Vol 25 (6) ◽  
pp. 120
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Indigenous People ◽  
Care Program ◽  
The Elderly ◽  
Care Plans ◽  
Department Of Health ◽  
Health Assessments ◽  
Case Conferences ◽  
Gender Patterns

We aimed to describe the characteristics of patients receiving health assessments (HA), care plans (CP) or case conferences (CC) through the Enhanced Primary Care (EPC) program between November 1999 and October 2001. The Commonwealth Department of Health and Ageing provided data. In all, 43%of non-Indigenous people who had a HA were aged 75-79 years and 32%were aged 80-84 years. Those having a HA at home were older (30.3% aged 85 years and above) than those having a HA in GP's rooms (20.2%85 years and above). For Indigenous people, between 12 and 17%of all HAs were done among each five-year age group between 55 and 84 years. As a group, CPs were mostly done among older people, with a higher proportion done among older women (74.2%among those 55 years and above) than older men (66.4%). Most CCs were also done among older people (60.4%55 years and above). Of the 286,250 people that had at least one EPC service, most (219,210; 76.6%)had only one. Of these, 153,624 (70.1%)had a HA. Of those having at least one EPC service, 95.7%had two services (most often a HA plus a CP). To date EPC activity has been concentrated among the elderly, gender patterns are similar, and few patients have received more than a single EPC service, which is usually a HA.

scholarly journals Variation between Divisions of General Practice in the uptake of health assessments, care plans and case conferences through the Enhanced Primary Care program

2002 ◽  
Vol 25 (6) ◽  
pp. 119
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Total Population ◽  
Care Program ◽  
Care Plans ◽  
Eligible Population ◽  
Primary Care Program ◽  
Health Assessments ◽  
Case Conferences ◽  
Second Year

We aimed to describe the variation in rates of uptake of the enhanced primary care (EPC) Medicare Benefits Schedule items for health assessments (HA), care plans (CP) and case conferences (CC), between Divisions of General Practice from November 1999 (when these items first became available) to October 2001.There was substantial variation in uptake of the various EPC services between Divisions of General Practice, ranging from very low to high. For HA the rate in the highest uptake Division was 496 per 1000 eligible population, and the lowest was zero. There are seven Divisions with high and six with very low uptake, with the rest ranging between 100 and 400/1000.Five Divisions had CP rates over 15/1000 total population; most Divisions had fewer than 10/1000,and many had less than 5/1000.A similar pattern is observed for CC. The levels of uptake for HA increased in the second year of the program for all but eight Divisions of General Practice, and the levels of uptake for CP increased in all but two Divisions. In the first two years of availability, uptake has been highly variable across Divisions of General Practice. Uptake has however increased substantially and consistently in the second year of the program.

scholarly journals Characteristics of general practitioners that provided health assessments, care plans or case conferences, as part of the Enhanced Primary Care program

2002 ◽  
Vol 25 (6) ◽  
pp. 121 ◽  
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Care Program ◽  
First Year ◽  
Care Plans ◽  
Primary Care Program ◽  
Wide Range ◽  
Health Assessments ◽  
Case Conferences ◽  
Second Year

We aimed to describe the characteristics of general practitioners (GPs) who provided health assessments (HA), care plans (CP) or case conferences (CC) as part of the Enhanced Primary Care (EPC) program between November 1999 and October 2001.While the gender distribution of EPC-active GPs is similar to that of non-EPC-active GPs, EPC-active GPs tend to be younger (72% vs 58% aged 35-54 years). Among EPC-active GPs, males account for about 66% of providers and about 80%of services. There is a very wide range in the number of EPC services provided per GP. In all, 1591 (14%)have rendered a single service while 919 (8.1%)have rendered over 100 services each (accounting for almost half of all EPC activity in Australia). The number of GPs providing any EPC service each month gradually increased to around 5000 in October 2001.Most patients (80-90%)that received multiple EPC services did so from the same GP. Across Divisions of General Practice the proportion of practices registered for the Practice Incentive Program (PIP) that have provided EPC services ranges from 100 to 0%. In the first year at least 50% of all practices in 84 Divisions rendered at least one EPC service while in the second year 108 did. Across Australia 58% of PIP practices rendered at least one service in the first year and 76% did in the second year. A little over half the GP workforce rendered at least one EPC service in the first year of the program, but there was a very wide range in the number of services provided per GP. Most GPs provide very few and a small number provide very many. There is wide variation in the proportion of practices providing EPC services, but this is increasing.

scholarly journals Uptake of health assessments, care plans and case conferences by general practitioners through the Enhanced Primary Care program between November 1999 and October 2001

2002 ◽  
Vol 25 (4) ◽  
pp. 1 ◽  
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Health Assessment ◽  
Care Program ◽  
Care Plan ◽  
Steady Increase ◽  
Case Conference ◽  
Care Plans ◽  
Department Of Health ◽  
Primary Care Program

We aimed to describe the uptake of the Enhanced Primary Care (EPC) item numbers listed on the Medicare Benefits Schedule for health assessment (HA), care plan (CP) and case conference (CC) between November 1999 (when these items first became available) and October 2001. We used data provided by the Commonwealth Department of Health and Ageing. General practitioners rendered 371,409 EPC services in all. Most services were HA (225,353;61%), most of the remainder were CP (134,688;36%), and CC comprised the rest (11,368;3%). The number of HA done increased steadily and has stabilised at around 13,000 HA per month. Most CP done (80%) were in the community and with the GP preparing the plan. From a slow start, the number of CP done increased rapidly in 2001 to about 15,000 per month. There has been a slow and steady increase in the number of CC done each month, reaching 8-900 per month. Uptake of the EPC item numbers in the first two years of their availability has been rapid and has reached substantial levels, especially for HA and CP. The uptake of CC has been slower.

Variation in levels of uptake of Enhanced Primary Care item numbers between medical practices, within Divisions of General Practice and jurisdictions

2002 ◽  
Vol 25 (6) ◽  
pp. 122
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
National Level ◽  
Substantial Variation ◽  
Medical Practices ◽  
Care Plans ◽  
Health Assessments ◽  
Case Conferences ◽  
Almost All ◽  
Control Limits

We aimed to report on variation in levels of uptake of services between medical practices across Divisions of General Practice, and jurisdictions, through the Enhanced Primary Care (EPC) program between November 1999 and October 2001.No Divisions had levels of EPC uptake outside upper control limits plus/minus three standard deviations the national level, suggesting limited substantial systematic variation relating to high uptake. Four Divisions had rates of practices providing EPC services (33.3%-67.7%)substantially lower than the national rate (81.2%). For all EPC services combined and for health assessments (HAs) there is substantial variation between practices in almost all Divisions of General Practice, and in some this is extreme. For care plans (CPs), while several Divisions show wide variation in rates across practices (and in a few there is extreme variation), in other Divisions there are very low rates of CP across all practices. For case conferences (CCs) the picture is even more extreme, and these patterns are expressed across all jurisdictions. There is substantial variation in the level of uptake of EPC services across medical practices in Australia.

scholarly journals Treatment Fidelity of an Evidence-Based Nurse-Led Intervention in a Proactive Primary Care Program for Older People

2016 ◽  
Vol 13 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Nienke Bleijenberg ◽  
Valerie H. ten Dam ◽  
Irene Drubbel ◽  
Mattijs E. Numans ◽  
Niek J. de Wit ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Care Program ◽  
Treatment Fidelity ◽  
Evidence Based ◽  
Primary Care Program

scholarly journals Meeting the Mental Health Needs of the Homebound: A Psychiatric Consult Service Within a Home-Based Primary Care Program

2015 ◽  
Vol 16 (3) ◽  
pp. 122-128 ◽  
Author(s):  
Jennifer M. Reckrey ◽  
Linda V. DeCherrie ◽  
Micheline Dugue ◽  
Anna Rosen ◽  
Theresa A. Soriano ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Care Program ◽  
Routine Care ◽  
Psychiatric Services ◽  
Depression And Anxiety ◽  
Care Plans ◽  
Home Based Primary Care ◽  
Home Based ◽  
Primary Care Program

The growing population of homebound adults increasingly receives home-based primary care (HBPC) services. These patients are predominantly frail older adults who are homebound because of multiple medical comorbidities, yet they often also have psychiatric diagnoses requiring mental health care. Unfortunately, in-home psychiatric services are rarely available to homebound patients. To address unmet psychiatric need among the homebound patients enrolled in our large academic HBPC program, we piloted a psychiatric in-home consultation service. During our 16-month pilot, 10% of all enrolled HBPC patients were referred for and received psychiatric consultation. Depression and anxiety were among the most common reasons for referral. To better meet patients’ medical and psychiatric needs, HBPC programs need to consider strategies to incorporate psychiatric services into their routine care plans.

scholarly journals Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019683 ◽  
Author(s):  
Tessa van Middelaar ◽  
Cathrien R L Beishuizen ◽  
Juliette Guillemont ◽  
Mariagnese Barbera ◽  
Edo Richard ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Computer Literacy ◽  
The Elderly ◽  
Self Management ◽  
Daily Routine ◽  
Semistructured Interview ◽  
User Friendliness ◽  
Increased Risk ◽  
Internet Platform

ObjectivesTo study older peoples’ experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care.DesignQualitative semistructured interview study, with thematic analysis.SettingPrimary care in the Netherlands.ParticipantsPeople ≥65 years with an increased risk of cardiovascular disease who used the ‘Healthy Ageing Through Internet Counselling in the Elderly’ internet platform with remote support of a coach. Participants were selected using a purposive sampling method based on gender, age, level of education, cardiovascular history, diabetes, duration of participation and login frequency.ResultsWe performed 17 interviews with 20 participants, including three couples. In the initial phase, platform engagement was influenced by perceived computer literacy of the participants, user-friendliness, acceptability and appropriateness of the intervention and the initial interaction with the coach. Sustained platform use was mainly facilitated by a relationship of trust with the coach. Other facilitating factors were regular automatic and personal reminders, clear expectations of the platform, incorporation into daily routine, social support and a loyal and persistent attitude. Perceived lack of change in content of the platform could work both stimulating and discouraging. Participants supported the idea of embedding the platform into the primary care setting.ConclusionsHuman support is crucial to initial and sustained engagement of older people in using an interactive internet platform for cardiovascular self-management. Regular reminders further facilitate sustained use, and increased tailoring to personal preference is recommended. Embedding the platform in primary healthcare may enhance future adoption.Trial registration numberISRCTN48151589; Pre-results.

PEDIATRICS AND ECONOMICS

PEDIATRICS ◽  
1948 ◽  
Vol 2 (1) ◽  
pp. 89-96
Author(s):  
WARREN R. SISSON
Keyword(s):  
Medical Care ◽  
Care Program ◽  
The State ◽  
Medical Services ◽  
Non Profit ◽  
Care Plans ◽  
Department Of Health ◽  
Recent Estimate ◽  
The Many ◽  
Blue Shield

WHETHER we like it or not, we must admit that we are living and working in a period of basic changes in the economic aspects of the practice of medicine. There was a day when the physician could make his visits on a completely individual basis and charge as much for his services as he considered appropriate. His bills were entirely between himself and his patients. But today an increasing number of physicians are finding themselves participants in one or another of the many medical care plans which are spreading rapidly throughout the country. A great variety of plans are being developed by public welfare agencies, health departments, non-profit organizations, medical societies, unions, cooperatives and other groups. Under the provisions of these plans the physician must abide by certain regulations directly affecting his practice and the fees he is entitled to collect. The growth of the Blue Shield plans for voluntary medical care insurance has been phenomenal and is now so rapid that it is impossible to state accurately from day to day the number of their subscribers. A recent estimate indicates that there are 48 plans with more than 7,000,000 subscribers. In fact Blue Shield seems to be on the way to catching up with Blue Cross, which now has some 30,000,000 subscribers. Other plans are testing different methods of providing service. One of the most notable of these is the Maryland Medical Care Program, which was established by legislation in 1945 providing that the State Department of Health should administer a program of medical services for indigent and medically indigent persons. Under the provisions of this plan county health officers have assumed administrative responsibility for this program of medical services; physicians are paid directly by the State Treasurer in accordance with a fixed fee schedule.

Mobility impairment in the elderly

2018 ◽  
Vol 11 (1) ◽  
pp. 14-19
Author(s):  
Rabia Mahmood Khan
Keyword(s):  
Primary Care ◽  
Older People ◽  
Functional Ability ◽  
Clinical Relevance ◽  
The Elderly ◽  
Clinical Disease ◽  
Screening Tools ◽  
Early Interventions ◽  
Mobility Impairment ◽  
Mobility Impairments

Decline in functional ability among the elderly is of clinical relevance as a marker of potentially treatable clinical disease. It is possible to screen older people for mobility issues and apply early interventions to prevent mobility problems and rehabilitate existing mobility impairments. This article discusses the predictors of mobility decline, available screening tools and the prevention and management of mobility impairment in primary care.

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