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Paediatric care in general practice: Case mix, referral patterns and healthcare costs
Harriet Hiscock1, Sonia Khano2, Lena Sanci3
1MBBS, FRACP, MD, Co-Group Leader, Health Services and Economics, Murdoch Children@s Research Institute, Melbourne, Vic; Professorial Fellow, Department of Paediatrics, The@University of Melbourne, Melbourne, Vic.
Insights
General practitioners (GPs) refer 10% of paediatric consultations, mainly for mental health issues to private specialists. This highlights potential access disparities and the need for increased public sector capacity.
Area of Science:
- Pediatric primary care
- General practice
- Health services research
Background:
- Limited contemporary data exists on pediatric conditions managed by general practitioners (GPs).
- Understanding GP referral patterns and associated factors is crucial for workforce planning and training.
- Knowledge gaps persist regarding the case mix, referral patterns, and costs of pediatric consultations in general practice.
Purpose of the Study:
- To analyze the case mix of pediatric consultations in general practice.
- To investigate GP referral patterns, including destinations and influencing factors.
- To estimate the healthcare system costs associated with pediatric general practice consultations.
Main Methods:
- Cross-sectional analysis of 49,932 pediatric consultations across 22 general practices.
- Involved 130 general practitioners (GPs) in Victoria and New South Wales.
- Utilized general practice electronic medical records to identify consultation reasons and referral data.
Main Results:
- Common consultation reasons included medical issues, immunizations, developmental-behavioral concerns, check-ups, and mental health.
- General practitioners (GPs) referred 10% of consultations, predominantly for mental health.
- Referral patterns were linked to private billing, GP demographics, patient characteristics, and GP experience; most referrals were to private specialists, costing $1.39 million.
Conclusions:
- General practitioners (GPs) predominantly refer to private specialists for mental health and developmental-behavioral concerns, especially under private billing, suggesting access inequities.
- There is a need for enhanced public sector capacity to manage these pediatric conditions.
- Strengthening pediatric primary care has the potential for significant healthcare cost savings through reduced referrals.
Background And Objectives:
There are no contemporary data to describe which paediatric conditions general practitioners (GPs) see, which conditions they refer, and where and whether referrals differ by general practice, patient or GP factors. A better understanding of the this could inform GP training needs and workforce planning. The aim of this study was to address knowledge gaps around the case mix of general practice paediatric consultations, as well as GP referral patterns, associated factors and costs.
Method:
A cross-sectional analysis of 49,932 paediatric consultations was performed across 22 general practices in Victoria and New South Wales involving 130 GPs. General practice electronic medical records were analysed to determine consultation reasons and referrals.
Results:
Common reasons for visits included medical issues, immunisations, developmental-behavioural concerns, check-ups and mental health. GPs referred 10% of visits, predominantly for mental health. Referral patterns were associated with private billing, GP demographics, patient characteristics and years of working in general practice. Most referrals were to private specialists. Estimated costs to the healthcare system were $1.39 million.
Discussion:
GPs mostly refer to private specialists for mental health and developmental-behavioural concerns, particularly with private billing, indicating access disparities. Increased public sector capacity for these conditions is needed. Strengthening paediatric primary care could yield significant cost savings by reducing referrals.
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