Den-Ching A Lee, Taya A Collyer, Grant Russell, Nadine E Andrew, Claire M C O'Connor, Keith D Hill, Kate Swaffer, Natasha Layton, Velandai Srikanth, Barbara Barbosa Neves, Lee-Fay Low, Yalchin Oytam, Galina Daraganova, Catherine Devanny, Michele L Callisaya
{"title":"转介到联合卫生专业人员的人与痴呆症：从两个澳大利亚初级卫生网络的全科医生数据的分析。","authors":"Den-Ching A Lee, Taya A Collyer, Grant Russell, Nadine E Andrew, Claire M C O'Connor, Keith D Hill, Kate Swaffer, Natasha Layton, Velandai Srikanth, Barbara Barbosa Neves, Lee-Fay Low, Yalchin Oytam, Galina Daraganova, Catherine Devanny, Michele L Callisaya","doi":"10.1136/fmch-2025-003470","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Setting: </strong>De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.</p><p><strong>Participants: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 3","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481295/pdf/","citationCount":"0","resultStr":"{\"title\":\"Referrals to allied health professionals for people with dementia: an analysis of general practitioner data from two Australian primary health networks.\",\"authors\":\"Den-Ching A Lee, Taya A Collyer, Grant Russell, Nadine E Andrew, Claire M C O'Connor, Keith D Hill, Kate Swaffer, Natasha Layton, Velandai Srikanth, Barbara Barbosa Neves, Lee-Fay Low, Yalchin Oytam, Galina Daraganova, Catherine Devanny, Michele L Callisaya\",\"doi\":\"10.1136/fmch-2025-003470\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Setting: </strong>De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.</p><p><strong>Participants: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":44590,\"journal\":{\"name\":\"Family Medicine and Community Health\",\"volume\":\"13 3\",\"pages\":\"\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481295/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Family Medicine and Community Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/fmch-2025-003470\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Family Medicine and Community Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/fmch-2025-003470","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
Referrals to allied health professionals for people with dementia: an analysis of general practitioner data from two Australian primary health networks.
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.
期刊介绍：
Family Medicine and Community Health (FMCH) is a peer-reviewed, open-access journal focusing on the topics of family medicine, general practice and community health. FMCH strives to be a leading international journal that promotes ‘Health Care for All’ through disseminating novel knowledge and best practices in primary care, family medicine, and community health. FMCH publishes original research, review, methodology, commentary, reflection, and case-study from the lens of population health. FMCH’s Asian Focus section features reports of family medicine development in the Asia-pacific region. FMCH aims to be an exemplary forum for the timely communication of medical knowledge and skills with the goal of promoting improved health care through the practice of family and community-based medicine globally. FMCH aims to serve a diverse audience including researchers, educators, policymakers and leaders of family medicine and community health. We also aim to provide content relevant for researchers working on population health, epidemiology, public policy, disease control and management, preventative medicine and disease burden. FMCH does not impose any article processing charges (APC) or submission charges.
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