Association between potential primary care emergency service and general practitioner care utilisation in New South Wales

2020 ◽  
Author(s):  
Baohui Yang ◽  
Raymond Messom
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Emergency Service ◽  
New South ◽  
New South Wales ◽  
General Practitioner Care ◽  
South Wales ◽  
Care Utilisation

scholarly journals Do hospitals influence geographic variation in admission for preventable hospitalisation? A data linkage study in New South Wales, Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e027639 ◽  
Author(s):  
Michael O Falster ◽  
Alastair H Leyland ◽  
Louisa R Jorm
Keyword(s):  
Primary Care ◽  
Hip Fracture ◽  
Geographic Variation ◽  
New South ◽  
New South Wales ◽  
The State ◽  
Hospital Variation ◽  
South Wales ◽  
Preventable Hospitalisation ◽  
A Performance

ObjectivePreventable hospitalisations are used internationally as a performance indicator for primary care, but the influence of other health system factors remains poorly understood. This study investigated between-hospital variation in rates of preventable hospitalisation.SettingLinked health survey and hospital admissions data for a cohort study of 266 826 people aged over 45 years in the state of New South Wales, Australia.MethodBetween-hospital variation in preventable hospitalisation was quantified using cross-classified multiple-membership multilevel Poisson models, adjusted for personal sociodemographic, health and area-level contextual characteristics. Variation was also explored for two conditions unlikely to be influenced by discretionary admission practice: emergency admissions for acute myocardial infarction (AMI) and hip fracture.ResultsWe found significant between-hospital variation in adjusted rates of preventable hospitalisation, with hospitals varying on average 26% from the state mean. Patients served more by community and multipurpose facilities (smaller facilities primarily in rural areas) had higher rates of preventable hospitalisation. Community hospitals had the greatest between-hospital variation, and included the facilities with the highest rates of preventable hospitalisation. There was comparatively little between-hospital variation in rates of admission for AMI and hip fracture.ConclusionsGeographic variation in preventable hospitalisation is determined in part by hospitals, reflecting different roles played by community and multipurpose facilities, compared with major and principal referral hospitals, within the community. Care should be taken when interpreting the indicator simply as a performance measure for primary care.

scholarly journals A retrospective review of primary care research projects completed by medical students at University of New South Wales Medicine

2020 ◽  
Vol 49 (12) ◽  
pp. 848-852
Author(s):  
Kerry Uebel ◽  
Maha Pervaz Iqbal ◽  
John Hall
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
New South ◽  
New South Wales ◽  
Research Capacity ◽  
Independent Learning ◽  
Research Projects ◽  
Primary Care Research ◽  
Care Research ◽  
South Wales

Background and objectives It is important for medical students to learn how to conduct sound medical research by implementing their own research projects. This study describes the primary care research projects conducted by fourth-year medical students for their Independent Learning Project/Honours (ILP/Honours) at University of New South Wales (UNSW) Medicine. Methods A review was conducted of research projects undertaken by medical students at UNSW to determine the number and themes of projects on primary care topics, and the departments that supervised these projects. Results Of 3116 student research projects, 482 (15.5%) were on primary care topics. Major themes were mental health and substance abuse (90; 18.7%), aged care issues (67; 13.7%), common chronic diseases (63; 13.1%), and issues facing Aboriginal and Torres Strait Islander people or people from culturally and linguistically diverse communities (59; 12.2%). Only 134 (4.3% of the total 3116) research projects were supervised through departments with primary care academics. Discussion The ILP/Honours program gives medical students at UNSW Medicine an opportunity to conduct research on primary care topics. There needs to be more attention given to growing the research capacity of primary care academic departments.

Goals and Targets: Applicability to Primary Health Care

1997 ◽  
Vol 3 (1) ◽  
pp. 92
Author(s):  
Debra Smith
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
New South ◽  
New South Wales ◽  
Care Staff ◽  
Health Improvement ◽  
Improvement Program ◽  
Primary Health ◽  
South Wales

The importance of outcomes in evaluating and judging health care programs is increasing, particularly in New South Wales. A review of the literature suggests the relevance of outcomes to primary health care might be limited. A small survey of primary care staff working out of Community Health Centres in rural New South Wales (NSW) revealed that staff believe they are often involved in population focus work, while health education and promotion are carried out by staff working with individuals. The identification of the use of primary care strategies is not high unless staff have had experience in a particular area, and the NSW Health Improvement Program is not particularly well understood.

scholarly journals A brief report on Primary Care Service Area catchment geographies in New South Wales Australia

2014 ◽  
Vol 13 (1) ◽  
pp. 38 ◽  
Author(s):  
Soumya Mazumdar ◽  
Xiaoqi Feng ◽  
Paul Konings ◽  
Ian McRae ◽  
Federico Girosi
Keyword(s):  
Primary Care ◽  
New South ◽  
Care Service ◽  
New South Wales ◽  
Service Area ◽  
Primary Care Service ◽  
South Wales

scholarly journals Effect Measure Modification of Multimorbidity On the Association Between Regularity of General Practitioner Contact and Potentially Avoidable Hospitalisations

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Rachael Moorin
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
New South ◽  
Population Attributable Fractions ◽  
South Wales ◽  
Frequency Of Contact ◽  
Effect Measure ◽  
Attributable Fractions ◽  
Effect Measure Modification ◽  
The Relationship

IntroductionRegular contact with a general practitioner (GP) has been shown to lower the risk of potentially avoidable hospitalisations (PAHs) independently of continuity of provider and frequency of contact. Multimorbidity affects between 55 and 98% people aged 65+ years and continues to place pressure on healthcare systems globally. However, little is known about its impact on the relationship between continuity of primary care and PAHs. Objectives and ApproachA retrospective, longitudinal cohort study using survey data linked to routinely-collected administrative health data from the 45 and Up Study conducted in New South Wales, Australia was used to investigate the effect measure modification by multimorbidity on the relationship between regularity of GP contact and PAHs. Multimorbidity was assessed using the Rx-Risk comorbidity score, which captures the number of condition groups, assigned based on medicine dispensing records, using a 5-year look-back period. PAHs were: (i) any unplanned hospitalisations, (ii) chronic ambulatory care sensitive conditions (ACSC) hospitalisations or (iii) unplanned ACSC hospitalisations. Multivariable logistic regression and population attributable fractions (PAF) were used to examine effect measure modification by multimorbidity. ResultsHigher GP regularity was significantly associated with a reduction in the probability of each PAH type. This reduction diminished with increasing multimorbidity with the effect measure modification most apparent for chronic ACSC and unplanned chronic ACSC hospitalisations. The PAF of moving to the highest quintile of regularity significantly reduced with increasing multimorbidity. For example, a reduction in the PAF of unplanned ACSC hospitalisations of 31.1% was observed in those with a RX Risk score of >10 (17.8%) compared with those with no multimorbidity (48.9%). Conclusion / ImplicationsWeakening of the relationship between GP visit regularity and PAHs with increasing levels of multimorbidity suggests a need to focus on improving primary care support to prevent PAHs for patients with multimorbidity.

scholarly journals Trends in Primary Care Presentations at Emergency Departments in New South Wales (1999–2006)

2008 ◽  
Vol 14 (3) ◽  
pp. 35 ◽  
Author(s):  
Peter Siminski ◽  
Kathy Eagar ◽  
Luise Lago ◽  
Andrew Bezzina
Keyword(s):  
Primary Care ◽  
Emergency Departments ◽  
New South ◽  
New South Wales ◽  
Future Research ◽  
Subsequent Period ◽  
South Wales ◽  
Ed Overcrowding ◽  
Trends Over Time ◽  
New Guidelines

This paper examines trends in potential 'primary care' presentations at emergency departments (ED), comparing these with other ED presentations and to primary care attendances in the community. The study draws on EDIS data (Emergency Department Information System), which, at December 2005, covered 76% of attendances in New South Wales, and from Medicare Australia MBS data. Annual counts of potential primary care presentations to EDs are compared with those of other ED presentations and to primary care presentations in the community. Changes in the percentage of ED presentations that are potentially for primary care are examined, as are changes in the percentage of total primary care presentations seen in EDs. Trends in age standardised presentation rates are also calculated for each of the three series. Primary care presentations at EDs increased marginally in the period under consideration, as did primary care presentations in the community. There was a substantial increase in other ED presentations. The proportion of ED presentations potentially for primary care decreased over the period. The proportion of primary care presentations seen in EDs and the proportion seen in the community changed little. Decline in the proportion of potential primary care presentations to EDs may have been impacted by new guidelines for the application of triage categories in 2001. However, trends over time do not show acute alterations and they continue to hold for the subsequent period after introduction of new guidelines. Primary care presentations at EDs are not responsible for recent changes to ED overcrowding in New South Wales, at least not for hospitals covered in the EDIS database. Future research might consider more specific trends in rural EDs.

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