INTRODUCTION
The availability of general practice data for analysis has the potential to benefit both health outcomes and health services research. The large sample sizes, breadth and uniquely longitudinal nature of the information that is available (e.g. medications used) are attributes not commonly found in other health data sets.1 – 3 The U.K.’s General Practice Research Database (now part of the Clinical Practice Research Datalink)4 is the largest and most comprehensive source of general practice data in the world. This database is considered the ‘gold standard’ for anonymised longitudinal medical records from primary care. Analysis of these data has resulted in the publication of a large number of studies that have contributed significantly to primary care policy and wider health research and practice.5
In contrast, primary health care in Australia has suffered from a particular lack of research capability to inform both policy and practice.6 – 8 A fundamental barrier to developing this capability has been the limited access to patient and health services data that could underpin this research.9 Approximately 75% of all medical consultations in Australia take place in general practice, with more than 85% of the population accessing a general practitioner (GP) every year.10 For this reason, access to pooled data represents a significant potential resource.
However, access to general practice data in Australia has been limited. The segregated nature of information systems that are currently being used to collect and store patient records has led to incompatibility between software packages, coding regimes, specific fields collected and privacy policies. Also, general practices, by nature, exist as individual small businesses,11 which makes recruiting individual practices for the purpose of data collection arduous and complex.
In Australia, there are currently only two significant sources of general practice data: Medicare Australia and the Bettering the Evaluation and Care of Health (BEACH) program.12 Data held by Medicare Australia (on behalf of the Australian government) are used primarily for financial administration. Apart from some broad descriptors of the types of consultations being billed (e.g. health assessments or mental health plans), Medicare data do not contain any information about the clinical problems being managed. Also, it is structured around individual GPs, but not practices. In contrast, the BEACH program uses a cross-sectional, paper-based survey to collect data on the characteristics of GPs, GP-patient encounters, and the services and treatments provided. However, BEACH only captures information at the GP level (i.e. GPs describe the care that they have provided) and is limited by its paper-based and cross-sectional design. Again, it is not a whole of practice program. Consequently, there is a need to develop other general practice data sources in Australia that are capable of addressing the limitations inherent in the data sources that are currently available.