Colleagues,
This from recent PHCRIS conference:
<http://www.phcris.org.au>
GP & PHC Research Conference Abstracts 2007
Effect of computerisation on quality of general practice care—a
comparison with quality indicators
Author(s)
Joan Henderson
<http://www.phcris.org.au/elib/browse.php?search=Joan+Henderson>, Graeme
Miller <http://www.phcris.org.au/elib/browse.php?search=+Graeme+Miller>,
Helena Britt
<http://www.phcris.org.au/elib/browse.php?search=+Helena+Britt>, Ying
Pan <http://www.phcris.org.au/elib/browse.php?search=+Ying+Pan>
Organisation
Family Medicine Research Centre, University of Sydney
Objectives
There is an assumption expressed in literature that computer use for
clinical activity will improve quality of general practice care, but
with little evidence to support or refute this assumption. This study
compares GPs using a computer to prescribe, order tests, or keep patient
records, with GPs who do not, using a set of validated quality indicators.
Methods
BEACH (Bettering the Evaluation and Care of Health) is a continuous
national cross-sectional survey of general practice activity in
Australia. A sub-sample of 1257 BEACH participants between November 2003
and March 2005 were grouped according to their computer use for: test
ordering, prescribing, and/or medical records. Linear regression
analysis was used to compare the two groups on a set of 33 quality
indicators.
Principal Findings
The univariate analysis showed that computerised GPs managed more
problems; provided fewer medications; ordered more pathology tests;
performed more Pap smears; provided more immunisations; ordered more
HbA1c tests and provided more referrals to ophthalmologists and allied
health workers for diabetes patients; and provided less lifestyle
counselling. After adjustment, the only differences that could be
contributed solely to computer use were prescribed medication rates,
lifestyle counselling and referrals to ophthalmologists. Two other
differences emerged—computerised GPs provided more referrals for allied
health workers for all patients, and fewer prescribed anti-depressants
for patients with depression. Twenty-two measures failed to discriminate
before or after adjustment.
Discussion
Deciding ‘best quality’ is subjective. While literature and guidelines
provide clear parameters for many measures, others are difficult to
judge. Only five differences were directly related to computer
use—computerised GPs performed better on four measures and worse on one.
Overall, there was little difference between the two groups.
Implications
This study has found little evidence to support the claim that
computerisation of general practice in Australia has changed the quality
of care provided to patients.
Presentation
Open document. <javascript:
openDoc('/phplib/filedownload.php?file=/elib/lib/downloaded_files/conference/presentations/3700_JoanHende.pdf');> PDF 563.5
Kb
Copyright © 2007 Primary Health Care Research and Information Service.
Copyright & Disclaimer information
<http://www.phcris.org.au/website/copyright_wd.php>
<http://www.phcris.org.au/images/logo/minilogo.gif> www.phcris.org.au
<http://www.phcris.org.au>
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
PRIVATE & CONFIDENTIAL
***********************************************************************
The information contained in this e-mail and their attached files,
including replies and forwarded copies, are confidential and intended
solely for the addressee(s) and may be legally privileged or prohibited
from disclosure and unauthorised use. If you are not the intended
recipient, any form of reproduction, dissemination, copying, disclosure,
modification, distribution and/or publication or any action taken or
omitted to be taken in reliance upon this message or its attachments is
prohibited.
All liability for viruses is excluded to the fullest extent permitted by
law.
***********************************************************************
_______________________________________________
Gpcg_talk mailing list
[email protected]
http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
