GPs see more than 90% of permanent aged care residents: Report

Doug Hendrie

16/09/2020 4:25:12 PM

And they see each resident an average of around twice a month, according to the latest AIHW figures.

Older man talking with young male GP
GPs play a vital role in caring for residents in permanent aged care.

Data from 2016–17 shows 92% of residents saw a GP while in care, up from 89% in 2012–13, the Australian Institute of Health and Welfare (AIHW) report on the GP–aged care interface indicates.
This figure includes GPs visiting a residential aged care facility (RACF) and external trips to see GPs.
The number of GP visits went up 30% in that period from 2012–13 to 2016–17, from 3.5 million to 4.5 million, while the number of aged care residents increased by only 5.9%.
Almost 60% of Australian aged care residents live in RACFs with inadequate staffing levels, while only 1.3% live in facilities with best practice ‘five star’ staffing, according to a recent MJA report.
The AIHW report notes that GPs are an 'important part of the healthcare team, as they provide whole-of-person clinical care and services such as prescribing and monitoring medicine use, referrals to specialists, and a point of liaison between the many healthcare professionals a person might see.'
‘For these reasons, regular access to GPs – either through the GPs visiting an aged care facility or through the resident leaving the facility to visit a GP – is a critical part of quality residential aged care.
‘As programs and policies have sought to assist people to live at home for as long as possible, those who enter permanent residential aged care may also do so in an increasingly more frail state, but this is difficult to assess using available aged care data.’
Residents who did not receive any GP services through Medicare were likely to do so elsewhere, with 84% of those who did not use Medicare-funded services accessing pharmacy services using a Department of Veterans’ Affairs card.
Dementia and musculoskeletal issues were the two most common medical issues for people in aged care, with both affecting 54% of residents. 
Around one in four (26%) people had a medication management review while in permanent aged care, while 37% had a chronic disease management plan done, and 33% had a health assessment.
Clinical Professor Leanne Rowe told newsGP the AIHW report shows the critical role GPs play in caring for older Australians in RACFs.
‘However, the pandemic has reminded us that we need to see better collaboration between primary and secondary healthcare providers, and better continuity of care, including after hours,’ she said.
‘This is difficult to achieve because of poor Medicare and other funding and fragmentation of services.
‘I am hopeful that the [aged care] royal commission will highlight the urgent need to transform the way healthcare is provided and funded in residential aged care.’
Aged care is currently under significant scrutiny, with last year’s aged care royal commission interim report finding significant deficiencies and calling for a ‘fundamental overhaul’ of the sector.
The COVID-19 pandemic has also hit the sector disproportionately hard, with aged care residents accounting for most of Australia’s deaths – 604 out of 816 in total.
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Dr Leah Curtis   17/09/2020 8:27:29 PM

One specific issue (among many) recently is the increased demand by facilities for us to sign multiple orders, directives etc. They are all different in each facility, especially re "chemical/restrictive medication" orders. Where is the evidence? Why aren't there standardised and electronic forms? And where do I get the time to complete them (and get paid for it?)