OBJECTIVE: To audit general paediatric outpatient practice in Australia, including consultation characteristics and management patterns, diagnoses, factors associated with diagnoses, and billing practices. DESIGN, SETTING AND PARTICIPANTS: In October-November 2008, members of the Australian Paediatric Research Network (APRN; a national network of paediatricians established to facilitate multisite secondary care research) were invited to prospectively complete brief standardised data collection forms for 100 consecutive patients or all patients during a 2-week period, whichever came first. MAIN OUTCOME MEASURES: Length of consultation and type of diagnoses made; proportions recorded as having medications, investigations or referral; odds ratios for factors associated with diagnoses; and proportions of Medicare items billed. RESULTS: Of 300 APRN members, 199 (66%) completed data forms for 8345 consultations in which 15 375 diagnoses were made (mean, 1.8 diagnoses per consultation); 46.0%, 30.9% and 22.8% of consultations involved 1, 2 and ≥ 3 diagnoses, respectively. New and review consultations lasted a mean of 41 (SD, 20) and 26 (SD, 15) minutes, respectively. The most common diagnoses were attention deficit hyperactivity disorder (18.3%), baby checks (9.1%), and learning difficulties (7.5%). Patients seen in 47.5% of consultations had medications (eg, prescriptions, vaccinations) recorded, and patients in 27.2% of consultations were referred elsewhere, usually to a subspecialist or psychologist (31.6% and 26.6% of referrals, respectively). Male sex of the child and owning a Health Care Card were associated with most developmental-behavioural diagnoses. Paediatricians tended to bill for single disease/non-complex consultations, even when seeing a child with multiple problems. CONCLUSIONS: Australian paediatricians see children with a range of diagnoses that are often multiple and complex. Our findings provide directions for future secondary care research, and may inform workforce planning and paediatricians' training requirements.
OBJECTIVE: To audit general paediatric outpatient practice in Australia, including consultation characteristics and management patterns, diagnoses, factors associated with diagnoses, and billing practices. DESIGN, SETTING AND PARTICIPANTS: In October-November 2008, members of the Australian Paediatric Research Network (APRN; a national network of paediatricians established to facilitate multisite secondary care research) were invited to prospectively complete brief standardised data collection forms for 100 consecutive patients or all patients during a 2-week period, whichever came first. MAIN OUTCOME MEASURES: Length of consultation and type of diagnoses made; proportions recorded as having medications, investigations or referral; odds ratios for factors associated with diagnoses; and proportions of Medicare items billed. RESULTS: Of 300 APRN members, 199 (66%) completed data forms for 8345 consultations in which 15 375 diagnoses were made (mean, 1.8 diagnoses per consultation); 46.0%, 30.9% and 22.8% of consultations involved 1, 2 and ≥ 3 diagnoses, respectively. New and review consultations lasted a mean of 41 (SD, 20) and 26 (SD, 15) minutes, respectively. The most common diagnoses were attention deficit hyperactivity disorder (18.3%), baby checks (9.1%), and learning difficulties (7.5%). Patients seen in 47.5% of consultations had medications (eg, prescriptions, vaccinations) recorded, and patients in 27.2% of consultations were referred elsewhere, usually to a subspecialist or psychologist (31.6% and 26.6% of referrals, respectively). Male sex of the child and owning a Health Care Card were associated with most developmental-behavioural diagnoses. Paediatricians tended to bill for single disease/non-complex consultations, even when seeing a child with multiple problems. CONCLUSIONS: Australian paediatricians see children with a range of diagnoses that are often multiple and complex. Our findings provide directions for future secondary care research, and may inform workforce planning and paediatricians' training requirements.
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Authors: Tamara D Hooper; Peter D Hibbert; Nicole Mealing; Louise K Wiles; Adam Jaffe; Les White; Christopher T Cowell; Mark F Harris; William B Runciman; Stan Goldstein; Andrew R Hallahan; John G Wakefield; Elisabeth Murphy; Annie Lau; Gavin Wheaton; Helena M Williams; Clifford Hughes; Jeffrey Braithwaite Journal: BMJ Open Date: 2015-04-08 Impact factor: 2.692
Authors: E Sciberras; M Mulraney; H Heussler; N Rinehart; T Schuster; L Gold; N Hayes; H Hiscock Journal: BMJ Open Date: 2017-04-04 Impact factor: 2.692
Authors: Jeffrey Braithwaite; Peter D Hibbert; Adam Jaffe; Les White; Christopher T Cowell; Mark F Harris; William B Runciman; Andrew R Hallahan; Gavin Wheaton; Helena M Williams; Elisabeth Murphy; Charlotte J Molloy; Louise K Wiles; Shanthi Ramanathan; Gaston Arnolda; Hsuen P Ting; Tamara D Hooper; Natalie Szabo; John G Wakefield; Clifford F Hughes; Annette Schmiede; Chris Dalton; Sarah Dalton; Joanna Holt; Liam Donaldson; Ed Kelley; Richard Lilford; Peter Lachman; Stephen Muething Journal: JAMA Date: 2018-03-20 Impact factor: 56.272
Authors: Emma Sciberras; Daryl Efron; Elizabeth J Schilpzand; Vicki Anderson; Brad Jongeling; Philip Hazell; Obioha C Ukoumunne; Jan M Nicholson Journal: BMC Psychiatry Date: 2013-01-10 Impact factor: 3.630