Older patients' consultations in an apprenticeship model-based general practice training program: A cross-sectional study

Abstract

Objective: To investigate older patients' encounters with general practice registrars (GPRs) to inform training and clinical practice. Methods: Cross-sectional analysis of data from GPR consultations across five regional training providers in Australia. Data were analysed using simple and multiple logistic regression models. Results: Our analysis included details of 118 831 consultations, 20 555 (17.6%, 95% CI 17.4–17.8) with patients aged ≥65 years. Older patient encounters had an increased likelihood of including chronic disease (OR 1.77, 95% CI 1.70, 1.86) and more problems (OR 1.24, 95% CI 1.20, 1.27). However, in-consultation information or advice was less likely to be sought (OR 0.92, 95% CI 0.88, 0.97), and consultations were briefer (OR 0.99, 95% CI 0.99, 1.00). Conclusion: Our results suggest relatively limited GPR exposure to older patients coupled with less complex consultations than expected. Solutions will need to be carefully constructed not only to increase caseloads, but also to address training and supervision concerns. © 2016 AJA Inc.

Keywords

Author Keywords

Vocational education Graduate Family Practice General Practice aged care Medical

Index Keywords

adult attitude to health cross-sectional study female human male medical education procedures Cross-Sectional Studies Health Knowledge, Attitudes, Practice Humans Australia education general practice general practitioner General Practitioners clinical practice middle aged educational model Models, Educational clinical trial age aged patient referral Practice Patterns, Physicians' Referral and Consultation Education, Medical, Graduate multivariate analysis statistical model multicenter study time factor Time Factors Physician-Patient Relations Logistic Models doctor patient relation Age Factors odds ratio patient attitude Patient Acceptance of Health Care

Author Affiliations

Discipline of General Practice, The University of Newcastle, Australia, Callaghan, NSW, Australia

Hunter Medical Research Institute, Australia, Newcastle, NSW, Australia

Discipline of General Practice, The University of Queensland, Brisbane, QLD, Australia

Department of General Practice, University of Melbourne, Melbourne, VIC, Australia

Elermore Vale General Practice, Newcastle, NS, Australia

School of Medicine, University of Wollongong, Wollongong, NSW, Australia

Funding & Acknowledgements

No funding information

References 10 References

1 World Population Ageing 1950 2050, (2002)

2 Brítt, Helena C., Prevalence and patterns of multimorbidity in Australia, Medical Journal of Australia, 189, 2, pp. 72-77, (2008)

3 Coleman, Eric A., Falling through the cracks: Challenges and opportunities for improving transitional care for persons with continuous complex care needs, Journal of the American Geriatrics Society, 51, 4, pp. 549-555, (2003)

4 Barnett, Karen N., Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study, The Lancet, 380, 9836, pp. 37-43, (2012)

5 General Practice Activity in Australia 2002 03, (2003)

6 Towards Age Friendly Primary Health Care, (2004)

7 de Jong, Jip, Exploring differences in patient mix in a cohort of GP trainees and their trainers, BMJ Open, 1, 2, (2011)

8 Clinical Activities of Vma Registrars in Each Stage of Training, (2006)

9 Caine, Noreen, Study of trainer/trainee workload with special reference to the care of the elderly., Journal of the Royal College of General Practitioners, 35, 278, pp. 419-422, (1985)

10 Bonney, Andrew D., The older patient, the general practitioner and the trainee: Patients' attitudes and implications for training, Education for Primary Care, 23, 3, pp. 186-195, (2012)

Older patients' consultations in an apprenticeship model-based general practice training program: A cross-sectional study

How to Cite