Paediatric care in general practice: Case mix, referral patterns and healthcare costs.

Abstract

Background and objectives: There are no contemporary data to describe which paediatric conditions general practitioners (GPs) see, which conditions they refer, and where and whether referrals differ by general practice, patient or GP factors. A better understanding of the this could inform GP training needs and workforce planning. The aim of this study was to address knowledge gaps around the case mix of general practice paediatric consultations, as well as GP referral patterns, associated factors and costs.

Method: A cross-sectional analysis of 49,932 paediatric consultations was performed across 22 general practices in Victoria and New South Wales involving 130 GPs. General practice electronic medical records were analysed to determine consultation reasons and referrals.

Results: Common reasons for visits included medical issues, immunisations, developmental-behavioural concerns, check-ups and mental health. GPs referred 10% of visits, predominantly for mental health. Referral patterns were associated with private billing, GP demographics, patient characteristics and years of working in general practice. Most referrals were to private specialists. Estimated costs to the healthcare system were $1.39 million.

Discussion: GPs mostly refer to private specialists for mental health and developmental-behavioural concerns, particularly with private billing, indicating access disparities. Increased public sector capacity for these conditions is needed. Strengthening paediatric primary care could yield significant cost savings by reducing referrals.