scholarly journals Are socio-economically disadvantaged Australians making more or less use of the Enhanced Primary Care Medicare Benefit Schedule item numbers?

2003 ◽  
Vol 26 (3) ◽  
pp. 43 ◽  
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Median Number ◽  
Disadvantaged Communities ◽  
Care Plans ◽  
Medicare Benefit Schedule ◽  
Medicare Benefit ◽  
Australian Bureau Of Statistics ◽  
National Trends ◽  
The Relationship

We aimed to examine the relationship between levels of socio-economic disadvantage (measured by the Socio EconomicIndexes for Areas [SEIFA] used by the Australian Bureau of Statistics) and uptake of the Enhanced Primary Care(EPC) item numbers on the Medicare Benefits Schedule. Health services are often less likely to reach those that mostneed them and so it is important to monitor whether disadvantaged communities are accessing EPC. The rates ofhealth assessments, care plans and case conferences are similar in each SEIFA quartile (from advantaged todisadvantaged populations), favouring the more disadvantaged quartiles in some cases. These national trends are notobserved in each state and territory. For all EPC services combined, the lowest number of doctors that provide EPCservices are found in the 2 most disadvantaged quartiles, yet more EPC services are provided in these quartiles, due tothe higher mean and median number of services provided by general practitioners in these quartiles. Overall,populations living in the most disadvantaged quartiles have similar or higher levels of EPC uptake, apparently due,at least in part, to greater than average use of EPC services by general practitioners in these areas.

Work Stress and Quality of Work Performance in Australian General Practitioners

2002 ◽  
Vol 8 (2) ◽  
pp. 59 ◽  
Author(s):  
Helen R. Winefield ◽  
Bronwyn M. Veale
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Work Stress ◽  
Work Performance ◽  
Stress Indicators ◽  
Response Biases ◽  
Work Supports ◽  
The Relationship ◽  
Level Analysis

The relationship between work stress and work performance has received little empirical attention in professional areas such as health care where measurement of work quality is difficult. In health sciences there is growing concern about work errors, although little is known about the determinants and prevention of these in primary care. This study aimed to explore connections between workload, work stress in terms of burnout, job satisfaction and retirement age intentions, and reported mistakes at work, in general practice. A randomly-selected sample of mid-career General Practitioners (aged 35-45 years) was approached and 86% agreed to participate (N = 30). Satisfaction with work supports was a better predictor of work stress indicators than was workload. There was no evidence of the hypothesised association between work stress and severity of mistakes. Although response biases are a likely threat to the validity of mistakes as a quality indicator, results can be seen as supporting the need for a systems-level analysis of primary care work performance.

scholarly journals Dimensional perspective on the recognition of depressive symptoms in primary care

2001 ◽  
Vol 179 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Chris Thompson ◽  
Kevin Ostler ◽  
Robert C. Peveler ◽  
Nigel Baker ◽  
Ann-Louise Kinmonth
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
General Practitioners ◽  
Representative Sample ◽  
Curvilinear Relationship ◽  
Dimensional Approach ◽  
Severity Of Depression ◽  
Definition Of ◽  
The Relationship ◽  
Probable Depression

BackgroundMost studies of the recognition of depression in primary care have used a categorical definition of depression. This may overstate the extent of the problem.AimsOur objective was to investigate the relationship between severity and recognition of depression, and its modification by patient and practitioner characteristics.MethodAn association study in multiple consecutive adult cohorts of 18 414 primary care consultations drawn from a representative sample of 156 general practitioners in Hampshire, UK.ResultsThere was a curvilinear relationship between the severity of depression and practitioners' ratings of depression. One case of probable depression was missed in every 28.6 consultations. Anxiety and unemployment altered the chances of recognition, but age, gender and deprivation scores did not.ConclusionsA dimensional approach to severity of depression shows that general practitioners may be better able to recognise depression than previous categorical studies have suggested. Efforts to improve the care of depression should therefore focus on doctors who have been shown to have difficulty making the diagnosis and on improving the treatment of identified patients.

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.

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 Liability and collaborative arrangements for nurse practitioner practice in Australia

2020 ◽  
Vol 44 (2) ◽  
pp. 172
Author(s):  
Mary Chiarella ◽  
Jane Currie ◽  
Tim Wand
Keyword(s):  
Nurse Practitioners ◽  
Medical Practitioners ◽  
Australian Health ◽  
Medicare Benefit Schedule ◽  
Medicare Benefit ◽  
History Of ◽  
The Relationship ◽  
Models Of Service Delivery ◽  
Successful Collaboration ◽  
Improve Patient

The purpose of this paper is to clarify the relationship between medical practitioners (MPs) and nurse practitioners (NPs) in general, and privately practising NPs (PPNPs) in particular, in relation to collaboration, control and supervision in Australia, as well as to explore the difficulties reported by PPNPs in establishing mandated collaborative arrangements with MPs in Australia. In order for the PPNPs to have access to the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) in Australia, they are required, by law, to establish a collaborative arrangement with an MP or an entity that employs MPs. This paper begins by describing the history of and requirements for collaborative arrangements, then outlines the nature of successful collaboration and the reported difficulties. It goes on to address some of the commonly held misconceptions in order to allay medical concerns and enable less restrictive access to the MBS and PBS for PPNPs. This, in turn, would improve patient access to highly specialised and expert PPNP care. What is known about the topic? NPs have been part of the Australian health workforce since 1998, but until 2009 their patients did not receive any reimbursement for care delivered by PPNPs. In 2009, the Federal government introduced limited access for PPNPs to the MBS and PBS, but only if they entered into a collaborative arrangement with either an MP or an entity that employs MPs. What does this paper add? The introduction of collaborative arrangements between PPNPs and MPs seems, in some instances, to have created confusion and misunderstanding about the way in which these collaborative arrangements are to operate. This paper provides clarification of the relationship between MPs and NPs in general, and PPNPs in particular, in relation to collaboration, control and supervision. What are the implications for practitioners? A clearer understanding of these issues will hopefully enable greater collegial generosity and improve access to patient care through innovative models of service delivery using NPs and PPNPs.

scholarly journals Influenza burden estimates in Portugal: seasons 2013/14 to 2018/19

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A R Torres ◽  
I Kislaya ◽  
S Silva ◽  
V Gomez ◽  
A Machado ◽  
...  
Keyword(s):  
Primary Care ◽  
Seasonal Influenza ◽  
Respiratory Infections ◽  
Median Number ◽  
Health Surveillance ◽  
Influenza B ◽  
Surveillance Systems ◽  
Poisson Regression Model ◽  
Severe Acute Respiratory Infections ◽  
The Relationship

Abstract Background Reliable influenza burden estimates are essential for a true understanding of the influenza epidemics' impact; informed decision-making and effective risk communication. This study aimed to estimate the influenza burden in Portugal in 2013/14 - 2018/19 seasons. Methods We estimated seasonal influenza burden, ranging from medically attended influenza cases in primary care to influenza-attributable deaths, using surveillance data. Data were collected for influenza like illness (ILI) epidemic periods, determined by the Moving Epidemic Method. Medically attended influenza cases were estimated by multiplying the number of ILI cases in primary care by the percentage of influenza-positive samples. Hospitalized severe acute respiratory infections (SARI) positive for influenza estimates were computed, multiplying the number of SARI by the percentage of influenza-positive samples. To determine influenza-attributable deaths, a Poisson regression model was used. Results The median number of medically attended influenza cases in primary care was 33,668 (325.8 cases per 10,000 population), ranging between 21,393 in 2017/18, [Influenza B and A(H1) co-dominance] and 61,768 in 2014/15 [Influenza B and A(H3) co-dominance]. The median number of SARI positive for influenza was 8,724 (84.4 cases per 10,000 population), ranging between 7,099 in 2013/14 [A(H1) and A(H3) co-dominance], and 9,125 in 2014/15. The median number of influenza-attributable deaths was 3,311 (32.0 cases per 10,000 population), ranging between 96 in 2015/16 [A(H1) dominance], and 5,224 in 2014/15. Conclusions Higher mortality, and higher rate of medically attended influenza cases, were found in seasons with A(H3) circulation. Little variability was observed in the number of influenza-positive SARI. The relationship between the number of SARI and the number of deaths requires further investigation. This work highlights the need of health surveillance systems for a better understanding of the influenza impact. Key messages Lower burden of influenza is found in seasons with A(H1) co-dominance. Higher burden of influenza is found in seasons with A(H3) circulation. Health surveillance systems are essential to provide data for a better understanding of the epidemiology and extent of seasonal influenza.

The Personal Sociability and Connections Scale (PeSCS): Development and initial assessment at a primary care facility

2021 ◽  
pp. 002076402199351
Author(s):  
Emmanouil K Symvoulakis ◽  
Manolis Linardakis ◽  
Apostolos Kamekis ◽  
Myfanwy Morgan ◽  
Spyridon Klinis
Keyword(s):  
Primary Care ◽  
Social Isolation ◽  
Convergent Validity ◽  
Interpersonal Relations ◽  
Linear Regression Analysis ◽  
Care Facility ◽  
Initial Assessment ◽  
Multivariate Linear Regression Analysis ◽  
Northern Greece ◽  
The Relationship

Purpose: An individual’s lack of social connections and social isolation is often associated with feelings of loneliness which is regarded as having a negative effect on health. This paper describes the development and assessment of a 10 item ‘Personal Sociability and Connections Scale’ (PeSCS) to measure individual’s disposition and accompanying skills to seek out companionship and engage in interpersonal relations. Methods: The study was conducted at a rural primary care unit in Northern Greece. A total of 199 attenders were recruited over a 6-week period in 2020 and questionnaires completed. This informed the 10-items PeSCS that comprises Social, Behavioral, and Emotional components focusing on the expression of social comfort, willingness to share experiences, stories and concepts, and feelings of similarity at first contact. Reliability of the PeSC scale was assessed and the relationship with scale scores examined as an indicator of convergent validity. A multivariate linear regression analysis was performed to examine the relationship of PeSC scale score with the characteristics of participants. Results: Assessment of reliability of PeSC scale produced a Cronbach’s alpha of 0.809. The relationship between components and the total PeSCS scores identified significant correlations ( p < .001). At a multivariate level, male gender was the sample characteristic with a significant association with scale levels ( p < .05) and higher annual income with Social component ( p < .05). Otherwise the distribution of sociability dispositions was similar across population groups. Conclusion: The 10-item PeSC scale forms a simple and quick to complete measure whose overall reliability was rated as ‘meritorious’. The PeSC instrument may be a useful tool for assessing the causes and appropriate responses to the negative health effects of loneliness and social isolation.

scholarly journals What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

Dementia ◽  
2020 ◽  
pp. 147130122097771
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Alexandre Freitas ◽  
Joana Grave ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Social Contexts ◽  
Dementia Care ◽  
Family Carers ◽  
Primary Care Teams ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Advanced Stages ◽  
Patient Relationships

Background Governments are being challenged to integrate at least part of dementia care into primary care. However, little is known about the current role of general practitioners (GPs) regarding dementia care, especially in countries that do not have dementia strategies in place. The aim of this study was to explore the experiences of GPs, persons with dementia and their family carers in Portuguese primary care settings, to better understand GPs’ contribution to dementia care. Methods A qualitative interview study of participants recruited from six practices in different social contexts within the Lisbon metropolitan area was carried out. Purposive sampling was used to recruit GPs, persons with dementia and carers. Interviews with GPs explored dementia care comprehensiveness, including satisfactory and challenging aspects. Interviews with patients and carers explored the experience of talking to GPs about cognitive impairments and related difficulties and the type of help received. Thematic analysis of interview transcripts was carried out using the framework approach. Results Five major themes were identified: GPs have a limited contribution to dementia care, the case of advanced dementia, doctor–patient relationships, doctor–carer relationships and management of chronic conditions other than dementia. Conclusion General practitioners seemed to contribute little to dementia care overall, particularly regarding symptom management. The exception was patients with advanced stages of dementia, given that specialists no longer followed them up. Remarkably, GPs seemed to be alone within primary care teams in providing dementia care. These findings strongly suggest that Portuguese primary care is not yet prepared to comply with policy expectations regarding the management of dementia.

Challenging care work: General practitioners’ perspectives on caring for young adults with complex psychosocial problems

2019 ◽  
pp. 136345931987410
Author(s):  
Julie Høgsgaard Andersen ◽  
Tine Tjørnhøj-Thomsen ◽  
Susanne Reventlow ◽  
Annette Sofie Davidsen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young Adults ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
Health Problems ◽  
Care Work ◽  
Psychiatric Nurses ◽  
Provision Of Care

The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners’ perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners’ care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto’s concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults’ difficulties with accessing and receiving available care.

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