Evaluation of imaging ordering by general practitioners in Australia, 2002-03 to 2011-12


Book Description

This book reports changes in GP ordering of imaging tests in Australia from 2002-03 to 2011-12, and evaluates alignment between guidelines and recent GP test ordering for selected problems. Over the decade, 9,802 GPs participated in BEACH, providing details of 980,200 GP-patient encounters. The likelihood of GPs ordering imaging in the management of a problem increased over time. In recent practice, at least one imaging test was ordered at 9% of encounters, at a rate of 10 imaging tests per 100 encounters. Diagnostic radiology was the most commonly ordered type of imaging test, but the order rate decreased over time, with a shift toward orders for ultrasound, CT and MRI, which all significantly increased. Eight selected problems accounted for one-third of all imaging orders. Imaging ordering behaviour suggests broad compliance with published guidelines in the management of osteoarthritis, shoulder problems, bursitis/tendonitis/synovitis, abdominal pain and other musculoskeletal injuries. Current ordering patterns for knee problems and some sprains/strains have potential for improvement. The ordering pattern for new presentations of back problems was inconsistent with all established guidelines for management of back problems.




A Decade of Australian General Practice Activity 2002-03 to 2011-12


Book Description

This report highlights changes in general practice activity in Australia over the decade from April 2002 to March 2012 of the BEACH program, a national cross-sectional study of general practice activity. Over this time 9,802 GPs provided details of 980,200 GP-patient encounters. The report highlights changes that have occurred over the decade in the characteristics of GPs and the patients they see, the problems managed and the treatments provided. Changes in prevalence of overweight and obesity, smoking status and alcohol use are also described for sub-samples of more than 30,000 adult patients each year. This report is a companion to the annual report General Practice Activity in Australia 2011-12.




General practice activity in Australia 2013-14


Book Description

This book provides a summary of results from the 16th year of the BEACH program, a continuous national study of general practice activity in Australia. From April 2013 to March 2014, 959 general practitioners recorded details of 95,900 GP-patient encounters, at which patients presented 148,880 reasons for encounter and 151,675 problems were managed. For an 'average' 100 problems managed, GPs recorded: 65 medications (including 53 prescribed, seven supplied to the patient and six advised for over-the-counter purchase); 12 procedures; 24 clinical treatments (advice and counselling); six referrals to specialists and three to allied health services; orders for 31 pathology tests and seven imaging tests. A subsample study of more than 31,000 patients suggests prevalence of measured risk factors in the adult (18 years and over) population who attended general practice at least once in 2013-14 were: obesity-27%; overweight-35%; daily smoking-17%; at-risk alcohol consumption-26%. One in four people in the attending population had at least two of these risk factors. A companion publication, A decade of Australian general practice activity 2004-05 to 2013-14 is also available.




A decade of Australian general practice activity 2004-05 to 2013-14


Book Description

This report highlights changes in general practice activity in Australia over the most recent decade (April 2004 to March 2014) of the BEACH program, a continuous national cross-sectional study of general practice activity. Over this time 9,731 general practitioners (GPs) provided details of 973,100 GP-patient encounters. The report highlights changes that have occurred over the decade in the characteristics of GPs and the patients they see, the problems managed, and the treatments provided. Changes in prevalence of overweight and obesity, smoking status and alcohol use are also described for subsamples of more than 30,000 adult patients each year. This report is a companion to the annual report, General practice activity in Australia 2012-13.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




General Practice Activity in Australia 2015-16


Book Description

The book provides a summary of results from the 13th year of the BEACH program, a continuing national study of general practice activity in Australia.




The Other Glass Ceiling


Book Description




Clinical Case Studies for the Family Nurse Practitioner


Book Description

Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use.




Principles and Practice of Geriatric Psychiatry


Book Description

The renowned Principles and Practice of Geriatric Psychiatry, now in its third edition, addresses the social and biological concepts of geriatric mental health from an international perspective. Featuring contributions by distinguished authors from around the world, the book offers a distinctive angle on issues in this continually developing discipline. Principles and Practice of Geriatric Psychiatry provides a comprehensive review of: geriatric psychiatry spanning both psychiatric and non-psychiatric disorders scientific advances in service development specific clinical dilemmas New chapters on: genetics of aging somatoform disorders epidemiology of substance abuse somatoform disorders care of the dying patient Continuing the practice of earlier editions, the major sections of the book address aging, diagnosis and assessment and clinical conditions, incorporating an engaging discussion on substance abuse and schizophrenic disorders. Shorter sections include the presentation of mental illness in elderly people from different cultures—one of the most popular sections in previous editions. Learning and behavioural studies, as well as models of geriatric psychiatry practice, are covered extensively. This book provides a detailed overview of the entire range of mental illness in old age, presented within an accessible format. Principles and Practice of Geriatric Psychiatry is an essential read for psychiatrists, geriatricians, neurologists and psychologists. It is of particular use for instructors of general psychiatry programs and their residents.