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Strengthening care for children: pilot of an integrated general practitioner–paediatrician model of primary care in Victoria, Australia
Resource type
Authors/contributors
- Hiscock, Harriet (Author)
- O’Loughlin, Rachel (Author)
- Pelly, Rachel (Author)
- Laird, Catherine (Author)
- Holman, Jessica (Author)
- Dalziel, Kim (Author)
- Lei, Shaoke (Author)
- Boyle, Douglas (Author)
- Freed, Gary (Author)
Title
Strengthening care for children: pilot of an integrated general practitioner–paediatrician model of primary care in Victoria, Australia
Abstract
Objective The aim of this study was to assess the acceptability of a novel, integrated general practitioner (GP)–paediatrician model of care, aiming to reduce referrals to hospitals and improve primary care quality.
Methods A pre-post study was conducted with five general practice clinics in north-west Melbourne. Over 12 months, 49 GPs and 896 families participated in the intervention that included weekly to fortnightly paediatrician–GP co-consultation sessions at the general practice, monthly case discussions and telephone or email clinical support for GPs. GPs and families completed surveys or interviews at three time points (before the intervention, after running the model for 4 months and at the end of the implementation). Non-identifiable consultation data were extracted from general practice medical records.
Results All GPs found the model acceptable. Although not significant, there was a trend towards a lower proportion of referrals to private paediatricians after the intervention (from 34% to 20%) and emergency departments (from 19% to 12%). Outpatient clinic referrals remained steady, and then increased as the paediatrician left the clinics (31% vs 47% before and after the intervention respectively). Unnecessary prescribing of acid suppression medications decreased by 20% (from 29% to 9%). GPs reported improved confidence in paediatric care (88% vs 100% before and after the intervention respectively). Families reported increased confidence in GP care (78% vs 94% before and after the intervention respectively). Model cost estimates were A$172 above usual care per child seen in the co-consultations.
Conclusions This novel model of care is acceptable to GPs and families and may improve access and quality of paediatric care.
What is known about the topic? A GP–paediatrician integrated model of care appears effective in reducing hospital burden in England, but has not been implemented in Australia.
What does this paper add? This pilot, an Australian first, found that a GP–paediatrician integrated model of care is feasible and acceptable in Australia’s primary healthcare system, improves GP confidence and quality of paediatric care, may reduce paediatric referrals to outpatient clinics and emergency departments and improves family confidence in, and preference for, GP care.
What are the implications for practitioners? This model may reduce hospital burden and improve quality in GP paediatric care while potentially producing cost savings for families and the healthcare system.
Additional keywords: clinical services, consumers, health services research, models of care, primary health care.
Publication
Australian Health Review
Volume
44
Issue
4
Pages
569-575
Date
2020-2-12
Journal Abbr
Aust. Health Rev.
Language
en
DOI
10.1071/AH19177
ISSN
0156-5788, 1449-8944
Short Title
Strengthening care for children
Accessed
2025-07-07T01:00:04Z
Library Catalog
DOI.org (Crossref)
Citation
Hiscock, H., O’Loughlin, R., Pelly, R., Laird, C., Holman, J., Dalziel, K., Lei, S., Boyle, D., & Freed, G. (2020). Strengthening care for children: pilot of an integrated general practitioner–paediatrician model of primary care in Victoria, Australia. Australian Health Review, 44(4), 569–575. https://doi.org/10.1071/AH19177
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