Dataset Information

Association between telehealth use and general practitioner characteristics during COVID-19: findings from a nationally representative survey of Australian doctors.

ABSTRACT:

Objective

To investigate factors associated with the use of telehealth by general practitioners (GPs) during COVID-19.

Design

A nationally representative longitudinal survey study of Australian doctors analysed using regression analysis.

Setting

General practice in Australia during the COVID-19 pandemic.

Participants

448 GPs who completed both the 11th wave (2018-2019) of the Medicine in Australia: Balancing Employment and Life (MABEL) Survey and the MABEL COVID-19 Special Online Survey (May 2020).

Outcome measures

Proportion of all consultations delivered via telephone (audio) or video (audiovisual); proportion of telehealth consultations delivered via video.

Results

46.1% of GP services were provided using telehealth in early May 2020, with 6.4% of all telehealth consultations delivered via video. Higher proportions of telehealth consultations were observed in GPs in larger practices compared with solo GPs: between +0.21 (95% CI +0.07 to +0.35) and +0.28 (95% CI +0.13 to +0.44). Greater proportions of telehealth consultations were delivered through video for GPs with appropriate infrastructure and for GPs with more complex patients: +0.10 (95% CI +0.04 to +0.16) and +0.04 (95% CI +0.00 to +0.08), respectively. Lower proportions of telehealth consultations were delivered via video for GPs over 55 years old compared with GPs under 35 years old: between -0.08 (95% CI -0.02 to -0.15) and -0.15 (95% CI -0.07 to -0.22), and for GPs in postcodes with a higher proportion of patients over 65 years old: -0.005 (95% CI -0.001 to -0.008) for each percentage point increase in the population over 65 years old.

Conclusions

GP characteristics are strongly associated with patterns of telehealth use in clinical work. Infrastructure support and relative pricing of different consultation modes may be useful policy instruments to encourage GPs to deliver care by the most appropriate method.

SUBMITTER: Scott A

PROVIDER: S-EPMC7992380 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Recent research suggests that mental health problems in spouses of cancer survivors are associated with worse mental health in the survivors themselves. Adequately treating spousal mental health problems therefore represents an opportunity to improve outcomes for both cancer survivors and their co-surviving family members. OBJECTIVE:Using nationally representative data, this study sought to determine how depression treatment differs between spouses of cancer survivors with depression compared to the general married population and assess rural/urban disparities in treatment. DESIGN:The design of the study is cross sectional. PARTICIPANTS:Data are from the Medical Expenditures Panel Survey, a household-based survey of US adults; we concatenated data from 2004 to 2013. We identified spouses of cancer survivors (n =?225) and a comparison group of married adults (n =?3678). MAIN MEASURES:Key measures included depression, guideline concordance of depression treatment (at least four prescriptions related to depression treatment, or at least eight psychotherapy or counseling visits), and sociodemographic characteristics. Logistic regressions evaluated the association between whether their spouse had cancer and receipt of guideline-concordant treatment, controlling for sociodemographic characteristics; secondary analyses included rurality as a moderator. Analyses were weighted to account for the complex sampling design. KEY RESULTS:Spouses of cancer survivors were 33% less likely to receive guideline-concordant depression treatment than comparison spouses (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.45-0.99), controlling for covariates. Rural-urban disparities were observed: rural spouses of cancer survivors were 72% less likely to receive guideline-concordant treatment (OR 0.28, 95% CI 0.11-0.68) than rural comparison spouses. Spouses of cancer survivors and comparison spouses were no different in their receipt of any treatment versus no treatment. CONCLUSIONS:Spouses of cancer survivors with depression may be at increased risk of non-guideline-concordant depression treatment, particularly in rural areas. The findings have implications for identifying and educating individuals with depression in primary care and other clinical areas.

Project description:BACKGROUND: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. OBJECTIVE: To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. METHODS: Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. RESULTS: In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. CONCLUSIONS: Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in excess of AU$1.4 billion, thus indicating the prominence of back pain as a major economic, social and health burden.

Project description:BackgroundWHO estimates that about 170,000 deaths by suicide occur in India every year, but few epidemiological studies of suicide have been done in the country. We aimed to quantify suicide mortality in India in 2010.MethodsThe Registrar General of India implemented a nationally representative mortality survey to determine the cause of deaths occurring between 2001 and 2003 in 1·1 million homes in 6671 small areas chosen randomly from all parts of India. As part of this survey, fieldworkers obtained information about cause of death and risk factors for suicide from close associates or relatives of the deceased individual. Two of 140 trained physicians were randomly allocated (stratified only by their ability to read the local language in which each survey was done) to independently and anonymously assign a cause to each death on the basis of electronic field reports. We then applied the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India to estimate the number of suicide deaths in India in 2010.FindingsAbout 3% of the surveyed deaths (2684 of 95,335) in individuals aged 15 years or older were due to suicide, corresponding to about 187,000 suicide deaths in India in 2010 at these ages (115,000 men and 72,000 women; age-standardised rates per 100,000 people aged 15 years or older of 26·3 for men and 17·5 for women). For suicide deaths at ages 15 years or older, 40% of suicide deaths in men (45,100 of 114,800) and 56% of suicide deaths in women (40,500 of 72,100) occurred at ages 15-29 years. A 15-year-old individual in India had a cumulative risk of about 1·3% of dying before the age of 80 years by suicide; men had a higher risk (1·7%) than did women (1·0%), with especially high risks in south India (3·5% in men and 1·8% in women). About half of suicide deaths were due to poisoning (mainly ingestions of pesticides).InterpretationSuicide death rates in India are among the highest in the world. A large proportion of adult suicide deaths occur between the ages of 15 years and 29 years, especially in women. Public health interventions such as restrictions in access to pesticides might prevent many suicide deaths in India.FundingUS National Institutes of Health.

Project description:ObjectiveThis study aimed to investigate the pattern of general practice services utilization for Australian children and to examine socio-demographic disparities in general practitioner (GP) visits.MethodsWe used the linked data from the nationally representative Longitudinal Study of Australian Children (LSAC) and the Medicare Australia claims data record. We used survey negative binomial and logistic regression to examine the socio-demographic factors associated with the utilisation of general practice services.ResultsThe average number of annual GP visits gradually declined from 7.0 at 0-1 year old to 2.4 at 5-8 years (p< .001 for trend) in the infant cohort and from 3.5 at 2-4 years to 2.0 at 9-12 years (p < .001 for trend) in the child cohort. Girls were more likely to visit GPs than boys at 0-1 year old in the infant cohort (RR = 1.06, 95%CI: 1.02-1.11) and at 2-4 years in the child cohort (RR = 1.09, 95%CI: 1.04-1.14), but there were no differences at 2-4 to 5-8 year age periods in the infant cohort and at 5-8 to 9-12 year age period in the child cohort. Children from non-English speaking background were more likely to have a greater number of GP visits compared with their counterparts from English-speaking and Indigenous background up to eight year old in both cohorts (all p < .001). Children from families with the higher socio-economic position, children without private health insurance and children living in non-metropolitan were less likely to have GP consultations in both cohorts. Fair or poor parent-rated health status was associated with greater number of GP visits.ConclusionSocio-demographic disparities existed in the utilisation of general practice services and varied at different age periods. Family socio-economic position, private health insurance coverage and region of residence strongly associates with the utilisation disparities over all age period. Further policy interventions are called to minimise the disparities in GP utilisation for children in Australian context.