Practice compared. The UK and Australia

To compare the processes and cost of management of chronic health problems between a rural general practice in the UK and a similar practice in Australia. Patients were selected from three groups with either diabetes, asthma or depression.

Case study, retrospective. This comparison was conducted during a 6 month practice exchange.

Wagin, Western Australia and Berwick upon Tweed, England.

Ten people (five men, five women) were selected from each practice, for each disease type. Their records were culled and compared on the basis of how well they had satisfied the requirements of the protocols (where they existed) on the management of each disease. Other comparisons also included the number and cost of consultations, prescriptions and hospital stays.

There was no apparent difference in the age/sex distributions of the populations studied. Comparisons of the three disease groups showed: Asthma-results similar on most counts, except hospital admissions. Protocol uniformly poorly followed. Diabetes-results similar, except use/cost of prescription drugs which was much greater in Australia. The UK was much better following its protocol. Depression-Australia again used significantly more prescription drugs. The use and cost of GP/specialist visits was higher overall in Australia.

This study suggests that a rural UK practice provides more cost effective review of chronic health problems. Further study would be warranted to investigate the impression that this was achieved at the expense of patient and doctor satisfaction.