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View from the BEACH

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We know from the Department of Health that 85 per cent of Australians visited a GP at least once during 2012-13.
Well, two new health reports released in the past fortnight have reinforced the leadership role played by GPs in Australia’s health system.
The reports – General practice activity in Australia 2012-13 and A decade of Australian general practice 2002-03 to 2012-13 –  are a valuable source of information on the content of patient encounters and the services and treatments GPs provide.
The reports are the latest in the University of Sydney’s Bettering the Evaluation and Care of Health (BEACH) continuous national study of general practice activity. This is the 15th year of the BEACH program, which I understand is the only continuous randomised study of general practice activity in the world.
Here’s a sample of the key findings:
• in 2012-13, Australians claimed 126.8 million GP services through Medicare, at an average of about 5.6 GP visits per head of population or 6.6 visits per person who visited at least once. This equates to about 2.44 million GP-patient encounters per week. A decade earlier there were 96.3 million claims at an average of 4.3 visits per head;
• GPs managed significantly more problems at encounters in 2012–13 (155 per 100 encounters) than in 2003–04 (146 per 100); and
• chronic problems accounted for 36 per cent of all problems managed, and an average of 55.7 chronic problems were managed per 100 encounters.

No surprise then, that GPs are busier and dealing with more problems during a consultation.
The BEACH reports also confirm what we are seeing in our surgeries on a daily basis – an ageing population and older patients with more complex care needs:
• between 2003–04 and 2012–13, the proportion of encounters with patients aged 65 years and older took up an increasing proportion of encounters, rising significantly from 27 per cent to 30 per cent; and
• the management rate of chronic conditions rose from 52 per 100 encounters in 2003–04, to 56 per 100 in 2012–13, this change accounting for about 40 per cent of the increase in problems managed overall.
These findings reinforce to me the urgency of slowing the costs imposed on Australia’s health system from the increasing burden of chronic disease.
I think that the AMA is on the money with our plan to improve care for patients with chronic and complex conditions by giving them more time with their GPs, and improving coordination of health and support services.
AMA President Dr Steve Hambleton has noted reports that underline the unique leadership role of GPs in the health system, and any moves to allow other health professionals to do the work of GPs must be avoided.
Unfortunately, the Government decided recently to let non-medical health professionals prescribe medications autonomously. This prescribing model is not aligned with integrated multi-disciplinary general practice teams, nor is it compatible with the safe and quality use of medicines.
We can only hope that sense will prevail, and that the decision is reversed before there are any risks to patient safety.
The BEACH reports contain much interesting and enlightening information on general practice activity, and I commend them to you.

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