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'The kids are alright' - Changes in GP consultations with children 2000-15
Clare Bayram1, Christopher Harrison, Janice Charles
1BAppSc (HIM) (Hons), PhD, Research Fellow and Project Manager, BEACH Program, Family Medicine Research Centre, University of Sydney, Sydney, NSW.
Insights
Australia's ageing population has shifted general practitioner (GP) focus from children's healthcare. Despite increased child encounters, GP workload for pediatric care declined, with rising mental health concerns noted.
Area of Science:
- Public Health
- Pediatrics
- General Practice
Background:
- Australia's population is ageing, raising concerns about pediatric healthcare resource allocation.
- The proportion of children in Australia has decreased while the absolute number of general practitioner (GP) encounters with children has risen.
- Children represent a larger population share than GP visits, contrasting with older adults who have a higher visit proportion relative to their population share.
Purpose of the Study:
- To examine children's general practice service utilization and managed problems between 2000-03 and 2012-15.
- To determine if the demands of managing an ageing population have impacted children's healthcare services.
- To assess the continuation of trends in childhood health problems managed in general practice.
Main Methods:
- Analysis of children's general practice service use and managed problems over two distinct periods (2000-03 and 2012-15).
- Comparison of demographic data, including population proportion versus GP visit proportion by age group.
- Tracking changes in the types of childhood health issues managed by GPs over time.
Main Results:
- While the absolute number of child GP encounters increased, their percentage of overall GP workload decreased from 14.3% to 11.2%.
- Children constituted 19.3% of the population but only 13.0% of GP visits, while those aged 65+ were 13.0% of the population and 26.5% of visits.
- There has been a decline in 'traditional' childhood illnesses and vaccinations, alongside a notable increase in the management of child mental health issues in general practice.
Conclusions:
- The decline in the proportion of GP workload for children may reflect a redistribution of services due to an ageing population rather than reduced service use.
- Trends indicate a shift in pediatric primary care from infectious diseases towards managing mental health conditions.
- Further research is needed to fully understand the implications of these shifts for children's long-term health outcomes and healthcare planning.
Abstract:
The ageing of Australia's population has led to a focus on the health resources required for older patients, and there has been concern that this might be at the expense of children's healthcare. Over the past few decades the number of children in Australia has increased, but has steadily declined as a proportion of the population. This has paralleled an increase in the absolute number of general practitioner (GP) encounters with children aged <15 years, but a decline in the percentage of GP workload from 14.3% in 2000-01 to 11.2% in 2013-14. There are disparities in the use of general practice services by age, with children making up a greater proportion of the population (19.3%) than of GP visits (13.0%), while people aged 65 years and older accounted for 13.0% of the population and 26.5% of visits in 2006. It is unclear whether the decline in the proportion of GP workload accounted for by children reflects a change in the way children use these general practice services, or a redistribution based on the ageing of the patient population. Over time, there have been marked changes in the types of problems managed in children. From the 1990s to 2001, Australia's children became well vaccinated and decreasingly likely to have 'traditional' childhood illnesses (notably infections). More recently, there has been significant growth in the management of child mental health problems in general practice, although mental health problems account for a small proportion of childhood problems managed. We examined children's use of general practice services and the problems managed in 2000-03 and 2012-15 to determine whether their service use has been influenced by the demands associated with the management of older Australians, and whether trends in problems managed identified in early studies have continued.
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