'It's what we should be doing anyway': using financial incentives to promote relational continuity in Australian General Practice-a nested case study analysis.

Background: Relational continuity is a fundamental component of primary care. The 'Quality in General Practice Trial' (EQuIP-GP), was a 12-month cluster randomized trial, designed to investigate whether financial incentives can improve relational continuity in primary care.

Aim: To examine (i) how financial incentives are perceived and experienced by primary care patients, providers, and practice staff, and (ii) how clinical and organizational routines related to relational continuity are influenced by the introduction of a financial model designed to incentivize relational continuity.

Australian medical practitioners: trends in demographics and regions of work 2013-2022.

ObjectiveThis study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9years.MethodsA retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013-2022.

Life, death, and statins: association of statin prescriptions and survival in older general practice patients.

Aims: This study serves as an exemplar to demonstrate the scalability of a research approach using survival analysis applied to general practice electronic health record data from multiple sites. Collection of these data, the subsequent analysis, and the preparation of practice-specific reports were performed using a bespoke distributed data collection and analysis software tool.

Background: Statins are a very commonly prescribed medication, yet there is a paucity of evidence for their benefits in older patients.

The Australian health workforce: Disproportionate shortfalls in small rural towns.

Introduction: The distribution of health care workers differs greatly across Australia, which is likely to impact health delivery.

Objective: To examine demographic and workplace setting factors of doctors, nurses and midwives, and allied health professionals across Modified Monash Model (MMM) regions and identify factors associated with shortfalls in the health care workforce.

Design: Descriptive cross-sectional analysis.

A comparison of rural and regional work locations and speciality choices between graduates from the University of Wollongong and all Australian medical schools using the Medical Schools Outcomes Database.

Introduction: The shortfall in medical workers in rural and remote Australia has led to health discrepancies in these regions. The University of Wollongong's medical program was designed to encourage graduates to work in these regions to address this shortfall.

Objective: To compare rural and regional locations of work and choices of speciality between University of Wollongong's graduates and graduates from all Australian universities.

CHIME-GP trial of online education for prescribing, pathology and imaging ordering in general practice - how did it bring about behaviour change?

Background: There is a need for scalable clinician education in rational medication prescribing and rational ordering of pathology and imaging to help improve patient safety and enable more efficient utilisation of healthcare resources. Our wider study evaluated the effectiveness of a multifaceted education intervention for general practitioners (GPs) in rational prescribing and ordering of pathology and imaging tests, in the context of Australia's online patient-controlled health record system, My Health Record (MHR), and found evidence for measurable behaviour change in pathology ordering among participants who completed the educational activities. This current study explored the mechanisms of behaviour change brought about by the intervention, with a view to informing the development of similar interventions in the future.

Alcohol consumption and health-related quality of life in regional, rural and metropolitan Australia: analysis of cross-sectional data from the Community Health and Rural/Regional Medicine (CHARM) study.

Background: Relationships between alcohol consumption and health are complex and vary between countries, regions, and genders. Previous research in Australia has focused on estimating the effect of alcohol consumption on mortality. However, little is known about the relationships between alcohol consumption and health-related quality of life (QoL) in Australia.

An automated protocol for assessing career rurality outcomes of Australian health professionals using retrospective data.

Introduction: Addressing the imbalance of the health workforce between metropolitan and rural areas requires a clear understanding of trends in choices of work location of health care staff.

Objective: Here, we provide an automated and highly reproducible protocol to examine the location of health care workers over multiple years using medical graduates as a case study.

Design: Data linkage cohort study.

Randomised trial of general practitioner online education for prescribing and test ordering.

Introduction: Potentially inappropriate medicine prescriptions and low-value diagnostic testing pose risks to patient safety and increases in health system costs. The aim of the Clinical and Healthcare Improvement through My Health Record usage and Education in General Practice study was to evaluate a scalable online quality improvement intervention, integrating online education regarding a national shared electronic health record and rational prescribing, pathology and imaging ordering by Australian general practitioners (GPs).

Methods: The study was a parallel three-arm randomised trial comprising a prescribing education arm, a pathology education arm and an imaging education arm.

Stress, burnout, and parenting: a qualitative study of general practice registrars.

Background: Early career medical professionals experience stress and burnout at higher levels than the wider community. Burnout can arise with competing demands of life and career, which is evident in early career development, where family planning can coincide with specialty training. General practice may be seen as a family friendly career option; however, few studies examine the experience of general practice trainees with stress and burnout and the impact that parenting has on their experience.

Cluster-randomised trial of the Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP): Prescribing of medicines outcomes.

Background: The Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP) study investigated whether targeted financial incentives promoting access to a preferred general practitioner, post-hospitalisation follow-up and longer consultations, increase patient-perceived relational continuity in primary care. Secondary outcomes included the use of medicines.

Objective: To evaluate whether introducing a general practice-level service model incorporating enrolment and continuous and graded quality improvement incentives influenced the total prescriptions written and potentially inappropriate prescribing of medicines.

"A cross-sectional study of burnout among Australian general practice registrars".

Objective(s): To identify if gender and parenting factors are associated with burnout in Australian general practice (GP) registrars.

Design: Cross sectional study. The main outcome measure was the Maslach Burnout Inventory, included as part of the GPRA (General Practice Registrars Australia) biannual online survey.

Effectiveness of Quality Incentive Payments in General Practice (EQuIP-GP) cluster randomized trial: impact on patient-reported experience.

Background: Relational continuity, 'a therapeutic relationship between a patient and provider/s that spans health care events', has been associated with improved patient outcomes.

Objectives: To evaluate whether an intervention incorporating patient enrolment and a funding model for higher-risk patients influenced patient-reported experience measures, particularly relational continuity.

Methods: Cluster-randomized controlled trial over 12 months (1 August 2018-31 July 2019).

Giving Asthma Support to Patients (GASP) program evaluation.

Background And Objectives: The Giving Asthma Support to Patients (GASP) program, developed in New Zealand, guides practice nurses to provide structured asthma care. This study assessed GASP in the context of Australian general practice.

Method: The study used a pre-post design and was conducted in 19 practices in Western Sydney and Illawarra/Shoalhaven.

Development of a COVID-19 virtual community of practice in New South Wales: A qualitative study.

Background And Objectives: In April 2020, a group of general practice leaders in NSW, Australia, established a COVID-19 virtual community of practice (VCoP) to facilitate rapid transfer and implementation of clinical guidance into practice. This research aimed to gain an understanding of the experience and effectiveness of the VCoP from leaders and members.

Method: The study used a qualitative participatory action research methodology.

Patient self-management and empowerment for multiple sclerosis: The implications of dietary lifestyle management for primary care.

Background: Multiple sclerosis (MS) is a chronic neurological condition of increasing prevalence. Many people living with MS will trial various alternative therapies, including changed patterns of eating, to try to gain control over their condition. New clinical guidelines advise reducing the time between first clinical symptoms and treatment.

Exploring consumer perspectives about the Health Care Home model of primary care provision: A qualitative study.

Background And Objectives: Australia's health system faces challenges in the management and prevention of chronic disease. Models of primary care delivery, such as the Health Care Home (HCH) model, have been proposed to help meet these challenges. The aim of this study was to explore pre-implementation consumer perspectives of the HCH model.

Analysis of current maternity leave policies for doctors in training.

Objective This study reviewed the maternity leave policies in Australian general practice speciality training and compared them to hospital-based speciality training policies. Methods Nine general practice regional training organisations' maternity leave policies were audited and compared to 11 Australian hospital speciality training maternity leave policies. Data pertaining to each component of Cheung's health policy analysis tool were reviewed.

Clinical and healthcare improvement through My Health Record usage and education in general practice (CHIME-GP): a study protocol for a cluster-randomised controlled trial.

Background: There is an international interest in whether improved primary care can lead to a more rational use of health resources. There is evidence that educational interventions can lead to improvements in the quality of rational prescribing and test ordering. A new national platform for shared medical records in Australia, My Health Record (MHR), poses new opportunities and challenges for system-wide implementation.

Implementation of a patient centred medical home (PCMH) initiative in general practices in New South Wales, Australia.

Background: With an ageing population and an increase in chronic disease burden in Australia, Patient Centred Medical Home (PCMH) models of care have been identified as potential options for primary care reform and improving health care outcomes. Adoption of PCMH models are not well described outside of North America. We examined the experiences of seven general practices in an Australian setting that implemented projects aligned with PCMH values and goals supported by their local Primary Health Network (PHN).

Medical care in Australian residential aged care: Perspectives of residents, family, nurses and general practitioners.

The importance of residential aged care facility (RACF)'s medical care is growing, driven by world-wide demographic trends in ageing populations. Despite this, there is a paucity of research into this care delivery from the perspective of those most involved. This study aimed to identify the enablers of and barriers to satisfactory RACF medical care by focusing on the general practitioner (GP) visit in the experience of residents, their family, registered nurses (RNs) and GPs.

Motherhood and medicine: systematic review of the experiences of mothers who are doctors.

Objective: To synthesise what is known about women combining motherhood and a career in medicine by examining the published research into their experiences and perspectives.

Study Design: We reviewed peer-reviewed articles published or available in English reporting original research into motherhood and medicine and published during 2008-2019. Two researchers screened each abstract and independently reviewed full text articles.