Table 3.
Comparison of general practitioner imaging and referral patterns and non-pharmacological management of knee and hip OA in period one and period two.
|
Knee OA Rate per 100 knee OA problems managed (95% CI) |
Hip OA Rate per 100 hip OA problems managed (95% CIs) |
|||||||
|---|---|---|---|---|---|---|---|---|
|
2005-10 |
2010-16 |
2005-10 |
2010-16 |
|||||
| N | n=3,058 | N | n=4,156 | N | n=1,106 | N | n=1,492 | |
| Medicare chronic disease management items ^ | 53 | 1•7 (1•1-2•3) | 137 | 3•3 (2•6-4•0) | 21 | 1•9 (0•9-2•9) | 93 | 6•2 (4•5-7•9) |
| Referrals | ||||||||
| All | 533 | 17•4 (16•0-18•9) | 879 | 21•2 (19•8-22•5) * | 196 | 17•7 (15•4-20•0) | 358 | 24•0 (21•7-26•3) * |
| New | 100 | 14•9 (12•1-17•7) | 181 | 18•9 (16•1-21•6) | 39 | 13•7 (9•6-17•8) | 73 | 19•7 (15•4-24•0) |
| Specialist referrals | 393 | 12•9 (11•6-14•1) | 586 | 14•1(13•0-15•2) | 151 | 13•7(11•6-15•7) | 249 | 16•7(14•8-18•6) |
| Orthopaedic surgeon | 363 | 11•9 (10•7-13•1) | 548 | 13•2 (12•1-14•3) | 147 | 13•3 (11•3-15•3) | 234 | 15•7 (13•8-17•6) |
| Rheumatologist | 19 | 0•6 (0•3-0•9) | 15 | 0•4 (0•2-0•5) | 0 | 0•0 (N/A) | 5 | 0•3 (0•0-0•6) |
| Allied health professionals | 118 | 3•9 (3•1-4•6) | 262 | 6•3 (5•5-7•1) * | 40 | 3•6 (2•5-4•7) | 96 | 6•4 (5•1-7•7) * |
| Physiotherapist | 97 | 3•2 (2•5-3•8) | 209 | 5•0 (4•3-5•7) * | 33 | 3•0 (2•0-4•0) | 67 | 4•5 (3•4-5•6) |
| Podiatrist/chiropodist | 5 | 0•2 (0•0-0•3) | 5 | 0•1 (0•0-0•2) | 2 | 0•2 (0•0-0•4) | 5 | 0•3 (0•0-0•6) |
| Exercise physiologist | 0 | 0•0 (N/A) | 8 | 0•2 (0•1-0•3) | 1 | 0•1 (0•0-0•3) | 6 | 0•4 (0•1-0•7) |
| Dietitian/nutritionist | 1 | 0•0 (0•0-0•1) | 7 | 0•2 (0•0-0•3) | 0 | 0•0 (N/A) | 2 | 0•1 (0•0-0•3) |
| Imaging | ||||||||
| All | 668 | 21•8 (20•2-23•5) | 1,037 | 25•0 (23•5-26•4) | 356 | 32•2 (28•9-35•5) | 464 | 31•1 (28•1-34•1) |
| New | 301 | 44•8 (40•7-48•9) | 444 | 46•3 (42•7-49•8) | 167 | 58•8 (51•1-66•5) | 209 | 56•3 (49•4-63•3) |
| Diagnostic radiology ¢ | 632 | 20•7 (19•1-22•2) | 913 | 22•0 (20•6-23•3) | 332 | 30•0 (26•8-33•2) | 400 | 26•8 (24•1-29•5) |
| Ultrasound | 26 | 0•9 (0•5-1•2) | 66 | 1•6 (1•2-2•0) | 16 | 1•4 (0•6-2•3) | 36 | 2•4 (1•6-3•2) |
| MRI | 5 | 0•2 (0•0-0•3) | 43 | 1•0 (0•7-1•4) * | 1 | 0•1 (0•0-0•3) | 10 | 0•7 (0•2-1•1) * |
| Counselling/advice/ education | ||||||||
| All | 472 | 15•4 (14•0-16•9) | 821 | 19•8 (18•3-21•2) * | 175 | 15•8 (13•3-18•4) | 268 | 18•0 (15•7-20•2) |
| New | 106 | 15•8 (12•7-18•8) | 195 | 20•3 (17•2-23•4) | 39 | 13•7 (9•0-18•4) | 65 | 17•5 (13•2-21•8) |
| Physical Treatments | ||||||||
| All | 345 | 11•3 (9•9-12•7) | 470 | 11•3 (9•9-12•7) | 39 | 3•5 (2•3-4•8) | 82 | 5•5 (3•9-7•1) |
| New | 65 | 9•7 (7•1-12•2) | 105 | 10•9 (8•8-13•1) | 5 | 1•8 (0•0-3•6) | 18 | 4•9 (2•5-7•2) |
| Exercise/rehabilitation | 114 | 3•7 (2•9-4•6) | 213 | 5•1 (4•3-6•0) | 23 | 2•1 (1•1-3•1) | 50 | 3•4 (1•9-4•8) |
| Acupuncture | 56 | 1•8 (1•2-2•5) | 50 | 1•2 (0•7-1•7) | 2 | 0•2 (0•0-0•4) | 9 | 0•6 (0•2-1•0) |
| Joint injection # | 134 | 4•4 (3•5-5•3) | 132 | 3•2 (2•5-3•9) | 6 | 0•5 (0•1-1•0) | 10 | 0•7 (0•3-1•1) |
| At least one lifestyle management † | ||||||||
| All | 546 | 17•9 (16•4-19•3) | 954 | 23•0 (21•5-24•4) * | 186 | 16•8 (14•5-19•1) | 292 | 19•6 (17•3-21•8) |
| New | 139 | 20•7 (17•5-23•9) | 257 | 26•8 (23•8-29•7) | 42 | 14•8 (10•4-19•1) | 77 | 20•8 (16•4-25•1) |
^ Medicare service item numbers (up to 3) could be recorded for each encounter. Chronic disease management items including case conferences: Identified by any of the following item numbers: 720, 721, 722, 723, 724, 725, 726, 727, 729, 730, 731, 732.
†At least one of the following being used in the management of OA: referral to a dietician/nutritionist or physiotherapist; advice/education/counselling; physical medicine/rehabilitation.
# performed by the GP and includes platelet rich plasma, hyaluronic acid, corticosteroid.
¢ including x-ray but excluding MRI and US.
* significant difference compared with 2005-2010 time period.
N/A=not applicable; CI=confidence interval.