The Research Process

The PCSIP will investigate the impact of different approaches to primary health care on the management of three chronic conditions: obesity, diabetes type 2, and depression.

The project will occur in four phases.

Phase 1: Practice recruitment

This phase involves the recruitment of 16 Practices in the Adelaide Northern Division of General Practice (ANDGP). Each Practice will be categorised into one of four models of Practice, based on the uptake of primary care-based initiatives relevant to the conditions, (such as diabetes incentives)

Phase 2: Patient identification and recruitment

Within each Practice, we plan to recruit a minimum of 10 patients diagnosed with one or more of the three study conditions (i.e. a minimum of 30 patients per Practice). To enhance identification of eligible patients via electronic patient records, a trained staff member can be made available to clean electronic patient records in participating Practices (optional service).

Phase 3: Data collection

The project will request patient consent to access the following data sources: electronic medical records held at the Practice and the ANDGP (if the patient has received services there), MBS and PBS records, hospitalisation data from the SA Department of Health and a maximum of 2 survey documents over the 1 year follow-up period. Data will be collected both retrospectively and prospectively (i.e. over a two-year period before and a one-year period from the point at which patients are recruited). The information collected about patients will include some socio-demographic characteristics, health services utilisation, and clinical measures (such as HbA1C in patients with diabetes).

Phase 4: Data analysis

Using primary data, we will identify differences in patient pathways and intermediate outcomes (such as control of HbA1c levels). We will analyse data collected from patients' medical records to identify differences between Practices, accounting for variations in socioeconomic status and casemix to isolate the effects of differing rates of uptake of alternative primary care-based initiatives. We will also use data from other sources (secondary data) to extrapolate the observed pathways, enabling us to estimate the long term benefits and costs associated with the implementation of primary care-based initiatives.

The research process has been summarised in figure 1.

  Figure 1: Flow Chart of the Research Process