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Policy changes bring different results in diabetes management

31 January, 2008

Government initiatives over the last few years have had different effects on the way general practitioners manage type 2 diabetes and depression, according to a report released by the Australian Institute of Health and Welfare (AIHW).

The report, General Practice Activity in Australia 2006–07, shows that diabetes policy initiatives have, on the whole, been associated with significant changes in management of this condition in GP surgeries. However, there is less evidence of change in depression management.

Professor Helena Britt, Head of the AIHW’s Australian General Practice Statistics and Classification Centre, based at the University of Sydney, said, ‘Since 2000, the Federal Government has introduced a number of programs and initiatives aiming to improve diabetes care, the most recent being the 2004 Action Plan.’

These programs and initiatives have had desired effects, including increased identification of new cases, higher referral rates to other health professionals, increased management rates in patients over 45, and increased attention to blood pressure and cholesterol levels as part of diabetes management plans,’ she said.

Initiatives in depression management, on the other hand, have had comparatively little effect, with the notable exception of the Government’s 2006 ‘Better Access’ initiative, which led to a big rise in GP referrals of patients with depression to psychologists.

‘Consultations involving the management of depression are 5–6 minutes longer than average. We believe that the increased referral rates reflect GP acknowledgement that counselling and therapy are important in the management of depression, but may be too time-consuming,’ Professor Britt said.

General Practice Activity in Australia 2006–07 reports the results from the Bettering the Evaluation and Care of Health (BEACH) program’s national survey of 100,000 GP–patient encounters. Other findings include:

- Patients aged 75 years and over and baby boomers (aged 45–64 years) are taking up an increasing proportion of GPs’ workloads.
- The number of tests and investigations ordered by GP continues to rise, particularly pathology test ordering. GPs ordered about 44% more tests (or batteries of tests) per 100 encounters in 2006–07 than in 2000–01.
- Among a sample of more than 32,000 attending patients, 58.5% were overweight or obese — a considerable increase on the 1998–99 figure of 51.1%.

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