Practice nurses now included in GP activity report
Data on practice nurses has been analysed for the first time in the most recent Bettering the Evaluation And Care of Health program (BEACH) report, released today by the Australian Institute of Health and Welfare (AIHW) and the University of Sydney.
'In late 2004, Medicare introduced new item numbers to cover certain practice nurse activities, giving the BEACH program an opportunity to record and measure the impact of practice nurses on general practitioner clinical activity,' said Professor Helena Britt of the AIHW's GP Statistics Centre, at the University of Sydney.
In brief, the newly collected data showed that practice nurses were actively involved in just under 4% of all patient encounters, and that they most often provided immunisations (30.2%), and treatments for chronic skin ulcers (6.7%) and lacerations (6.3%).
Between 1998 and 2004-05, there was a steady increase in the rate of clinical treatments - that is advice, education and counselling given by GPs on topics such as medication, nutrition and weight, and treatments.
However, in 2005-06 these clinical treatments, given by either the GP or the practice nurse, decreased by 20% in a single year. This result suggests there were about 10 million fewer clinical treatments given across the country at patient consultations than in the previous year.
There was no change in the rate of psychological counselling - a service that cannot be provided by a practice nurse.
'These results are interesting,' said Professor Britt. 'We don't know whether this decrease is being picked up in services provided by the nurse outside the GP consultations (such as in clinics run by nurses) or whether the nurse is providing advice and education as a natural part of the procedural work they do - or in fact, whether patients are still receiving, from GPs and practice nurses, the same level of advice and education that they were a year ago.
'We hope to shed some light on these issues through more complex analysis of these data in the next report,' she said.
The report, General practice activity in Australia 2005-06, based on surveys covering 101,700 GP-patient encounters completed by 1,017 randomly selected GPs in 2005-06, gives insight into the content of the 90 million + GP consultations claimed through Medicare in those 12 months.
Other findings include:
- Both the feminisation and ageing of the GP workforce continued in 2005-06, with females making up 37%, and practitioners 55 years or older making up 40% of those surveyed.
- GPs' workload across patient age groups is changing, with GPs spending less time with patients 45 and younger, and more time with 'baby boomers' (currently aged 45-64 years) and patients aged 75 years or older.
The BEACH program is a continuous national study of GP clinical activity. It serves to describe the role of general practice in the health care of the community, to measure changes in the problems being managed by GPs and in the care they provide.