Suchergebnisse

INTRODUCTION: The Asthma 3+ Visit Plan (rewarding systematic asthma care in primary care) is unique to Australia. Based on the Six Step Asthma Plan, it comprises three GP visits over four months for patients with moderate to severe asthma. GPs receive an incentive payment on completion of the three visits. OBJECTIVES: The Aim was to establish the degree of uptake of the Plan. Objectives included identifying barriers and enhancers to uptake for consumers and GPs. SUBJECTS: GPs, GP organisations and consumers (including non English speaking and Aboriginal and Torres Strait Islander peoples). METHODS: • Statistical analysis of Medicare GP Payment data • A semi structured phone interview of all 120 National GP Organisations • A GP Survey (of a stratified sample of GPs) • Consumer interviews • Focus groups with non English speaking Australians • Aboriginal and Torres Strait Islanders uptake analysis Data from all these elements were analysed and triangulated and this paper reports on this extensive analysis. RESULTS: Uptake remains low and has not increased notably since a peak six months after introduction in 2001. Key barriers identified were: • Structure of the incentive • Lack of consumer education • General Practice systems The current Plan is not appropriate for Aboriginal and Torres Strait Islander or CALD populations. CONCLUSION: A "one size fits all" policy does not meet the range of needs across the Australian community. The value of rewarding systematic asthma care in primary care was however demonstrated. Flexibility, multi-disciplinary participation and a recognition of differing practice circumstances is required and efficient general practice systems are demonstrated as the key to systematic chronic disease interventions. Consumer education is needed around preventive health care. Conflict of interest and funding Funding: Australian Government Department of Health and Ageing. No conflict of interest declared.

This cross-sectional study was carried out in department of cardiology, Combined Military Hospital, Dhaka, Bangladesh and department of cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of April 2000 to November 2001. The study was designed to see the coronary arteriographic (CAG) pattern in patients with Hypertrophic Cardiomyopathy and to compare the CAG findings between HCM patients and normal coronary patients, HCM was diagnosed by using diagnostic criteria defined by Western Working Group. The patients with hypertention, congenitalheart disease, valvular heart disease, coronary artery disease were excluded from the study. Among total 60 subjects, 30 had HCM and 30 age and sex matched control. The mean age of cases was 45.00±15.38 years and control subjects was 44.35±15.14 years. HCM cases had significantly higher left ventricular systolic pressure, higher left ventricular end diastolic pressure and more ejection fraction than control. Origin of coronary artery both in control and HCM cases were normal.

AbstractThere are inequities in engagement with established early childhood developmental surveillance programs, eclipsing disadvantaged families. The current study sought to address this by dovetailing developmental surveillance with immunization visits and other opportunistic contacts with children at general practices). While 53 General Practices were recruited, significant COVID-19 disruptions resulted in only 81 children being screened (both parent-administered and GP completed). Of the 81 children, 11 screened positive and all of them along with 5% of screen negatives (i.e. 4 children) received clinician-administered reference-standard assessment for autism and developmental delay (DD) using Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview Schedule –Revised (ADI-R), and Mullen Scales of Early Learning (MSEL). All children found by reference-standard assessment to have probable autism and/or DD had screened positive during the screening process, and 90.9% of children who screened positive were found by reference-standard assessment to have probable DD or autism. The findings provide early evidence for the feasibility and usefulness of parent completed and GP administered developmental measures during opportunistic contacts with GPs as a promising method to facilitate early identification of DD or autism.