This book provides a summary of results from the 16th year of the BEACH program, a continuous national study of general practice activity in Australia. From April 2013 to March 2014, 959 general practitioners recorded details of 95,900 GP-patient encounters, at which patients presented 148,880 reasons for encounter and 151,675 problems were managed. For an 'average' 100 problems managed, GPs recorded: 65 medications (including 53 prescribed, seven supplied to the patient and six advised for over-the-counter purchase); 12 procedures; 24 clinical treatments (advice and counselling); six referrals to specialists and three to allied health services; orders for 31 pathology tests and seven imaging tests. A subsample study of more than 31,000 patients suggests prevalence of measured risk factors in the adult (18 years and over) population who attended general practice at least once in 2013-14 were: obesity-27%; overweight-35%; daily smoking-17%; at-risk alcohol consumption-26%. One in four people in the attending population had at least two of these risk factors. A companion publication, A decade of Australian general practice activity 2004-05 to 2013-14 is also available.
This book provides a summary of results from the 17th year of the BEACH program, a continuous national study of general practice activity in Australia.
This report highlights changes in general practice activity in Australia over the most recent decade (April 2004 to March 2014) of the BEACH program, a continuous national cross-sectional study of general practice activity. Over this time 9,731 general practitioners (GPs) provided details of 973,100 GP-patient encounters. The report highlights changes that have occurred over the decade in the characteristics of GPs and the patients they see, the problems managed, and the treatments provided. Changes in prevalence of overweight and obesity, smoking status and alcohol use are also described for subsamples of more than 30,000 adult patients each year. This report is a companion to the annual report, General practice activity in Australia 2012-13.
This book is about optimizing the use of medicines and medical tests in primary care. It provides a comprehensive resource for students, researchers, health practitioners and administrators seeking information on how to design, implement, scale-up and build capability for interventions and programs that result in changes in prescribing and medical/diagnostic test ordering by health professionals. Drawing on work from Australia, Canada and the United States of America, the book begins with the evidence-base and theoretical frameworks that underpin successful behaviour change programs. It provides details on particular interventions such as clinical audit, academic detailing, choosing wisely and supports for consumers. Real world examples explore the process of designing, implementing and evaluating interventions and the factors that can help and hinder this process. This is a practical text that will be useful to the beginner and more experience program implementation professionals alike.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
This visionary reframing of health and healthcare uses a complexity science approach to building healthcare systems that are accessible, effective, and prepared for change and challenges. Its holistic map for understanding the human organism emphasizes the interconnectedness of the individual’s physical, psychological, cognitive, and sociocultural functioning. Applications of this approach are described in primary, specialist, and emergency care and at the organizational and policy levels, from translating findings to practice, to problem solving and evaluation. In this model, the differences between disease and illness and treating illness and restoring health are not mere wordplay, but instead are robust concepts reflecting real-world issues and their solutions. Based on the Proceedings of the 1st International Conference of Systems and Complexity for Healthcare, topics covered include: • Coping with complexity and uncertainty: insights from studying epidemiology in family medicine • Anticipation in complex systems: potential implications for improving safety and quality in healthcare • Monitoring variability and complexity at the bedside • Viewing mental health through the lens of complexity science • Ethical complexities in systems healthcare: what care and for whom? • The value of systems and complexity thinking to enable change in adaptive healthcare organizations supported by informatics • If the facts don’t fit the theory, change the theory: implications for health system reform The Value of Systems and Complexity Sciences for Healthcare will interest and inspire health and disease researchers, health professionals, health care planners, health system financiers, health system administrators, health services administrators, health professional educators, and, last but not least, current and future patients.