Abstract
ObjectivesTo estimate prevalence of chronic conditions among patients seeing a general practitioner (GP), patients attending general practice at least once in a year, and the Australian population.Design, setting and participantsA sub-study of the BEACH (Bettering the Evaluation and Care of Health) program, a continuous national study of general practice activity conducted between July 2008 and May 2009. Each of 290 GPs provided data for about 30 consecutive patients (total 8,707) indicating diagnosed chronic conditions, using their knowledge of the patient, patient self-report, and patient's health record.Main outcome measuresEstimates of prevalence of chronic conditions among patients surveyed, adjusted prevalence in patients who attended general practice at least once that year, and national population prevalence.ResultsTwo-thirds (66.3%) of patients surveyed had at least one chronic condition: most prevalent being hypertension (26.6%), hyperlipidaemia (18.5%), osteoarthritis (17.8%), depression (13.7%), gastro-oesophageal reflux disease (11.6%), asthma (9.5%) and Type 2 diabetes (8.3%). For patients who attended general practice at least once, we estimated 58.8% had at least one chronic condition. After further adjustment we estimated 50.8% of the Australian population had at least one chronic condition: hypertension (17.4%), hyperlipidaemia (12.7%), osteoarthritis (11.1%), depression (10.5%) and asthma (8.0%) being most prevalent.ConclusionsThis study used GPs to gather information from their knowledge, the patient, and health records, to provide prevalence estimates that overcome weaknesses of studies using patient self-report or health record audit alone. Our results facilitate examination of primary care resource use in management of chronic conditions and measurement of prevalence of multimorbidity in Australia.
Highlights
The ageing of the population [1] is expected to lead to increases in prevalence of chronic conditions, multimorbidity [2], and the demand on primary care [3]
Data analysis To ensure as many patients as possible were kept in the denominator, we examined general practitioner (GP)’ response patterns for missing data
Completed research packs were returned by 290 GPs (77.3%) who responded for 8,333 (95.7%) patients out of a total 8,707. ‘‘No chronic problems in this patient’’ was ticked for 2,620 (31.4%) patients and 5,713 (68.6%) had at least one chronic condition recorded
Summary
The ageing of the population [1] is expected to lead to increases in prevalence of chronic conditions, multimorbidity [2], and the demand on primary care [3]. To enable the health systems to respond to these increases, the prevalence of chronic conditions needs to be measured in an accurate and timely manner. There are three major methods by which prevalence is usually measured: respondent self-report; health record audit; and screening. Many governments use large population health surveys that rely on respondent self-report to measure the prevalence of chronic conditions [4,5,6]. Using health records (paper and/or electronic) to estimate prevalence is often seen as superior to patient self-report [13,14,15]. The quality of information in health records can be compromised through inaccurate [16,17,18] or incomplete records [9,15], and there are often issues in obtaining patient consent. Studies that screen the population, such as the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) [19], avoid these issues, but are usually limited to a specific disease or groups of diseases and are relatively expensive - the most recent AusDiab study costing over $2.5 million [20]
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