Section 57
Chapter 56,939

Whither Divisions of General Practice? An empirical and policy analysis of the impact of Divisions within the Australian health care system

Scott, A.; Coote, W.

Medical Journal of Australia 187(2): 95-99


ISSN/ISBN: 0025-729X
PMID: 17635092
DOI: 10.5694/j.1326-5377.2007.tb01149.x
Accession: 056938620

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To examine the effect of Divisions of General Practice on various measures of primary care performance. Regression analysis using longitudinal data across Australia. All Divisions of General Practice between 2002 and 2004. Fourteen indicators of primary care performance in the areas of general practice infrastructure, access, multidisciplinary working, chronic disease, and measurable aspects of quality of care. Between 2002 and 2004, Divisions and the activities they performed were associated with a number of measures of primary care performance, particularly measures of general practice infrastructure. Of the total variation in each performance indicator, between 19% and 64% can be attributed to the influence of Divisions while controlling for remoteness, health needs, and general practitioner characteristics. In all regression models, these effects were significant (P < 0.05). Divisions that provided support in electronic communication and electronic transfer of data were associated with: a 0.56 (95% CI, 2 0.04 to 1.2; P = 0.07) percentage point increase in the proportion of Practice Incentives Program (PIP) practices; a 0.73 (95% CI, 2 0.09 to 1.5; P = 0.08) percentage point increase in the proportion of PIP practices with electronic prescribing software; and a 0.66 (95% CI, 0.05 to 1.3; P = 0.03) percentage point increase in the proportion of PIP practices with a modem. Divisions providing activities with an asthma focus were associated with a 0.84 (95% CI, 0.02 to 1.5; P = 0.01) percentage point increase in the proportion of PIP practices receiving the asthma sign-on payment. There were no significant effects of Division activities on clinical aspects of care, such as GP claims for Service Incentive Payments for asthma, diabetes or cervical screening. Divisions of General Practice had an effect on primary care performance in a difficult health system context.

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