Prof Hylton Menz1, Dr Christopher Harrison2, Dr Clare Bayram2
1Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia, 2Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
There are approximately 5,000 podiatrists currently practicing in Australia. Many patients are referred to podiatrists through their general practitioner (GP), but little is known about the types of patients they refer. Therefore, the objective of this study was to describe patterns of referral to podiatrists by GPs in Australia. We analysed data from the Bettering the Evaluation and Care of Health Program, a continuous cross-sectional study of Australian general practice activity, from April 2000 to March 2016 inclusive. Data were summarised using descriptive statistics with 95% conﬁdence intervals around point estimates. Multivariate logistic regression was used to identify characteristics independently associated with referral. The dataset included 1,568,100 encounters including 5,912 podiatry referrals. Referrals increased from 7.0 to 39.5 per 1,000 population over the evaluation period. In multivariate analyses, female GPs were more likely than males to refer and GPs aged ≥55 years less likely to refer. Patients referred to podiatrists were more likely to be aged ≥85 years, Indigenous, from an English-speaking background, and have previously been seen at the practice. The problem generating the highest number of referrals was diabetes. Following the introduction of Medicare funding, referred patients were more likely to be female, aged >45 years, have a healthcare card, be socioeconomically disadvantaged, and have previously been seen at the practice. Overall, these findings suggest that GP referral to podiatrists in Australia increased markedly following the introduction of Medicare funding and appears to be targeted to those with the greatest need. However, further research is required to determine whether the observed increase in the utilisation of podiatry results in improved clinical outcomes for patients and has a broader public health benefit.
Professor Hylton Menz is a National Health and Medical Research Council of Australia (NHMRC) Senior Research Fellow at La Trobe University. Professor Menz’s broad research disciplines are human movement, rehabilitation and rheumatology, with a particular focus on musculoskeletal foot problems in older people. His research extends from laboratory-based biomechanical studies through to analysis of epidemiological datasets and the conduct of clinical trials.