Intervention overuse in paediatric care in Australian metropolitan general practice

Area of Science:

• Primary Care Research
• Paediatric Health Services
• Health Economics

Background:

• Low-value care (LVC) in paediatric primary care is not routinely evaluated.
• Understanding the prevalence and drivers of LVC is crucial for improving healthcare quality.
• Overuse of interventions in paediatric consultations contributes to healthcare costs and potential patient harm.

Purpose of the Study:

• To evaluate the prevalence of low-value paediatric primary care (LVC) provided by general practitioners (GPs).
• To identify GP characteristics associated with providing LVC.
• To estimate the cost of GP-provided LVC for common paediatric conditions.

Main Methods:

• Analysis of patient-level data from 22 general practices in Sydney and Melbourne.
• GP surveys to gather data on practice characteristics.
• Cost evaluation of identified LVC interventions.

Main Results:

• LVC was provided in 10.2% of paediatric consultations.
• Antibiotics for upper respiratory tract infections accounted for a significant portion of LVC (11.4%).
• GPs with >15 years of experience, male GPs, and bulk-billing practices were associated with higher LVC rates.

Conclusions:

• Low-value paediatric care persists among urban GPs.
• Targeted quality improvement strategies focusing on GP characteristics are needed.
• Addressing LVC can potentially strengthen paediatric primary care and reduce healthcare expenditure.