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Changing rural general practitioner practice : evaluating health assessment uptake

The Enhanced Primary Care Package aimed to improve health and quality of life through enhancing primary health care for those over 75 years, Aboriginal and Torres Strait Islanders over 55 years and those with chronic conditions and multidisciplinary needs. A multi-level approach was implemented to promote the package. West Vic Division of General Practice conducted the General Practice Education Support and Community Linkages implementation program for the package in Western Victoria and focused on health assessments for those over 75 years. This research investigated what factors affected change in rural general practitioner practice through surveying general practitioners and collecting Health Insurance Commission data prior to and following the program. Patients were also interviewed to determine acceptance of health assessments and nurse involvement. The program increased awareness, but had little effect on increasing uptake, as only 53% of general practitioners began undertaking health assessments. However the general practitioners indicated an increased frequency of health assessment prescription. Health Insurance Commission data suggested an immediate increase in the use of the assessments, however the rate fluctuated and then declined. Lack of sustained uptake of the program was not associated with remuneration, as 77% of general practitioners did not regard finance as a barrier. Respondents’ major barrier was time (40% pre-education, 73% post-education). This data reflected a rural environment where general practitioners face competing priorities, time constraints, workforce shortage and long consultation lists. A notable change did however occur from practice nurse employment as the involvement of a practice nurse generally resulted in patient satisfaction with the assessment. It was apparent that a complex multifaceted and longer-term view is needed to address factors which limit rural general practitioners’ ability to change. This needs to be addressed at the Commonwealth level and not in isolation in order to produce an integrated framework to enhance and promote, rather than demand change. / Master of Applied Science

Identiferoai:union.ndltd.org:ADTP/266100
Date January 2003
CreatorsMcGrath, Alicia
PublisherUniversity of Ballarat
Source SetsAustraliasian Digital Theses Program
Detected LanguageEnglish
RightsCopyright Alicia C. McGrath

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