PubMed Health⌕ Search

Biomedical subjects

Graeme Miller

Publications and source records attributed to Graeme Miller.

9 recordsLinked to original sources

Extent and utilisation of computerisation in Australian general practice.

OBJECTIVE: To assess the availability of computers to general practitioners and individual GPs' use of computers for clinical functions. DESIGN, SETTING AND PARTICIPANTS: A secondary analysis of data from a random sample of 1319 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of general practice activity, between November 2003 and March 2005. Participants reported the availability of computers at their major practice address and the clinical functions for which they used the computers. MAIN OUTCOME MEASURES: Proportion of practices with computers available; proportion of individual GPs who used computers for clinical purposes. RESULTS: The proportion of GPs not using a computer was 11.2% (6% did not have a computer at their major practice address and a further 5.2% chose not to use an available computer). The majority of GPs using a computer at work used it for electronic prescribing (94.7%), ordering tests (82.2%) and keeping some patient data in an electronic medical record (79.5%). Of those with clinical software available (n = 1114), 6.6% chose not to use it. A third of GPs (32.8%) kept all patient information in an electronic format. The proportion of GPs keeping all data electronically and using all clinical functions available in their computer was 21.7%. CONCLUSION: While the physical presence of computers has increased significantly over the past decade, GPs are still reluctant to fully embrace the technology.

Attitude of Health Personnel↗

Management of psychosis in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of psychoses. In this analysis we have included schizophrenia, affective disorders/bipolar, organic psychoses, and senile psychoses, with undefined psychosis and chronic brain syndrome grouped as 'other'. This synopsis provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

Adolescent↗

GI malignancies in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of gastrointestinal (GI) malignancy. In this analysis we have included all bowel cancers; upper GI malignancies (stomach, oesophagus); and 'other' which include carcinomas of the liver, gall bladder, pancreas, tongue and parotid gland. This synopsis provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

Age Distribution↗

Use of diagnostic imaging in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of diagnostic imaging ordered by Australian general practitioners. This provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

Adolescent↗

Management of type 2 diabetes in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of type 2 diabetes management in Australian general practice. Terms used by the general practitioner participants included in this analysis were: type 2 diabetes, noninsulin dependent diabetes, diabetes mellitus, adult onset diabetes, and insulin treated type 2 diabetes. This provides a backdrop against which the articles in this issue of Australian Family Physician can be further considered.

Adult↗

Presentations of diarrhoea in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of the consultations in general practice involving a patient presentation of diarrhoea. This provides a backdrop against which articles in this issue of the Australian Family Physician can be further considered.

Adolescent↗

Management of renal problems in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of renal problems. In this analysis, we have included renal failure, glomerulonephritis/nephrosis (all forms of nephritis and nephrotic syndrome), renal insufficiency, nephropathy (including diabetic and analgesic), and uraemia and nephrosclerosis grouped as 'other'. This synopsis provides a backdrop against which articles in this issue of Australian Family Physician can be further considered.

Adult↗

Relationship between general practitioner certification and characteristics of care.

BACKGROUND: The introduction of mandatory or quasimandatory certification processes for general/family doctors has become common in many countries, including Australia. Whether certification effects the care provided is rarely investigated. OBJECTIVES: The objective of this study was to determine whether certification of general/family physicians is associated with clinical performance. RESEARCH DESIGN: We conducted a secondary comparative analysis of data from an Australian national cross-sectional survey (April 2000-March 2002). SUBJECTS: Subjects consisted of a random sample of 1982 general practitioners (GPs) METHODS: Each participant provided demographic details and information about 100 consecutive patient encounters (total 197,500). We compared characteristics of certified and uncertified general practitioners (GPs), their patients, encounters, problems, management actions, and tested 34 performance indicators. We investigated whether differences identified in descriptive analyses were explained by other factors. RESULTS: Of 1975 GPs who indicated certification status, 659 (33.4%) were vocationally certified. Certificants were more likely to be female, younger, Australian graduates, working fewer sessions, in larger practices, in accredited practices, and using computers for clinical purposes. Their patients were younger, more often female, and less likely to hold a healthcare concession card. Their consultations were longer; they prescribed fewer medications and more clinical treatments and procedures, ordered more pathology tests, and referred more to other health professionals. After adjustment for GP/practice, patient and morbidity differences, certificants had longer consultations, did more therapeutic procedures, prescribed less overall, prescribed fewer nonsteroidal antiinflammatory drugs in the elderly, and fewer antibiotics for upper respiratory infections. CONCLUSION: Certification of general practitioners has a significant association with consultation behavior and patient management.

Adult↗

Time for care. Length of general practice consultations in Australia.

BACKGROUND: Past estimates of the length of Australian general practice consultations have been based on Medicare item numbers claimed, which carries probable serious inaccuracies. AIMS: To describe the length of general practitioner consultations. METHODS: A random sample of 926 GPs recorded the start and finish times in minutes of their consultations for which a Medicare item number was claimed between April 2000 and March 2001, within a continuous cross sectional national study of general practice activity. RESULTS: Mean length of the consultations was 14.8 minutes (range 1-106). Mean length per GP varied widely (mean of means 14.8, range 3-39, mode 15.0 minutes). Female GPs had significantly longer consultations than males. Younger (< 45 years) male metropolitan GPs had the shortest mean length. Most attendances (85.7%) were designated Level B, 1.5% as Level A, 11.7% Levels C and 1.1% as level D. Mean length of Level A was 7.1 minutes, Level B-13.0, Level C-26.1, and Level D-44.9 minutes. CONCLUSION: This study suggests that the majority of GPs are not practising 'six minute medicine', and may assist cost projections of any changes to the Medicare Schedule.

Adult↗