Australian Medical Association

MJA media release - With the introduction of the Government’s Medicare Locals scheme, the future role of Divisions of General Practice is unclear, according to an article published in the Medical Journal of Australia.

Professor Philip Davies, Professor of Health Systems and Policy for the School of Population Health at the University of Queensland, analysed the potential future role of Divisions under the establishment of Medicare Locals.

Prof Davies said that the Australian Government intends for Medicare Locals to assume many of the roles currently undertaken by Divisions.

“Decisions by the Australian Government will play a large part in determining the future of Divisions,” Prof Davies said.

MJA media release - Medicare reforms recently introduced by the Federal Government, including changes to Levels B, C and D consultation item descriptors, may not be sufficient to change consultation patterns in general practice to better match health policy objectives, according to research published in the Medical Journal of Australia.

Dr Michael Taylor, Research Fellow at the Australian Institute for Primary Care at La Trobe University, Melbourne, and co-authors conducted a retrospective analysis of more than one billion Medicare claims made between 1994 and 2009 for general practice standard consultations, health assessments, care plans and other special MBS items.

They found that the use of Levels C and D (long) consultations increased consistently from 1994 to 2004, but declined dramatically by 2009. This was accompanied by an increase in the use of Level A (short) consultations.

MJA media release - Evidence shows no difference in professional satisfaction between metropolitan and rural GPs, according to a study published in the Medical Journal of Australia.

Dr Matthew McGrail from the Gippsland Medical School and the School of Rural Health at Monash University, VIC, and his co-authors conducted a study investigating whether the level of professional satisfaction of Australian general practitioners varied according to community size and location.

The authors used data from 3906 GPs who participated in the first wave of the Medicine in Australia: Balancing Employment and Life (MABEL) study conducted between June and November 2008.

MJA media release - GPs’ close relationships with pathology companies do not appear to influence the volume of tests they order, according to a study published in the Medical Journal of Australia.

Using data from the Bettering the Evaluation and Care of Health (BEACH) program, Prof David Studdert, from the School of Population Health at the University of Melbourne, and co-authors calculated test ordering rates of GPs in practices that were co-located with pathology collection centres (PCCs) operated by private companies, and compared them with test ordering rates of GPs working in practices located apart from these collection centres.

Prof Studdert said simple comparisons showed that GPs in co-located practices ordered more pathology tests than GPs in practices located apart from PCCs (40.3 tests compared with 37 tests per 100 GP-patient encounters). The GPs in co-located practices were also more likely to order one or more tests in any given consultation (16.8 per cent compared with 15.5 per cent).

MJA media release - Obese and morbidly obese patients are at significantly greater risk of complications after a total hip reconstruction than non-obese patients, according to research published in the Medical Journal of Australia.

Prof Peter Choong, Director of the Department of Orthopaedics at St Vincent’s Hospital, Melbourne, and co-authors conducted a prospective study of 471 patients who underwent total hip arthroplasty (THA) between 2006 and 2007.

They found that the risk of complications in the first 12 months after THA increased by seven per cent for each unit increase in body mass index (BMI), after adjusting for age and sex, with morbidly obese patients having an almost sixfold higher complication rate than non-obese patients.

MJA media release - A majority of Australians support laws that enable women to access late abortion, depending on the circumstances, according to research published in the Medical Journal of Australia.

Dr Lachlan de Crespigny, Prof Julian Savulescu and colleagues from the Oxford Uehiro Centre for Practical Ethics at the University of Oxford, UK, report an anonymous survey of 1050 Australians aged 18 years or older between 28 and 31 July 2008. It was conducted by Crosby/Textor, a leading public opinion research firm.

Their study found a high level of support for access to early abortion, with 87 per cent of respondents indicating that abortion should be lawful in the first trimester.

MJA media release - Removing reimbursements to hospitals for treating hospital-acquired conditions (HACs) could add further incentive to current initiatives aimed at reducing complications of care, according to research published in the Medical Journal of Australia.

Mr Peter McNair, Clinical Epidemiologist at the Palo Alto Medical Foundation Research Institute, US, and Visiting Fellow at the University of California, San Francisco (UCSF), and co-authors conducted a retrospective study to model the effect of excluding payment for eight HACs on hospital payments in Victoria.

Such a policy has been implemented by the US Centers for Medicare and Medicaid Services, which ceased paying for eight specific HACs that are considered preventable.

MJA media release - Effective implementation of an evidence-based bowel cancer-screening program could reduce the number of deaths from the disease by almost a quarter, according to an article published in the Medical Journal of Australia.

The article by Ms Kathy Flitcroft, Research Fellow (Health Policy) at the Sydney School of Public Health and co-authors, analyses the history, development, implementation and effectiveness of bowel cancer-screening policy in Australia over the past fifteen years.

“Research evidence appears to have played a major role in the development of bowel cancer screening policy proposals.  However, policy decisions about how best to implement the program have not been evidence based and reflect a lack of understanding of the importance of research evidence in population screening programs,” Ms Flitcroft said.

MJA media release - Medical staff rarely consider family history when caring for acutely ill patients in hospital, according to research published in the Medical Journal of Australia.

Dr Andrew Langlands, from the Royal Perth Hospital, and co-authors conducted an audit of the medical records of 300 randomly selected patients who were admitted to the hospital’s short-stay medical unit between July and December 2007.

Their study showed that 73.7 per cent of patient records had no family history documented, and just 16 per cent contained a family history with specific details about the presence or absence of a medical condition in at least one relative.

MJA media release - Inconsistent guidelines for low alcohol intake or abstinence during pregnancy are confusing for pregnant women and have little effect on women’s alcohol intake during pregnancy, according to research published in the Medical Journal of Australia.

Ms Jennifer Powers, statistician at the University of Newcastle, NSW, and co-authors analysed data collected by the Australian Longitudinal Study on Women’s Health from women aged 22-33 years who were pregnant before October 2001, when guidelines recommended zero alcohol, or who were first pregnant after October 2001, when guidelines recommended low alcohol intake.

They found that women’s alcohol intake prior to pregnancy was the strongest determinant of alcohol intake during pregnancy, whereas guidelines for low alcohol intake or abstinence had little effect.