Frequent GP user survey shows coordination need

GP explaining file to patient

A report on the frequent GP users has revealed the need for better primary care coordination to reduce costs and provide better quality care.

The National Health Performance Authority report showed 12.5% of Australians saw a GP 12 or more times in 2012/13, compared to the national average of 5.6 attendances. This group also had significantly higher use of other non-hospital health services such as pathology and specialists, accounting for $6.5bn or 41% of all non-hospital Medicare costs.

The report showed that while frequent (12-19 visits) and very high (20+ visits) attenders came from all walks of life, they were more likely to be older, have more chronic conditions and come from lower socio-economic areas than people who saw their GPs less often.

Importantly they were also much more likely to have seen multiple GPs during the period, with those in the very high category seeing nearly five different GPs on average.

Inner North West Melbourne Medicare Local CEO Associate Professor Christopher Carter says this could lead to a breakdown in care coordination, with tests and investigations being repeated and multiple specialists referrals provided for the same or similar issues.

“The report reveals that the more GPs a person sees the more they are to be higher users of other health services, increasing costs and making it more difficult to effectively coordinate their care,” A/Prof Carter says.

“This really shows the importance of the person-centred medical home model, where a person has consistent contact with a general practice that understands their needs and is able to facilitate their engagement with the primary health system.

“This allows for structured, ongoing care that promotes self-management, reducing the need for GP attendances and other health services – especially important for people with multiple chronic health conditions.

“Frequent and very high GP attenders are also much more likely to be admitted to hospital than average, so better targeted and integrated care at the primary level for these people will help right across the health system.”

12.1% of people in the INWMML region were frequent or very high GP attenders in 2012/13, higher than the average for similar metropolitan areas. However the average non-hospital Medicare expenditure for each of these people was only $2,253, substantially lower than the $2,410 average for peer regions.

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