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澳大利亚初级保健中的足部、踝关节和腿部问题:咨询模式、管理实践和费用。

Foot, ankle, and leg problems in Australian primary care: consultation patterns, management practices, and costs.

机构信息

Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia.

School of Primary and Allied Health Care, Monash University, Frankston, VIC 3199, Australia.

出版信息

Fam Pract. 2024 Aug 14;41(4):426-433. doi: 10.1093/fampra/cmac122.

Abstract

OBJECTIVE

To explore consultation patterns, management practices, and costs of foot, ankle, and leg problems in Australian primary care.

STUDY DESIGN

We analyzed data from the Bettering the Evaluation and Care of Health program, April 2000 to March 2016. Foot, ankle, and leg problems were identified using the International Classification of Primary Care, Version 2 PLUS terminology. Data were summarized using descriptive statistics examining general practitioner (GP) and patient characteristics associated with a foot, ankle, or leg problem being managed. Cost to government was estimated by extracting fees for GP consultations, diagnostic imaging, and pathology services from the Medicare Benefits Schedule (MBS) database. Costs for prescription-only medicines were extracted from the Pharmaceutical Benefits Schedule and for nonprescribed medications, large banner discount pharmacy prices were used.

RESULTS

GPs recorded 1,568,100 patient encounters, at which 50,877 foot, ankle, or leg problems were managed at a rate of 3.24 (95% confidence intervals [CIs] 3.21-3.28) per 100 encounters. The management rate of foot, ankle, or leg problems was higher for certain patient characteristics (older, having a health care card, socioeconomically disadvantaged, non-Indigenous, and being English speaking) and GP characteristics (male sex, older age, and Australian graduate). The most frequently used management practice was the use of medications. The average cost (Australian dollars) per encounter was A$52, with the total annual cost estimated at A$256m.

CONCLUSIONS

Foot, ankle, and leg problems are frequently managed by GPs, and the costs associated with their management represent a substantial economic impact in Australian primary care.

摘要

目的

探索澳大利亚初级保健中足部、踝关节和腿部问题的咨询模式、管理实践和成本。

研究设计

我们分析了 2000 年 4 月至 2016 年 3 月期间 Bettering the Evaluation and Care of Health 计划的数据。使用国际初级保健分类第 2 版加术语识别足部、踝关节和腿部问题。使用描述性统计方法总结与足部、踝关节或腿部问题管理相关的一般从业者(GP)和患者特征数据。从医疗保险福利计划(MBS)数据库中提取 GP 咨询、诊断成像和病理服务的费用来估算政府成本。从药品福利计划中提取处方药的费用,并使用大型招牌折扣药店的价格提取非处方药的费用。

结果

GP 记录了 1568100 次患者就诊,其中有 50877 次足部、踝关节或腿部问题的管理率为每 100 次就诊 3.24(95%置信区间[CI]3.21-3.28)。某些患者特征(年龄较大、持有医疗卡、社会经济地位较低、非土著居民和讲英语)和 GP 特征(男性、年龄较大和澳大利亚毕业生)的足部、踝关节或腿部问题管理率较高。最常用的管理实践是使用药物。每次就诊的平均费用(澳元)为 52 澳元,估计每年的总成本为 2.56 亿澳元。

结论

足部、踝关节和腿部问题经常由 GP 管理,其管理相关成本代表了澳大利亚初级保健中重大的经济影响。

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