GPs manage common conditions differently depending on location
GPs in some parts of Australia are up to twice as likely to prescribe drugs for some common health conditions such as depression and heart disease compared to doctors in other areas.
The National Health Performance Authority's first report on how GPs manage patients who have one or more chronic health conditions shows GPs deal with these patients in markedly different ways depending on the community.
The report, which captures data from 2009 to 2013, shows that around half of the people (44% to 56%) who visited a GP once a year had one or more chronic conditions such as back pain, high cholesterol, arthritis, type 2 diabetes, asthma and anxiety.
People with chronic conditions are high users of the health care system, comprising around 85% of the total burden of disease in Australasia.
Depending on the community, GPs spend from 51% to 66% of their consultations providing care to people with one or more common chronic conditions. However, GPs actively manage these conditions in just 34% to 50% of consultations through activities such as counselling, prescription of medicine or referral to a specialist.
The report provides a unique profile of the management actions taken by GPs in respect of different medical conditions, by revealing what treatments were provided in different areas to patients with those conditions and who were actively managed for them.
The report shows:
- The percentage of patients in big cities who were actively managed for anxiety or depression and received a prescription for psychotropic drugs (such as anti-depressants) ranged from 38% in Northern Sydney to 59% in Sydney North Shore & Beaches. Across regional and rural communities, this ranged from 57% in Barwon (Vic) to 74% in Hume (Vic/NSW). GP referral to other health professionals ranged from 11% in Southern Adelaide-Fleurieu-Kangaroo Island and Central Adelaide & Hills to 21% in Eastern Sydney.
- The percentage of patients who were actively managed for select cardiovascular conditions and prescribed statins ranged from 26% in South Eastern Melbourne and Sunshine Coast (QLD) to 40% in Eastern Sydney and Central Qld. GP referral to other health professionals ranged from 4% in Northern Melbourne, Bayside (Vic) and Central Qld to 11% in Nepean-Blue Mountains (NSW).
- The percentage of patients who were actively managed for arthritis or chronic back pain and prescribed medications ranged from 52% in Northern Sydney to 75% in Nepean-Blue Mountains (NSW). Ordering of imaging by GPs ranged from 8% in North Coast NSW, Macedon Ranges and North Western Melbourne and Northern Adelaide to 20% in Central Coast (NSW).
National Health Performance Authority CEO Dr Diane Watson said the variation revealed in today's report showcases the diverse approaches GPs used to manage chronic conditions in local areas across Australia.
"Today's report offers new information that can provide a starting point for health care professionals to better learn about optimal approaches to care for their community's needs," Dr Watson said.
This report is a another step towards revealing different approaches to chronic care management and encourages Australia's research community to tease out the impact of these local approaches on patient outcomes to inform efforts to increase the productivity and performance of Australia's health system.
The Healthy Communities: GP care for patients with chronic conditions in 2009–2013 report uses data sourced from the Bettering the Evaluation and Care of Health (BEACH) program, which is conducted by the Family Medicine and Research Centre based at the University of Sydney. To ensure comparisons are as fair as possible, local areas across Australia are allocated to peer groups in the report, based on similar geographic remoteness and socioeconomic status.
The new report is available on www.myhealthycommunities.gov.au, which has a new tool – MyReport – that allows users to build their own free customised report for more than 100 measures of health and care. These measures include those in today's report and others previously reported on such as obesity rates, childhood immunisation, life expectancy, avoidable hospitalisations and more.
From next week (Monday 15 December) MyReport will have enhanced capacity to build reports by Primary Health Network (PHN) boundaries which will replace Medicare Locals.
Note to media:
- The percentage of GP consultations in which one, two or three or more chronic conditions were actively managed by local area can be found on page 13 of the report.
- A full list of chronic conditions used in the report can be found on page 4 of the report.
- A summary of how GP activity is measured in the report can be found from page 6 of the report.