Trends in general practitioner services to residents in aged care
Jodie B. Hillen A B , Agnes Vitry A and Gillian E. Caughey AA Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
B Corresponding author. Email: smijb002@mymail.unisa.edu.au
Australian Journal of Primary Health 22(6) 517-522 https://doi.org/10.1071/PY15119
Submitted: 28 July 2015 Accepted: 4 November 2015 Published: 9 May 2016
Abstract
To date, access to appropriate and timely GP services for those in aged care has been described as limited, in part due to inadequate models of care and remuneration. As the Australian population ages and more Australians become dependent on aged-care services, the need for good quality medical care that meets the needs of residents will continue to grow. The purpose of this study was to provide a current analysis of trends in GP services in residents in Australian aged-care facilities. Longitudinal population data (2005–2014) was used to describe the changing population demographics and calculate annual rates for GP services specific to this population. Total population and age-group strata (<85 years and 85+ years) rates were calculated for standard consultations, after-hours consultations, contribution to a care plan and collaborative medication review. For the period 2005–2014 there was an increase of 1.5 million GP services to this population, which had simultaneously grown by 19 800 residents, aged (6% increase in residents aged 85+ years) and become more dependent (14% increase is high-care residents). Significant increases in all GP service rates were observed, with a shift towards after-hours consultations. Residents aged <85 years received significantly more services than residents aged 85+ years. GP service delivery to the whole aged-care population continues to be heavily weighted towards standard and after-hours consultations, while collaborative GP services remain a very small proportion of services accessed by this population. There is scope to increase collaborative GP services, which have been linked to improved outcomes for this population.
Additional keywords: general practitioner (GP), Medicare, nursing home, over 80, primary health care, residential aged care.
References
Australian Commission on Safety and Quality in Health Care (2010) Patient-centred care: improving quality and safety by focussing care on patients and consumers. Available at http://www.safetyandquality.gov.au [Verified 9 January 2015]Australian Commission on Safety and Quality in Health Care (2012) Australian safety and quality framework for health care. Available at http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/32296-Australian-SandQ-Framework1.pdf [Verified 1 July 2014]
Australian Government (2009) Aged care access initiative program guidelines. Available at www.phcris.org.au/division/reporting/documents/ACAI_aug08.pdf [Verified 27 February 2015]
Australian Institute of Health and Welfare (AIHW) (2006) Residential aged care in Australia 2004–05: a statistical overview. Cat. no. AGE 45. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2007) Residential aged care in Australia 2005–06: a statistical overview. Cat. no. AGE 54. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2008) Residential aged care in Australia 2006–07: a statistical overview. Cat. no. AGE 56. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2009) Residential aged care in Australia 2007–08: a statistical overview. Cat. no. AGE 58. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2010) Residential aged care in Australia 2008–09: a statistical overview. Cat. no. AGE 62. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2011) Residential aged care in Australia 2009–10: a statistical overview. Cat. no. AGE 66. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2012) Residential aged care in Australia 2010–11: a statistical overview. Cat. no. AGE 68. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2013) Movement between hospital and residential aged care 2008–09. Cat. no. CSI 16. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2014) Residential aged care and aged care packages in the community 2012–13. Available at www.aihw.gov.au/aged-care/resdiential-and-community-2012-2013/ [Verified 9 January 2015]
Brown L, Davis J, Benetas (2015) PHC and integration with aged care services: challenges and approaches in Australia. Available at www.phcris.org.au [Verified 15 April 2015]
Clark S, Parker R, Prosser B, Davey R (2013) Aged care nurse practitioners in Australia: evidence for the development of their role. Australian Health Review 37, 594–601.
| Aged care nurse practitioners in Australia: evidence for the development of their role.Crossref | GoogleScholarGoogle Scholar | 24176166PubMed |
Commonwealth of Australia (2010) Australia to 2050: future challenges. The 2010 Intergenerational report. Commonwealth of Australia, Canberra.
Curtis K (2013) Romancing GPs in aged care. Available at http://www.australianageingagenda.com.au/2013/08/30/romancing-gps-in-aged-care/ [Verified 10 November 2015]
Department of Health (2014) Chronic Disease Management (formerly Enhanced Primary Care or EPC) – GP services. Available at www.health.gov.au/internet/main/publishing.nsf/content/mbsprimarycare-chronicdiseasemanagement [Verified 19 October 2015]
Department of Health and Ageing. (2010) ‘Evaluation of the Residential Medication Management Review program.’ (Campbell Research: Canberra)
Finn JC, Flicker L, Mackenzie E, Jacobs IG, Fatovich DM, Drummond S, Harris M, Holman DACDJ, Sprivulis P (2006) Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia. The Medical Journal of Australia 184, 432–435.
Gadzhanova S, Reed R (2007) Medical services provided by general practitioners in residential aged-care facilities in Australia. The Medical Journal of Australia 187, 92–94.
Gordon J, Harrison C, Miller G (2015) General practice encounters with patients living in residential aged care facilities. Australian Family Physician 44, 173–174.
Graverholt B, Forsetlund L, Jamtvedt G (2014) Reducing hospital admissions from nursing homes: a systematic review. BMC Health Services Research 14, 36
Hillen JB, Reed RL, Woodman RJ, Law D, Hakendorf PH, Fleming BJ (2011) Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999–2005). Australasian Journal on Ageing 30, 202–207.
| Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999–2005).Crossref | GoogleScholarGoogle Scholar | 22176565PubMed |
Medicare Australia (2013) Practice Incentives Program. General practitioner aged care access incentive guidelines – September 2013. Available at http://www.humanservices.gov.au/health-professionals/services/practice-incentives-programme/ [Verified 1 January 2015]
Mumford V, Hass M (2014) Nurse practitioners and physician assistants: adapting models of care to changing demographics. Available at http://refinephc.org.au/wp-content/uploads/2013/06/Refine-Factsheet-No-5-.pdf [Verified 10 November 2015]
Nishtala PS, Hilmer SN, Mclachlan AJ, Hannan PJ, Chen TF (2009) Impact of residential medication management reviews on drug burden index in aged-care homes: a retrospective analysis. Drugs & Aging 26, 677–686.
| Impact of residential medication management reviews on drug burden index in aged-care homes: a retrospective analysis.Crossref | GoogleScholarGoogle Scholar |
Pain T, Stainkey L, Chapman S (2014) AgedCare+GP: description and evaluation of an in-house model of general practice in a residential aged-care facility. Australian Journal of Primary Health 20, 224–227.
| AgedCare+GP: description and evaluation of an in-house model of general practice in a residential aged-care facility.Crossref | GoogleScholarGoogle Scholar | 24134857PubMed |
Reed RL (2015) Models of general practitioner services in residential aged care facilities. Australian Family Physician 44, 176–179.
Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, Killer G, Gilbert AL (2009) The effectiveness of collaborative medicine reviews in delaying time to next hospitalisation for patients with heart failure in the practice setting. Circulation: Heart Failure 2, 424–428.
| The effectiveness of collaborative medicine reviews in delaying time to next hospitalisation for patients with heart failure in the practice setting.Crossref | GoogleScholarGoogle Scholar |
Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, Killer G, Gilbert AL (2011) Collaborative home medicines review delays time to next hospitalisation for warfarin associated bleeding in Australian war veterans. Journal of Clinical Pharmacy and Therapeutics 36, 27–32.
| Collaborative home medicines review delays time to next hospitalisation for warfarin associated bleeding in Australian war veterans.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3M%2Fot1Khsw%3D%3D&md5=026bd743a5325c5b4b089adb3cc84020CAS | 21108651PubMed |
Taylor MJ, Edvardsson D, Horey D, Fetherstonhaugh D, Nay R, Swerissen H (2013) General practitioner service provision in residential aged care facilities: 1998–2011. Australasian Journal of Ageing 32, 56–59.
| General practitioner service provision in residential aged care facilities: 1998–2011.Crossref | GoogleScholarGoogle Scholar |
