Adolescent health presentations to Victorian general practice: a descriptive study using electronic medical records
Ronnen Leizerovitz A # , Ian Williams A # * , Adrian Laughlin
A
Abstract
Although most young Australians visit their general practitioner at least once a year, discrepancies remain between healthcare need and healthcare support in this group. A detailed contemporary understanding of youth presentations to general practice is needed, given that the last comprehensive investigation into Australian adolescent encounters with primary care is now over two decades old. The aim of this study is to describe rates of presentation and reasons for visit among young people in Victorian primary care using data extracted from electronic medical records.
A retrospective descriptive study of de-identified electronic medical records data from >22,000 adolescents aged 10–24 years who presented to Victorian general practice in 2019 was undertaken.
The overall mean attendance rate of young people was 2.89 visits/patient per year, with rates highest amongst older patients, females and those in regional localities. Young people presented most frequently for physical (biomedical) concerns (such as respiratory, skin and general physical complaints), and psychological (mental health) reasons for visit.
The study addresses a significant gap in our understanding of the role of general practice for young Australians. Although physical problems continue to predominate among Australian adolescents’ reasons for visit to general practice, psychological presentations occur much more frequently than estimated in past studies. This study also demonstrates that general practice electronic medical records data can be harnessed to provide a meaningful description of primary care activity.
Keywords: adolescent, electronic medical records, EMR, general practice research, mental health, primary care, reason for visit, youth.
References
Australian Bureau of Statistics (2020–2022) National study of mental health and wellbeing. Available at https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release [cited 5 October 2024]
Australian Bureau of Statistics (2022–2023) Patient experiences. Available at https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release [cited 10 July 2024]
Australian Government Department of Health and Aged Care (2021) Modified Monash Model. Available at https://www.health.gov.au/topics/rural-health-workforce/classifications/mmm
Booth ML, Bernard D, Quine S, Kang M, Usherwood T, Alperstein G, Bennett D (2004) Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution. Journal of Adolescent Health 34(1), 97-103.
| Crossref | Google Scholar | PubMed |
Booth ML, Knox S, Kang M (2008) Encounters between adolescents and general practice in Australia. Journal of Paediatrics and Child Health 44(12), 699-705.
| Crossref | Google Scholar | PubMed |
Brown A, Rice SM, Rickwood DJ, Parker AG (2015) Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people. Asia-Pacific Psychiatry 8(1), 3-22.
| Crossref | Google Scholar | PubMed |
Canaway R, Boyle DIR, Manski-Nankervis J-AE, Bell J, Hocking JS, Clarke K, Clark M, Gunn JM, Emery JD (2019) Gathering data for decisions: best practice use of primary care electronic records for research. Medical Journal of Australia 210(S6), S12-s16.
| Crossref | Google Scholar |
Canaway R, Chidgey C, Hallinan CM, Capurro D, Boyle DIR (2024) Undercounting diagnoses in Australian general practice: a data quality study with implications for population health reporting. BMC Medical Informatics and Decision Making 24(1), 155.
| Crossref | Google Scholar | PubMed |
Department of Health (2023) Better access initiative. Available at https://www.health.gov.au/our-work/better-access-initiative [cited 21 March 2023]
Frese T, Klaussa S, Herrmanna K, Sandholzer H (2011) Children and adolescents as patients in general practice – the reasons for encounter. Journal of Clinical Medicine Research 3(4), 177-182.
| Crossref | Google Scholar | PubMed |
Harrison C, Bayram C, Britt H (2013) Suicide-related contacts – experience in general practice. Australian Family Physician 42(9), 605.
| Google Scholar | PubMed |
Hickie IB, Fogarty AS, Davenport TA, Luscombe GM, Burns J (2007) Responding to experiences of young people with common mental health problems attending Australian general practice. Medical Journal of Australia 187(S7), S47-S52.
| Crossref | Google Scholar | PubMed |
Hiscock H, Neely RJ, Lei S, Freed G (2018) Paediatric mental and physical health presentations to emergency departments, Victoria, 2008–15. Medical Journal of Australia 208(8), 343-348.
| Crossref | Google Scholar | PubMed |
Jorm AF, Kitchener BA (2021) Increases in youth mental health services in Australia: have they had an impact on youth population mental health? Australian & New Zealand Journal of Psychiatry 55(5), 476-484.
| Crossref | Google Scholar | PubMed |
Manski-Nankervis J-A, Canaway R, Chidgey C, Emery J, Sanci L, Hocking JS, Davidson S, Swan I, Boyle D (2024) Data resource profile: primary care audit, teaching and research open network (patron). International Journal of Epidemiology 53(1), dyae002.
| Crossref | Google Scholar |
Morgan AJ, Wright J, Reavley NJ (2021) Review of Australian initiatives to reduce stigma towards people with complex mental illness: what exists and what works? International Journal of Mental Health Systems 15(1), 10.
| Crossref | Google Scholar | PubMed |
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, McGovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F, Viner RM (2016) Our future: a Lancet commission on adolescent health and wellbeing. The Lancet 387(10036), 2423-2478.
| Crossref | Google Scholar | PubMed |
Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD (2009) Global patterns of mortality in young people: a systematic analysis of population health data. The Lancet 374(9693), 881-892.
| Crossref | Google Scholar | PubMed |
Quine S, Bernard D, Booth M, Kang M, Usherwood T, Alperstein G, Bennett D (2003) Health and access issues among Australian adolescents: a rural-urban comparison. Rural and Remote Health 3(3), 245.
| Crossref | Google Scholar | PubMed |
Sawyer SM, Afifi RA, Bearinger LH, Blakemore S-J, Dick B, Ezeh AC, Patton GC (2012) Adolescence: a foundation for future health. The Lancet 379(9826), 1630-1640.
| Crossref | Google Scholar | PubMed |
Strauss P, Winter S, Waters Z, Wright Toussaint D, Watson V, Lin A (2022) Perspectives of trans and gender diverse young people accessing primary care and gender-affirming medical services: findings from trans pathways. International Journal of Transgender Health 23(3), 295-307.
| Crossref | Google Scholar |
The Royal Australian College of General Practitioners (2018) Maternity care in general practice: position statement. (The Royal Australian College of General Practitioners) Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Maternity-care-in-general-practice.pdf
Tylee A, Haller DM, Graham T, Churchill R, Sanci LA (2007) Youth-friendly primary-care services: how are we doing and what more needs to be done? The Lancet 369(9572), 1565-1573.
| Crossref | Google Scholar | PubMed |
University of Melbourne Department of General Practice and Primary Care (2024) Data for decisions and the patron program of research. Available at https://medicine.unimelb.edu.au/research-groups/general-practice-research/data-for-decisions [cited 15 July 2024]
Victoria State Government (2022) Our promise, your future: Victoria’s youth strategy 2022–2027. (Department of Families, Fairness and Housing) Available at https://www.vic.gov.au/victorias-youth-strategy-2022-2027
Western Australian Department of Health (2018) WA youth health policy 2018–2023. (Health Networks, Western Australian Department of Health, Perth) Available at https://www.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Youth-Policy/PDF/Youth-policy.pdf
Wood SM, Alston L, Chapman A, Lenehan J, Versace VL (2024) Barriers and facilitators to women’s access to sexual and reproductive health services in rural Australia: a systematic review. BMC Health Services Research 24(1), 1221.
| Crossref | Google Scholar | PubMed |