Intervention overuse in paediatric care in Australian metropolitan general practice

General practitioner (GP)-provided low-value paediatric primary care (LVC)/intervention overuse is not routinely evaluated. The aim of this paper is to evaluate prevalence, associated GP characteristics and cost of GP-provided LVC for five common paediatric conditions.

Patient-level data were extracted from 22 practices in Sydney and Melbourne. GPs were surveyed and costs of LVC were evaluated.

LVC was provided in 628/6182 (10.2%) consultations, including antibiotics for upper respiratory tract infections (511/4469, 11.4%). GPs practising for >15 years demonstrated increased risk of providing LVC (risk difference [RD] 9.8 %; 95% confidence interval [CI]: 4.0 to 15.6), and LVC occurred less at private versus bulk billing practices (RD 7.2 %; 95% CI: 2.9 to 11.5) and with female versus male GPs (RD -4.5%; 95% CI: -8.7 to -0.4). Estimated LVC cost was $17,254.15, extrapolated to $41.2 million when applied to all Australian LVC paediatric visits.

Low-level intervention overuse continues among urban GPs. Targeted quality improvement approaches addressing associated GP characteristics might strengthen paediatric care.