Referrals to allied health professionals for people with dementia: an analysis of general practitioner data from two Australian primary health networks.

Abstract

Objective: To examine general practitioners' (GPs) referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks (PHNs).

Design: A retrospective cohort study using routinely collected general practice data. Logistic regression was used to compare odds of allied health referrals, adjusting for age, sex and socioeconomic status.

Setting: De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.

Participants: Data from 1 153 304 patients and 28 667 517 GP episodes of care were analysed. After merging records, 693 328 unique patients were identified, including 16 610 patients with dementia. Subcohorts included patients with dementia, stroke, Parkinson's disease and combinations of these conditions.

Results: The dementia cohort (n=16 610) had a similar overall allied health referral rate (36.1%) to the control cohort (n=48 977) (35.4%). Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke (adjusted OR (aOR) 0.76, 95% CI 0.72 to 0.80; p<0.001) or Parkinson's disease (aOR 0.72, 95% CI 0.66 to 0.78; p<0.001). Those with dementia and stroke were also less likely to receive referrals than those with stroke only (aOR 0.71, 95% CI 0.61 to 0.82; p<0.001). No significant difference was found between dementia with Parkinson's and Parkinson's only groups (p=0.48). Patients with dementia were consistently less likely to be referred to key allied health services (p<0.05).

Conclusion: Despite strong evidence supporting allied health interventions for dementia, referral rates remain comparatively low. Enhancing GP referral resources and education, integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.