MBBS, DipRACOG, Honorary Clinical Associate Professor, Department of General Practice, University of Melbourne, Vic.
MBBS, MSc, Study Investigator, AusTrials, Brisbane, Qld.
Aust J Gen Pract. 2022 Sep;51(9):713-720. doi: 10.31128/AJGP-10-21-6197.
General practitioners (GPs) play a central role in healthcare, serving as the first point of contact, making appropriate referrals and coordinating care for chronic conditions such as heart failure (HF). We sought to determine healthcare use by people with HF in primary care.
In this Study of Heart failure in the Australian Primary carE setting (SHAPE), we analysed records of 1.93 million adult patients who attended a total of 43 practices between 1 July 2013 and 30 June 2018. We identified and examined the data of 20,219 patients with HF to describe the frequency of visits and use of Medicare Benefits Schedule items.
Patients with HF saw GPs 14.4 times per annum on average; 59.5% had a General Practice Management Plan (GPMP), 2.9% of GPMPs were reviewed annually or more frequently, and 46.8% of patients had been referred to a cardiologist. A total of 3761 had coexisting anxiety or depression, and of these 37.1% had a mental health plan.
Patients with HF visit their GP frequently, with many not reaching guideline therapy nor referred to cardiologists. Low use of care planning and reviews presents an opportunity for GPs to improve care.
全科医生（GP）在医疗保健中发挥着核心作用，是患者的首要联络点，负责为心力衰竭（HF）等慢性病患者进行适当转诊和协调治疗。本研究旨在确定 HF 患者在初级保健中的医疗保健使用情况。
在这项澳大利亚初级保健中心力衰竭的研究（SHAPE）中，我们分析了 2013 年 7 月 1 日至 2018 年 6 月 30 日期间，43 家诊所共 193 万成年患者的记录。我们确定并检查了 20219 例 HF 患者的数据，以描述就诊频率和使用医疗保险福利计划项目的情况。
HF 患者平均每年看医生 14.4 次；59.5%的患者有全科医生管理计划（GPMP），2.9%的 GPMP 每年或更频繁地进行审查，46.8%的患者被转诊给心脏病专家。共有 3761 例患者同时患有焦虑或抑郁，其中 37.1%有心理健康计划。
HF 患者经常看医生，但许多患者未接受指南推荐的治疗，也未被转诊给心脏病专家。护理计划和审查的低使用率为 GP 提供了改善护理的机会。
