Summary
This is the third major study of general practice activity in Australia that allows a comparison of rural and metropolitan general practice. The first was a major national survey of general practice in 1969–74 conducted by the Royal Australian College of General Practitioners (Bridges-Webb & RACGP 1976) from which a small secondary comparison of rural and metropolitan general practice was made. The second was a specific comparative study of practice patterns in rural and metropolitan areas in the three eastern states of Australia in 1990 91 (Britt et al. 1993). In order to measure the effectiveness of programs designed to improve the plight of both patients and practitioners from rural and remote areas, data are needed on service provision and the care provided by general practitioners.
Aims
The aims of this study were to determine the extent to which rural and metropolitan general practice differed in 1998–2000 in terms of GP and patient characteristics, the type of work undertaken, the characteristics of the patients at encounter, the patients’ reasons for encounter, the morbidity managed, treatments provided including pharmacological, clinical and procedural management, tests ordered/undertaken and referrals.
Preliminary material: Foreword; List of tables and figures; Acknowledgments; Prologue
1. Introduction
2. Methods
- GP sampling
- GP recruitment
- Data elements
- Statistical methods
- The BEACH relational database
- Classification of data
- Notes on the analyses in this report
3. The GP sample
- Characteristics of the GPs by stratum
- Activity level by stratum
- Discussion
4. The encounters
- Distribution of services by stratum
- Summary of morbidity and management by stratum
- Discussion
5. The patients
- Patient characteristics by stratum
- Patient reasons for encounter by stratum
- Discussion
6. Problems managed
- Number of problems managed at encounter by stratum
- Problems managed (in ICPC-2 chapter groups) by stratum
- Most frequent individual problems managed by stratum
- Discussion
7. Medications
- Rates of medications prescribed (in groups and sub-groups) by stratum
- Most frequently prescribed generic medications by stratum
- Discussion
8. Other (non-pharmacological) treatments
- Clinical treatments by stratum
- Therapeutic procedures
- Discussion
9. Referrals and admissions
- Referral rates to specialists and allied health professionals
- Problems referred to specialists
- Problems referred to allied health professionals
- Problems referred for hospital admission
10. Test order
- Pathology ordering by stratum
- Imaging orders by stratum
11. Patient wellbeing and risk factors
- Background
- Patient-assessed wellbeing by stratum
- Patient body mass by stratum
- Patient smoking status by stratum
- Patient-reported alcohol consumption by stratum
12. Level of computer usage in the practice
13. After-hours arrangements of the practice
14. Summary of differences between strata
15. Discussion
- Methodological issues
16. Conclusion
- Current status of BEACH
- Access to the BEACH data
Appendixes
Appendix 1: Summary of the 1990-91 study of country and metropolitan general practice
Appendix 2: Example of a recording form used in 1998-99
Appendix 3: Example of a recording form used in 1999-2000
Appendix 4: GP characteristics questionnaire 1998-99
Appendix 5: GP characteristics questionnaire 1999-2000
Appendix 6: Reasons for encounter and problems managed - code groups from ICPC- 2 and ICPC-2 PLUS used in this report
Appendix 7: Clinical treatments - code groups from ICPC-2 PLUS used in this report
Appendix 8: Procedural treatments - code groups from ICPC-2 PLUS used in this report
Appendix 9: Referrals - code groups from ICPC-2 and ICPC-2 PLUS used in this report
Appendix 10: Pathology test orders - code groups from ICPC-2 and ICPC-2 PLUS used in this report
Appendix 11. Imaging test orders - code groups from ICPC-2 and ICPC-2 PLUS used in this report
End matter: Glossary; Abbreviations