Older, wider, newer - the five-year changing face of the GP patient

Over the last five years GP patients have become older, are more likely to be obese, and are more likely to be new to any given general practice, according to a new report by the Australian Institute of Health and Welfare (AIHW) and the University of Sydney.

General Practice Activity in Australia 2003-04 was launched today at the National Health Information Summit in Melbourne by the Chair of the AIHW Board, the Hon Peter Collins AM, QC. It is the sixth annual report of the BEACH (Bettering the Evaluation and Care of Health) data collection program. Every year the BEACH program draws on data from 100,000 GP-patient encounters nationally (1,000 randomly recruited GPs across Australia, 100 consecutive patient encounters each).

Director of the AIHW's General Practice Statistics and Classification Unit at the University of Sydney, Professor Helena Britt, said that older patients (65+) are taking up an increasing proportion of the GP workload, moving from 24.1% in 1999-00 to 26.8% in 2003-04.

'This perhaps reflects the well-publicised ageing of the population, and increased life expectancy,' Dr Britt said.

More of the patients visiting GPs are obese or overweight. The proportion of adults who were obese rose from 19.4% to 22.0%, while the proportion who were overweight rose from 33.1% to 34.5% over the five years. The proportion of children who were obese (13%) had not changed since 2000-01, but the proportion who were overweight rose from 15.3% to 19.0%.

Dr Britt said she did not think this augured well for the future health of the community.

The proportion of patients new to doctors' practices has increased, by 27% over the five-year period, from 7.3% to 9.3%.

'This may be indicating increased mobility in the Australian population, but raises questions about possible future decreases in continuity of care,' Dr Britt said.

The decrease in GP-prescribed medications reported last year was sustained through 2003-04, but the number of pathology tests ordered by GPs rose by 14% over the last 2 years (an estimated 4 million additional test orders).

Professor Britt said that patients were increasingly making appointments for prescriptions, referrals, tests or investigations, and less likely to visit GPs with symptoms and complaints, or for specified diseases.

'This may suggest increasing long-term management of chronic diseases. This year, for the first time, we investigated the extent to which GPs are managing chronic diseases, and found that at least one chronic problem was managed at 40% of all encounters. Hypertension was the most-frequently managed chronic problem, followed by depression, then diabetes, lipid disorders and osteoarthritis. Together these accounted for almost half of all chronic problems managed.'

Dr Britt also said there had been a steady decline in the management rate of respiratory problems, largely due to a significant fall in management rates of upper respiratory tract infections, acute bronchitis and asthma.


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