General practitioners' role in preventive medicine: scenario analysis using alcohol as a case study.
The purpose of this analysis is threefold: first, to extract from the literature, current levels of GP detection of at-risk drinking by their patients, rates at which general practitioners (GPs) offer an intervention; and the effectiveness of these interventions; secondly, to develop a model based on this literature to be used in conjunction with scenario analysis; and thirdly, to consider the cost implications of current efforts and various scenarios. This study deals specifically with Australian general practice. A two-step procedure is used in the scenario analysis, which involves identifying opportunities for detection, intervention, effectiveness and assigning probabilities to outcomes. The results suggest that increasing rates of GP intervention achieves greatest benefit and return on resource use. For every 5% point increase in the rate of GP intervention, an additional 26 754 at-risk drinkers modify their drinking behaviour at a cost of dollars 231.45 per patient. This compares with a cost per patient modifying drinking behaviour of dollars 232.60 and dollars 208.31 for every 5% point increase in the rates of detection and effectiveness, respectively. The knowledge, skill and attitude of practitioners toward drinking are significant, and they can be the prime motivators in persuading their patients to modify drinking behaviour.
Doran
Christopher M
CM
School of Population Health University of Queensland, Australia. c.doran@sph.uq.edu.au
Shakeshaft
Anthony P
AP
Fawcett
Julia E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control* / Q000534:rehabilitation; D001315:Australia; D001521:Behavior Therapy / Q000191:economics; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D005194:Family Practice / Q000191:economics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010349:Patient Compliance / Q000706:statistics & numerical data; D010819:Physician's Role; D011336:Probability; D018570:Risk Assessment; D016896:Treatment Outcome