Background
Methods
Phase 1: Practice recruitment
-
installation of a clinical auditing software package on desktop software or a desire to install and use the Pen Computer Systems (PCS) Clinical Audit Tool: ™(PCS CAT) (multiple licensing for PCS CAT has been procured by ISML and is therefore freely available to all general practices within its catchment); and
-
a willingness to provide de-identified practice data extracts to the researchers for surveillance purposes.
Phase 2: Data cleansing and enhancement of data accuracy
-
encouraging all practice staff to use the ‘drop down box functionality’ of their clinical software to define and code all medical diagnoses and other sections of the patient record;
-
strictly avoiding free text entries in all sections of the patient record;
-
finding all identifiable free text non-coded past medical history items, and either linking them to appropriate coded items or replacing them with the correct coded item; and
-
coding all inactive patients as ‘Inactive’ (an ‘active patient’ is one who has attended the practice three or more times in the past two years as defined in the Royal Australian College of General Practice: Standards for general practices [12]).
Phase 3: Data collection
Phase 4: Data collation and analysis
Results
Illawarra-Shoalhaven SLAs | No. of patients from the SLA within the sample | Proportion of the sample from the SLA (%) | Estimated Resident Population of the SLA, 2011* | Proportion of the SLA population included in the sample (%) |
---|---|---|---|---|
Jervis Bay Territory | 6 | 0.0 | 387 | 1.6 |
Kiama (A) | 19769 | 12.9 | 20832 | 94.9 |
Shellharbour (C) | 44971 | 29.4 | 66054 | 68.1 |
Shoalhaven (C) - Pt A | 15347 | 10.0 | 34444 | 44.6 |
Shoalhaven (C) - Pt B | 26000 | 17.0 | 61599 | 42.2 |
Wollongong (C) - Inner | 23351 | 15.3 | 104601 | 22.3 |
Wollongong (C) Bal | 23323 | 15.3 | 96614 | 24.1 |
Total
^
|
152767
|
100
|
384531
|
39.7
|
SLA | Age | Denominator (n) | Type 2 Diabetes | CHD | Stroke | Asthma | COPD | Osteoarthritis | Osteoporosis | Depression | Anxiety | Cancer | Hypertension |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Jervis Bay Territory | 0-14 | 3 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
15-24 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
25-34 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
35-44 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
45-54 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
55-64 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
65-74 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
75 & Above | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |
Total
^
|
6
|
0
|
1
|
0
|
0
|
0
|
0
|
0
|
0
|
0
|
0
|
0
| |
Kiama (A) | 0-14 | 3348 | 0 | 0 | 0 | 262 | 0 | 0 | 0 | 6 | 20 | 1 | 0 |
15-24 | 2572 | 1 | 0 | 1 | 190 | 0 | 0 | 2 | 118 | 57 | 1 | 5 | |
25-34 | 2138 | 0 | 0 | 2 | 137 | 1 | 4 | 1 | 115 | 80 | 3 | 13 | |
35-44 | 2450 | 12 | 5 | 6 | 147 | 4 | 30 | 3 | 191 | 94 | 8 | 115 | |
45-54 | 2558 | 39 | 18 | 15 | 143 | 13 | 96 | 19 | 218 | 104 | 24 | 286 | |
55-64 | 2751 | 124 | 100 | 26 | 180 | 29 | 267 | 80 | 227 | 113 | 59 | 691 | |
65-74 | 2094 | 203 | 152 | 53 | 134 | 72 | 355 | 145 | 152 | 71 | 128 | 844 | |
75 & Above | 1844 | 209 | 284 | 126 | 137 | 132 | 437 | 329 | 147 | 63 | 122 | 980 | |
Total
^
|
19755
|
588
|
559
|
229
|
1330
|
251
|
1189
|
579
|
1174
|
602
|
346
|
2934
| |
Shellharbour (C) | 0-14 | 9359 | 0 | 1 | 1 | 1028 | 1 | 1 | 0 | 31 | 64 | 2 | 5 |
15-24 | 6826 | 0 | 0 | 1 | 598 | 1 | 7 | 2 | 483 | 334 | 3 | 19 | |
25-34 | 6381 | 10 | 4 | 4 | 543 | 8 | 39 | 4 | 714 | 478 | 5 | 55 | |
35-44 | 6191 | 33 | 15 | 13 | 530 | 33 | 131 | 6 | 816 | 511 | 16 | 245 | |
45-54 | 5378 | 106 | 64 | 32 | 490 | 85 | 336 | 34 | 767 | 434 | 26 | 627 | |
55-64 | 4340 | 168 | 158 | 50 | 456 | 161 | 629 | 126 | 598 | 323 | 68 | 1055 | |
65-74 | 3328 | 254 | 329 | 99 | 338 | 233 | 841 | 236 | 447 | 298 | 94 | 1276 | |
75 & Above | 3156 | 302 | 638 | 215 | 343 | 405 | 1146 | 575 | 567 | 256 | 117 | 1504 | |
Total
^
|
44959
|
873
|
1209
|
415
|
4326
|
927
|
3130
|
983
|
4423
|
2698
|
331
|
4786
| |
Shoalhaven (C) - Pt A | 0-14 | 2865 | 0 | 0 | 0 | 236 | 0 | 0 | 0 | 1 | 16 | 0 | 0 |
15-24 | 2027 | 1 | 0 | 2 | 271 | 0 | 0 | 1 | 133 | 85 | 1 | 3 | |
25-34 | 1774 | 9 | 0 | 2 | 172 | 0 | 3 | 3 | 178 | 101 | 1 | 27 | |
35-44 | 1794 | 18 | 3 | 5 | 159 | 5 | 26 | 4 | 267 | 138 | 10 | 97 | |
45-54 | 1930 | 84 | 32 | 23 | 169 | 29 | 94 | 19 | 280 | 102 | 19 | 310 | |
55-64 | 1928 | 190 | 108 | 39 | 194 | 56 | 269 | 62 | 261 | 93 | 50 | 642 | |
65-74 | 1554 | 265 | 167 | 68 | 147 | 104 | 394 | 128 | 200 | 99 | 108 | 760 | |
75 & Above | 1457 | 238 | 318 | 153 | 139 | 140 | 541 | 286 | 167 | 109 | 106 | 863 | |
Total
^
|
15329
|
805
|
628
|
292
|
1487
|
334
|
1327
|
503
|
1487
|
743
|
295
|
2702
| |
Shoalhaven (C) - Pt B | 0-14 | 4344 | 0 | 0 | 0 | 307 | 3 | 0 | 2 | 5 | 15 | 0 | 2 |
15-24 | 2970 | 0 | 0 | 0 | 302 | 0 | 0 | 0 | 129 | 86 | 2 | 4 | |
25-34 | 2486 | 3 | 1 | 0 | 188 | 2 | 5 | 3 | 249 | 94 | 10 | 39 | |
35-44 | 3032 | 26 | 7 | 5 | 186 | 1 | 44 | 5 | 366 | 163 | 18 | 119 | |
45-54 | 3486 | 78 | 45 | 20 | 201 | 29 | 178 | 27 | 410 | 173 | 72 | 429 | |
55-64 | 3767 | 222 | 134 | 28 | 191 | 81 | 430 | 110 | 403 | 168 | 171 | 921 | |
65-74 | 3297 | 403 | 323 | 86 | 221 | 149 | 736 | 200 | 299 | 152 | 291 | 1414 | |
75 & Above | 2576 | 356 | 418 | 133 | 164 | 160 | 786 | 314 | 238 | 107 | 351 | 1292 | |
Total
^
|
25958
|
1088
|
928
|
272
|
1760
|
425
|
2179
|
661
|
2099
|
958
|
915
|
4220
| |
Wollongong (C) - Inner | 0-14 | 3914 | 0 | 0 | 3 | 339 | 1 | 0 | 0 | 3 | 14 | 3 | 1 |
15-24 | 2926 | 2 | 0 | 1 | 221 | 1 | 0 | 1 | 125 | 123 | 2 | 2 | |
25-34 | 3095 | 4 | 0 | 2 | 205 | 1 | 2 | 2 | 202 | 158 | 0 | 39 | |
35-44 | 3305 | 29 | 9 | 4 | 180 | 9 | 26 | 9 | 307 | 200 | 20 | 100 | |
45-54 | 3070 | 79 | 28 | 12 | 184 | 26 | 99 | 43 | 316 | 203 | 52 | 344 | |
55-64 | 2713 | 158 | 119 | 21 | 179 | 53 | 281 | 141 | 253 | 189 | 98 | 638 | |
65-74 | 2082 | 267 | 199 | 55 | 138 | 95 | 376 | 216 | 196 | 134 | 145 | 790 | |
75 & Above | 2203 | 362 | 403 | 136 | 157 | 173 | 614 | 454 | 169 | 115 | 230 | 1186 | |
Total
^
|
23308
|
901
|
758
|
234
|
1603
|
359
|
1398
|
866
|
1571
|
1136
|
550
|
3100
| |
Wollongong (C) Bal | 0-14 | 4411 | 0 | 0 | 1 | 370 | 9 | 2 | 0 | 6 | 24 | 0 | 0 |
15-24 | 3141 | 1 | 1 | 3 | 270 | 17 | 4 | 0 | 193 | 167 | 2 | 11 | |
25-34 | 3121 | 6 | 0 | 6 | 236 | 13 | 7 | 5 | 379 | 269 | 4 | 33 | |
35-44 | 3080 | 23 | 13 | 7 | 208 | 35 | 47 | 7 | 461 | 311 | 12 | 174 | |
45-54 | 2850 | 96 | 49 | 18 | 186 | 86 | 162 | 28 | 402 | 263 | 40 | 440 | |
55-64 | 2489 | 199 | 143 | 43 | 161 | 137 | 380 | 105 | 319 | 209 | 78 | 780 | |
65-74 | 2036 | 236 | 216 | 89 | 134 | 229 | 538 | 177 | 210 | 156 | 129 | 888 | |
75 & Above | 2180 | 290 | 420 | 189 | 127 | 284 | 729 | 403 | 254 | 150 | 207 | 1173 | |
Total
^
|
23308
|
851
|
842
|
356
|
1692
|
810
|
1869
|
725
|
2224
|
1549
|
472
|
3499
| |
Entire Sample | 0-14 | 28244 | 0 | 1 | 5 | 2542 | 14 | 3 | 2 | 52 | 153 | 6 | 8 |
15-24 | 20462 | 5 | 1 | 8 | 1852 | 19 | 11 | 6 | 1181 | 852 | 11 | 44 | |
25-34 | 18995 | 32 | 5 | 16 | 1481 | 25 | 60 | 18 | 1837 | 1180 | 23 | 206 | |
35-44 | 19854 | 141 | 52 | 40 | 1410 | 87 | 304 | 34 | 2408 | 1417 | 84 | 850 | |
45-54 | 19272 | 482 | 236 | 120 | 1373 | 268 | 965 | 170 | 2393 | 1279 | 233 | 2436 | |
55-64 | 17989 | 1061 | 763 | 207 | 1361 | 517 | 2256 | 624 | 2061 | 1095 | 524 | 4727 | |
65-74 | 14391 | 1628 | 1386 | 450 | 1112 | 882 | 3240 | 1102 | 1504 | 910 | 895 | 5972 | |
75 & Above | 13416 | 1757 | 2481 | 952 | 1067 | 1294 | 4253 | 2361 | 1542 | 800 | 1133 | 6998 | |
Total
^
|
152623
|
5106
|
4925
|
1798
|
12198
|
3106
|
11092
|
4317
|
12978
|
7686
|
2909
|
21241
|
SLA~ | Age | Quantified BMI*: Denominator (n) [proportion of sample population (%)] | Obese | Overweight/obese |
---|---|---|---|---|
Kiama (A) | 18-24 | 367 [19.7] | 42 | 101 |
25-34 | 366 [17.1] | 75 | 178 | |
35-44 | 513 [20.9] | 164 | 336 | |
45-54 | 782 [30.6] | 283 | 557 | |
55-64 | 979 [35.6] | 372 | 782 | |
65-74 | 958 [45.7] | 354 | 726 | |
75 & Above | 1125 [61] | 275 | 735 | |
Total
^
|
5090 [32.4]
|
1565
|
3415
| |
Shellharbour (C) | 18-24 | 510 [10.4] | 132 | 257 |
25-34 | 754 [11.8] | 277 | 465 | |
35-44 | 778 [12.6] | 366 | 602 | |
45-54 | 983 [18.3] | 445 | 779 | |
55-64 | 832 [19.2] | 367 | 689 | |
65-74 | 744 [22.4] | 333 | 610 | |
75 & Above | 775 [24.6] | 228 | 524 | |
Total
^
|
5376 [16.0]
|
2148
|
3926
| |
Shoalhaven (C) - Pt A | 18-24 | 528 [37.5] | 90 | 187 |
25-34 | 596 [33.6] | 200 | 345 | |
35-44 | 696 [38.8] | 277 | 507 | |
45-54 | 987 [51.1] | 417 | 751 | |
55-64 | 1119 [58] | 470 | 892 | |
65-74 | 993 [63.9] | 417 | 798 | |
75 & Above | 1004 [68.9] | 261 | 676 | |
Total
^
|
5923 [50.0]
|
2132
|
4156
| |
Shoalhaven (C) - Pt B | 18-24 | 468 [21.9] | 55 | 135 |
25-34 | 524 [21.1] | 147 | 296 | |
35-44 | 823 [27.1] | 252 | 541 | |
45-54 | 1258 [36.1] | 414 | 889 | |
55-64 | 1492 [39.6] | 517 | 1102 | |
65-74 | 1641 [49.8] | 625 | 1290 | |
75 & Above | 1481 [57.5] | 376 | 990 | |
Total
^
|
7687 [37.0]
|
2386
|
5243
| |
Wollongong (C) - Inner | 18-24 | 583 [26.1] | 73 | 167 |
25-34 | 729 [23.6] | 161 | 355 | |
35-44 | 1048 [31.7] | 295 | 681 | |
45-54 | 1179 [38.4] | 414 | 846 | |
55-64 | 1042 [38.4] | 372 | 782 | |
65-74 | 870 [41.8] | 355 | 688 | |
75 & Above | 1138 [51.7] | 322 | 746 | |
Total
^
|
6589 [35.2]
|
1992
|
4265
| |
Wollongong (C) Bal | 18-24 | 441 [19.1] | 87 | 181 |
25-34 | 634 [20.3] | 252 | 422 | |
35-44 | 812 [26.4] | 373 | 622 | |
45-54 | 1099 [38.6] | 476 | 850 | |
55-64 | 970 [39] | 467 | 804 | |
65-74 | 891 [43.8] | 424 | 714 | |
75 & Above | 1195 [54.8] | 350 | 811 | |
Total
^
|
6042 [33.4]
|
2429
|
4404
| |
Entire sample | 18-24 | 2897 [19.5] | 479 | 1028 |
25-34 | 3603 [19] | 1112 | 2061 | |
35-44 | 4670 [23.5] | 1727 | 3289 | |
45-54 | 6288 [32.6] | 2449 | 4672 | |
55-64 | 6434 [35.8] | 2565 | 5051 | |
65-74 | 6097 [42.4] | 2508 | 4826 | |
75 & Above | 6718 [50.1] | 1812 | 4482 | |
Total
^
|
36707 [30.9]
|
12652
|
25409
|
Chronic Disease/Conditions (as defined and entered into electronic records by GP) | Crude prevalence in sample (%) (95% CI) | Australian crude disease prevalence (AHS 2011–12~) (%) (95% CI) |
---|---|---|
Type 2 Diabetes | 3.3 (3.26 - 3.44) | 3.4 (3.09 - 3.71) |
CHD | 3.2 (3.14 - 3.32) | 4.7 (4.39 - 5.01) |
Stroke |
1.2 (1.12 - 1.23)
| 1.1 (0.94 - 1.26) |
Asthma | 8.0 (7.86 - 8.13) | 10.2 (9.58 - 10.82) |
COPD | 2.0 (1.96 - 2.11) | 2.4 (2.09 - 2.71) |
Osteoarthritis | 7.3 (7.14 - 7.4) | 8.3 (7.84 - 8.76) |
Osteoporosis | 2.8 (2.75 - 2.91) | 3.3 (3.03 - 3.57) |
Depression | 8.5 (8.36 - 8.64) | 9.7 (9.19 - 10.21) |
Anxiety |
5.0 (4.93 - 5.15)
| 3.8 (3.45 - 4.15) |
Cancer |
1.9 (1.84 - 1.97)
| 1.5 (1.29 - 1.71) |
Hypertension |
13.9 (13.74 - 14.09)
| 10.2 (9.72 - 10.68) |
Obesity (BMI ≥ 30)* |
34.5 (33.98 - 34.95)
| 28.3 (27.36 - 29.24) |
Overweight or obese (BMI ≥ 25)* |
69.2 (68.75 - 69.69)
| 63.4 (62.28 - 64.52) |
Chronic Disease/Conditions (as defined and entered into electronic records by GP) | Age-standardised disease prevalence in sample (%) | Australian age-standardised disease prevalence (AHS 2011–12~) (%) |
---|---|---|
Type 2 Diabetes | 2.8 | 3.4 |
CHD | 2.6 | 4.9 |
Stroke | 0.9 | 1.1 |
Asthma | 8.0 | 10.2 |
COPD | 1.7 | 2.4 |
Osteoarthritis | 6.1 | 8.4 |
Osteoporosis | 2.2 | 3.4 |
Depression | 8.4 | 9.7 |
Anxiety |
5.0
| 3.8 |
Cancer |
1.6
| 1.5 |
Hypertension |
11.9
| 10.4 |
Obesity (BMI ≥ 30)* |
33.6
| 28.3 |
Overweight or obese (BMI ≥ 25)* |
65.9
| 63.4 |