Health assessments of an 'at risk' population in general practice. Resource implications of identifying unmet health care needs--a case study.
OBJECTIVE
To estimate the resource implications associated with health care assessments for patients with chronic disease and those aged 75-years and over.


METHODS
A four doctor general practice on the NSW Central Coast.


METHODS
Examination of eligible patients according to health assessment guidelines, and development of health care plans where appropriate. Economic modelling of time and monetary resource requirements for these activities and the follow up management of identified health care issues.


RESULTS
Eighty-four patients (80.8%) had a total of 181 additional health care issues identified--73 were geriatric specific, 32 preventive, 63 general medical and 13 of a support services nature. The assessments required a total of 61.5 hours (mean: 36 mins)--GP: 42 hours (mean: 24 mins); nurse: 20 hours (mean: 11 mins)--at a total cost to Medicare of $15,075 (mean: $145). Modelling of the resource requirements estimate a time requirement of 117.5 hours for the GP (mean: 1.1 hours), 57 hours for specialists (mean: 33 mins) and 140 hours for allied health providers (mean: 1.3 hours). The costs to the community are $11,511 for the GP (mean: $111), $18,791 for specialists (mean: $181) and $6688 for allied health care professionals (mean: $64).


CONCLUSIONS
Health assessments of an 'at risk' population in general practice may be worthwhile. However, the resource requirements of all members of the health care system may be so high as to make it unsustainable.
Sturmberg
J P
JP
Rural Health, School of Rural Health, University of New South Wales. j.sturmberg@unsw.edu.au
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy*; D005194:Family Practice / Q000191:economics* / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D020380:Needs Assessment; D009517:New South Wales; D018570:Risk Assessment