Bridget R Dijkmans-Hadley

A valuable approach to the use of electronic medical data in primary care research Panning for gold

Background: Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable. Objective: The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research. Method: EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit. Results: The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age (p = 0.36) or sex (p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns. Conclusion: Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.

Australian general practitioner attitudes to residential aged care facility visiting

Demographic trends suggest that the sustainability of the general practitioner (GP) Residential Aged Care Facility (RACF) workforce, worldwide and in Australia, is under threat, compromising the ongoing care of chronically ill RACF residents. It is therefore important to ascertain current GP attitudes towards this work, to better understand and hypothesise means of reversing this trend. To this end, during 2014 the views of 26 GPs and GP Registrars working in rural and regional New South Wales, Australia, were captured during focus group discussions and one-on-one interviews. Analysis of the qualitative date revealed that GP attitudes towards RACF visiting fell into five key themes: pleasure, duty, remuneration and logistics, hesitation, and frustration. The data also revealed that the overriding emotion GPs felt about RACF visitation was frustration with the avoidable delays and inefficiencies associated with the work. Despite the pleasure GPs derived from their work in RACFs and their sense of obligation to be involved, their hesitation and frustration was compounded by the works perceived poor remuneration. This research suggests that the barriers to GP participation in RACF visiting were managerial rather than attitudinal, and that a strategic focus upon improving administrative and logistical support is needed.

A feasibility study of team-based primary care for chronic disease management training in rural Australia.

Increasing rates of chronic disease management (CDM) are projected to contribute to significant effective shortfalls in the primary care workforce in Australia.1 Additionally, rural Australia carries a higher burden of chronic illness2 and has existing medical workforce shortages.3 Therefore, it is imperative that rural primary care maximises the efficiency of the CDM it provides. Disciplines Medicine and Health Sciences Publication Details Bonney, A., Dijkmans-Hadley, B., Seidel, B., MacKinnon, D. & Phillipson, L. (2017). A feasibility study of team-based primary care for chronic disease management training in rural Australia. Australian Journal of Rural Health, 25 (1), 66-67. This journal article is available at Research Online: http://ro.uow.edu.au/ihmri/1034 Article Title: A feasibility study of team-based primary care for chronic disease management training in rural Australia