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BEACH. B ettering the E valuation A nd C are of H ealth Joan Henderson (for A/Prof Helena Britt) Family Medicine Research Centre Sydney School of Public Health The University of Sydney. What is BEACH ?. A continuous national study of general practice activity
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BEACH Bettering the Evaluation And Care of Health Joan Henderson (for A/Prof Helena Britt) Family Medicine Research Centre Sydney School of Public Health The University of Sydney Chronic Disease and Ageing 2011
What is BEACH? A continuous national study of general practice activity Run by FMRC, Uni of Sydney (self-funded, not-for-profit) Began April 1998, in its 14th year National random sample ~ 1,000 GPs p.a. (~13,000) National data for 100,000 encounters p.a. (~1.3 million) Paper-based data collection – numerous variables Used by governments, industry, health planners, researchers Continuity allows measures of change Chronic Disease and Ageing 2011
Types of BEACH data Two main sets of data BEACH – encounter data … cross-sectional SAND – patient-based data … semi-longitudinal Chronic Disease and Ageing 2011
Age distribution of patients 2009-10
Observed (SAND) vs expected (MBS) patient age distribution – Australia n = 6,015 Chronic Disease and Ageing 2011
Selected morbidity management over time / 100 encounters Chronic Disease and Ageing 2011
Ageing and chronic illness? O’Halloran JF, Miller GC, Britt HC. Defining chronic conditions for primary care with ICPC-2. Family Practice, 2004; 21:381-386 (in use internationally – 47 citations). Knox S, Harrison C, Britt H, Henderson J. Estimating prevalence of common chronic morbidities in Australia. MJA2008; 189: 66-70. (34 citations) Britt H, Harrison C, Miller G, Knox. Prevalence patterns of multi-morbidity in Australia.MJA2008; 189:72-77 (40 citations). Chronic Disease and Ageing 2011
Most common chronic conditions in patients aged 65+ (n=2,216) % 1. Hypertension 64.3 2. Osteoarthritis 46.8 3. Hyperlipidaemia 38.6 4. IHD 26.7 5. GORD 24.5 6. Diabetes T2 19.0 7. Depression 16.0 8. Osteoporosis 14.6 9. Malignant neoplasm 12.3 % 10. Chronic back pain 11.3 11. COAD 11.1 12. Anxiety 9.9 13. Obesity 9.8 14. Asthma 9.7 15. CHF 9.4 16. CVA / Stroke 9.2 17. PVD 6.7 18. Chronic renal failure 5.6 Chronic Disease and Ageing 2011
‘LongBEACH’ …Longitudinal BEACH … ‘Active’ collection – with aid of data extraction tool Completeness …prompt to add what’s missing Prompt to include contact with other health professionals Standard record structure – problem oriented Standard set of data elements and defined terms Background coding and classification Link to other data sources – MBS, PBS, hospital separations, National Death Index etc Outcome measurement – not just processes Chronic Disease and Ageing 2011
Collaboration & PhDs Planned collaborations - Internationally with … Dr Stephen Sutch, (Johns Hopkins University, Baltimore) - An adaption of Adjusted Clinical Groups (AGC) system for predicting service utilisation in Primary Care (Glenn Salkeld & Michelle Cunich) (PhD opportunity) Dr Andrew Bazemore, (Robert Graham Center, Washington) – mapping BEACH and LongBEACH data to Geographical Information Systems (GIS) (PhD opportunity – Chris Harrison) Chronic Disease and Ageing 2011
Collaboration & PhDs Nationally with … Prof. Richard Madden (University of Sydney) - development of research methods and statistical analyses Prof. Kathryn Refshauge (University of Sydney) - physiotherapy Dr Simon French (University of Melbourne) - chiropractic A/Prof. Elizabeth Halcomb (University of Western Sydney) - practice nurses Prof. James Dunbar (Flinders and Deakin Universities) - rural health Prof. Adrian Mindel (STIRC, University of Sydney) - sexual health Dr Michael Harrison (Chair, Quality Use of Pathology) – Pathology. … All potential collaborative PhD opportunities Chronic Disease and Ageing 2011
BEACH Bettering the Evaluation And Care of Health www.fmrc.org.au Helena.Britt@sydney.edu.au Joan.Henderson@sydney.edu.au Chronic Disease and Ageing 2011
BEACH 2010-11 Chronic Disease and Ageing 2011
and endorsed by BEACH 2010-11 Chronic Disease and Ageing 2011
(Mean no. of chronic co-morbidities = 6.5 per diabetes patient)