Administrative encounters in general practice: low value or hidden value care?

Area of Science:

• General Practice
• Health Services Research
• Health Economics

Background:

• Administrative tasks, medication requests, and referrals form a significant portion of general practice encounters.
• Determining the value of these encounters is crucial for healthcare resource allocation and policy.
• Previous research has not fully elucidated the nature and value of these specific types of general practice visits.

Purpose of the Study:

• To quantify the frequency of general practice administrative encounters.
• To assess whether these encounters represent low-value care.
• To investigate the context and additional care provided during these encounters.

Main Methods:

• Secondary analysis of the Bettering Evaluation and Care of Health (BEACH) dataset (2000-01 to 2015-16).
• Inclusion of 1,568,100 general practitioner (GP)-patient encounters from a nationally representative sample.
• Categorization of encounters based on patient reasons: administrative, medication, or referral requests, and analysis of additional care provided.

Main Results:

• In 2015-16, 18.5% of GP encounters involved potentially low-value care requests, with 7.4% being solely for such reasons.
• Administrative requests (3.8%) included care planning, coordination, and certification.
• Medication requests (13.1%) and referral requests (2.8%) often occurred alongside other health needs and additional care provision, especially for chronic diseases.

Conclusions:

• Most patient requests for administrative tasks, medications, and referrals were part of broader health needs.
• General practitioners provided additional health care during the majority of these encounters, particularly for chronic disease management.
• The hidden value of these encounters warrants consideration in healthcare policy, such as the Medicare Benefits Schedule (MBS) Review.