General practice activity in Australia 
1999–00 to 2008–09: 10 year data tables
BEACH 
Bettering the Evaluation And Care of Health
Helena Britt, Graeme C Miller, Jan Charles, Joan Henderson, Clare Bayram, Lisa Valenti, Ying Pan, Christopher Harrison, Salma Fahridin, Julie O’Halloran
December 2009

The Australian Institute of Health and Welfare is Australia’s national
health and welfare statistics and information agency. The Institute’s mission is
 better information and statistics for better health and wellbeing.

© Australian Institute of Health and Welfare and the University of Sydney 2009

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Media and Communications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.

This publication is part of the Australian Institute of Health and Welfare’s General practice series, from the Australian General Practice Statistics and Classification Centre (AGPSCC), a collaborating unit of the Family Medicine Research Centre (FMRC) of the University of Sydney and the Australian Institute of Health and Welfare (AIHW). A complete list of the Institute’s publications is available at the Institute’s website <www.aihw.gov.au>.

ISSN 1442-3022
ISBN 978 1 74024 973 7
Suggested report citation 
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Valenti L, Pan Y, Harrison C, Fahridin S, O’Halloran J 2009. General practice activity in Australia 1999–00 to 2008–09: 10 year data tables. General practice series no. 26. Cat. no. GEP 26. Canberra: AIHW.
Keywords
Australia, delivery of health care/statistics and numerical data, family practice/statistics and numerical data, health care surveys/methods.
Companion publication
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, Fahridin S, O’Halloran J 2009. General practice activity in Australia, 2008–09. General practice series no. 25. 
Cat. no. GEP 25. Canberra: AIHW.
Australian Institute of Health and Welfare 
Board Chair
Hon. Peter Collins, AM, QC

Director 	
Penny Allbon

Any enquiries about or comments on this publication should be directed to:
The Australian General Practice Statistics and Classification Centre
Sydney School of Public Health, University of Sydney
Level 7, 16–18 Wentworth Street
Parramatta NSW 2150
Phone: +61 2 9845 8151; Fax: +61 2 9845 8155; Email: gpstats@fmrc.org.au
Published by the Australian Institute of Health and Welfare 

Please note that there is the potential for minor revisions of data in this report.
Please check the online version at <www.aihw.gov.au> for any amendments.

Contents
Acknowledgments	v
Abbreviations	vi
Symbols	vii
Executive summary	viii
1	Introduction	1
1.1	Background—general practice in Australia	2
2	Methods	3
2.1	Sampling methods	3
2.2	Recruitment methods	3
2.3	Data elements	4
2.4	The BEACH relational database	5
2.5	Supplementary Analysis of Nominated Data	5
2.6	Statistical methods	9
2.7	Changes over time	10
2.8	Extrapolated national estimates	10
2.9	Changes to data elements and reporting methods	12
2.10	Classification of data	13
2.11	Quality assurance	17
2.12	Validity and reliability	18
3	The sample	20
4	The participating GPs	21
5	The encounters	27
5.1	Content of the encounters	27
6	The patients	33
6.1	Age–sex distribution of patients at encounter	33
6.2	Other patient characteristics	33
6.3	Patient reasons for encounter	33
7	Problems managed	44
7.1	Number of problems managed	44
7.2	Distribution of problems managed by ICPC-2 component	45
7.3	Problems managed by ICPC-2 chapter and individual problems managed	45
7.4	Most common new problems	46
7.5	Most frequently managed chronic problems	46
8	Overview of management	58
9	Medications	64
9.1	Prescribed medications	64
9.2	Medications supplied by GPs	73
9.3	Medications advised for over-the-counter purchase	73
10	Other treatments	76
10.1	Clinical treatments	76
10.2	Procedures	77
11	Referrals and admissions	85
12	Investigations	89
12.1	Number of encounters where pathology or imaging was ordered	89
12.2	Pathology test orders by MBS groups	90
12.3	Imaging test orders by MBS group	90
13	Practice nurse activity	95
13.1	Overview of practice nurse activity	96
13.2	Distribution of practice nurse item numbers claimed at encounters	96
13.3	Treatments provided by practice nurses	97
13.4	Problems managed with practice nurse involvement	98
14	Patient risk factors	101
14.1	Body mass index	102
14.2	Smoking	102
14.3	Alcohol consumption	102
References	107
Glossary	111
Appendices	114
Appendix 1: Example of a 2008–09 recording form	114
Appendix 2: GP characteristics questionnaire, 2008–09	116
Appendix 3: Dissemination of results from the BEACH program	117
Appendix 4: Code groups from ICPC-2 and ICPC-2 PLUS	135
Appendix 5: Chronic code groups from ICPC-2 and ICPC-2 PLUS	162
List of tables	166
List of figures	168

Acknowledgments
The Australian General Practice Statistics and Classification Centre (formerly the General Practice Statistics and Classification Unit) wishes to thank the general practitioners who participated in BEACH (Bettering the Evaluation And Care of Health) since it began in April 1998. This report would not have been possible without their valued cooperation and effort in providing the data.
We also thank the following organisations for their financial support and their contribution to the ongoing development of the BEACH program since it began:
•	AstraZeneca Pty Ltd (Australia) (1998–2009)
•	Janssen-Cilag Pty Ltd (2000–2009)
•	Merck, Sharp and Dohme (Australia) Pty Ltd (2002–2009)
•	Pfizer Australia (2003–2009)
•	National Prescribing Service Ltd (2005–2009)
•	Australian Government Department of Health and Ageing (1998–2004, 2007–2009)
•	Abbott Australasia (2006–2009)
•	Sanofi-Aventis Australia Pty Ltd (2006–2009)
•	Wyeth Australia Pty Ltd (2008–2009)
•	Roche Products Pty Ltd (1998–2006)
•	Aventis Pharma Pty Ltd (1998–2002)
•	National Occupational Health and Safety Commission (1998–2000)
•	Australian Government Department of Veterans’ Affairs (1998–2000).
Some financial support for the program was also provided by:
•	Australian Government Department of Veterans’ Affairs (2004–2009)
•	The Office of the Australian Safety and Compensation Council, Department of Employment and Workplace Relations (2004–2006).
We acknowledge the support of the Royal Australian College of General Practitioners, the Australian Medical Association, the Australian General Practice Network, the Australian College of Rural and Remote Medicine, and the Consumers Health Forum, and the contribution of their representatives to the BEACH Advisory Board.
The research team is grateful to Clare Bayram for her coordination and editing of this report, for the IT support of Timothy Chambers and the administrative support of Denise Barratt and Gervaise Woods, and for the valuable contribution of the general practitioner recruitment staff (Errol Henderson, Jan Fitzgerald and David Went) and data entry staff. We recognise the contribution of past members of the BEACH team. We appreciate the cooperation of the Primary and Ambulatory Care Division of the Australian Government Department of Health and Ageing in regularly supplying general practitioner random samples and national Medicare data. 
Ethics approval for this study was obtained from the Human Ethics Committee of the University of Sydney and the Ethics Committee of the Australian Institute of Health and Welfare.
Abbreviations
ABS	Australian Bureau of Statistics	
ACE	angiotensin-converting enzymes 	
AIHW	Australian Institute of Health and Welfare	
ASGC	Australian Standard Geographical Classification	
ATC	Anatomical Therapeutic Chemical (classification)	
AUDIT	Alcohol Use Disorders Identification Test	
BEACH	Bettering the Evaluation And Care of Health	
BMI	body mass index	
CAPS	Coding Atlas for Pharmaceutical Substances	
CI	confidence interval (in this report 95% CI is used)	
CT	computerised tomography	
DVA	Australian Government Department of Veterans’ Affairs	
encs	Encounters	
FRACGP	Fellowship of the Royal Australian College of General Practitioners	
GORD	gastro-oesophageal reflux disease 	
GP	general practitioner	
HbA1c	haemoglobin, type A1c	
ICPC	International Classification of Primary Care	
ICPC-2	International Classification of Primary Care—Version 2	
ICPC-2 PLUS	a terminology classified according to ICPC-2	
INR	international normalised ratio	
MBS	Medicare Benefits Schedule	
NHS	National Health Survey	
NSAID	non-steroidal anti-inflammatory drug	
OTC	over-the-counter (i.e. medications advised for over-the-counter purchase)	
PBS	Pharmaceutical Benefits Scheme	
PN	practice nurse	
RACGP	Royal Australian College of General Practitioners	
RFE	reason for encounter	
SAND	Supplementary Analysis of Nominated Data	
SAS	Statistical Analysis System	
URTI	upper respiratory tract infection	
WHO	World Health Organization	
N/A	not applicable	
NAv	not available	
NEC	not elsewhere classified	
n	number	
NOS	not otherwise specified	
Symbols
/	indicates a statistically significant linear change 	
/	indicates a marginally significant linear change	
§	indicates a non-linear significant or marginal change	
—	indicates no change	
<	less than	
>	more than	

Executive summary
This report compares results from each of the last 10 years of the BEACH (Bettering the Evaluation And Care of Health) program, and highlights changes in the characteristics of general practitioners (GPs) and their patients, and in GP clinical activities in Australia over the decade 1999–00 to 2008–09. 
BEACH is a continuous national study of general practice in which data are collected from a new sample each year of about 1,000 GPs. Each GP provides details for 100 consecutive 
GP–patient encounters. BEACH began in April 1998 and this report uses data collected between April 1999 and March 2009 inclusive, from about 9,900 GP participants, covering about 990,000 GP–patient encounters.
Changes in the population influence GP clinical work. Since 1999 the estimated population of Australia increased by 13.7% to 21.64 million in December 2008. More than 85% of the population visit a GP at least once in any year. From March 2008 to April 2009, there were about 112 million general practice consultations paid for by Medicare, up from 101 million in 1999–00; an average of 5.1 per person, a similar visit rate to 1999–00 (5.4 visits per head). 
The GPs
•	The feminisation of the GP workforce is reflected in the growing proportion of GP BEACH participants who are female, increasing from 30% in 1999–00 to 33% in 2008–09. 
•	The GP workforce is ageing—those aged 55 years or more at the time they participated increased from 27% of the final sample in 1999–00 to 46% in 2008–09.
•	Most GPs are in group practices and the average GP is working fewer hours.
•	In 2008–09 about 40% of GPs h old specialist GP qualifications, an increase from 30% 10 years earlier.
•	Almost 60% of GPs work in practices that do not provide their own or cooperative practice coverage of after-hours care compared with 40% in 2000. 
Why do the patients see their GP?
•	In 1999–00 about half the GP–patient encounters were with people aged <45 years but with the ageing population and increased prevalence of diagnosed chronic disease, in 2008–09 patients aged 45+ years accounted for 60% of all GP–patient encounters.
•	Compared with 1999–00 fewer patients went to their GP for only one reason. 
•	There were increases in patient requests for prescriptions, immunisations, blood tests, tests results, and administrative actions such as medical certificates. In 2008–09 patients also presented more often about their diabetes, depression and hypertension. 
•	In contrast, patient presentations of symptoms and complaints such as ear pain, throat complaints and headaches decreased by about a 25% over the 10 years.
Have the problems that GPs manage changed?
•	GPs managed increasing numbers of problems per encounter and this applied to both newly diagnosed problems and chronic conditions. We estimate 24.7 million more problems were managed at GP encounters in Australia in 2008–09 than in 1999–00. 
•	Respiratory problems were the most common type of problem managed throughout the decade but were managed less often in 2008–09 (21 per 100 encounters) than in 1999–00 (24 per 100). The decrease was mainly due to drops in upper respiratory tract infection, acute bronchitis, allergic rhinitis, tonsillitis and asthma. This suggests that nationally GPs managed 1.2 million fewer respiratory problems in 2008–09 than 10 years earlier. 
•	Hypertension was the most common individual problem managed throughout the decade but was managed with increasing frequency, resulting in 2.8 million more visits nationally in 2008–09 than in 1999–00. Other problems managed more often in 2008–09 than 10 years earlier included general check-ups, immunisations/vaccinations, depression, diabetes, cholesterol, osteoarthritis oesophageal disease, atrial fibrillation, pregnancy, and malignant skin neoplasms. 
How has disease management changed?
•	The major change in management was a decrease in the number of prescribed medications (down from 64 to 56 per 100 problems managed by the GP). There was an increase in the number of medications supplied directly by the GP (from 5 to 7 per 100 problems managed) and these were mostly vaccinations. However the increase in GP-supplied medications did not fully counteract the decrease in prescriptions. Consequently there was a decrease from 75 to 69 per 100 problems managed for all medications prescribed, supplied or advised for over-the-counter purchase. 
•	The decrease in prescribing did not apply to all types of medications. Increased prescribing rates were apparent for some, particularly cholesterol-lowering agents and drugs for acid-related digestive problems. 
•	In 2008–09 GPs provided clinical treatments (such as advice, education and psychological counselling) at a similar rate to 1999–00, after a sudden decrease in these activities at the time of the introduction of practice nurse item numbers in 2004.
•	GPs undertook more procedures in 2008–09 than 10 years earlier. 
•	GPs referred their patients more often, particularly to specialists, with a smaller increase in referrals to allied health services.
•	The number of orders for pathology tests increased by more than 50%, from 30 test orders per 100 encounters to 46 per 100.
•	There was also a significant but smaller increase in orders for imaging. 
•	Since first measured in 2005–06, practice nurse involvement in GP–patient encounters increased—they were involved in 6.4% of encounters (compared with 4.2% in 2005–06), but in all years only about 40% of these activities were claimable from Medicare. The increase in nurse activity was particularly notable in the number of INR blood tests and check-ups they did. In all years, they were most often involved in immunisations/ vaccinations.
Patient risk factors
•	In adult patients aged 18 years and over, between 1999–00 and 2008–09 prevalence of overweight increased from 33% to 36%, obesity from 19% to 25%, daily smoking decreased from 19% to 15% and at-risk alcohol consumption remained static at 26%. 
•	In children aged 2–17 years prevalence of overweight and obesity remained static at about 11% obese and 17% overweight. 
•	
1	Introduction
This publication is the 26th book in the series from the BEACH program. This report includes summary results from the most recent 10 years of the program, from 1999–00 to 2008–09 inclusive.
BEACH is a continuous national study of general practice activity conducted by the Australian General Practice Statistics and Classification Centre (AGPSCC). The AGPSCC is a collaborating unit of the Family Medicine Research Centre (FMRC) at the University of Sydney and the Australian Institute of Health and Welfare (AIHW). BEACH is currently supported financially by government instrumentalities and private industry (see Acknowledgments).
BEACH began in April 1998, and at the end of its 11th year (March 2009) the BEACH database included records for almost 1.1 million encounters from 10,885 participants representing more than 7,824 individual general practitioners (almost half of the practising recognised GP population in Australia).
Annual results from the BEACH study are published each year. The most recent of these, released in parallel with this book, is General practice activity in Australia 2008–09.1 This book brings the last 10 years of data together to provide a reference document for those interested in changes that have occurred over the decade 1999–00 to 2008–09 in the GP workforce, the patients consulting them, the problems managed and the treatments provided by GPs. 
Like the rest of the developed world, Australia has an ageing population—from 1998 to 2007 there was about a 1% decrease in the proportion of the population aged less than 15 years and an extra 1% aged 65 years and over.2 As life expectancy improves, people are living longer with disease, so that a greater part of the GP workload will involve management of older patients with multiple chronic diseases.
The highest annual average number of Medicare GP items of service claimed per head of population was in 1998–99, at 5.5 visits per head. Average attendance then steadily decreased to a low of 4.87 visits per head in 2003–04. This decreasing attendance rate raised questions about equity of access, leading the Australian Government to make substantial changes to laws governing Medicare benefits in 2004 and 2005. General practice attendance rates are now approaching the 1998–99 levels.3
The structure of this report follows the usual approach of the annual BEACH reports. 10 years of results are provided for the GPs, the patients and the problems managed, together with an overview of management, specific chapters for each management action and a chapter on practice nurse activity. Changes in the prevalence of some risk factors among patients at GP encounters are also presented. 
Each chapter contains an overview of the section (including definitions where relevant), the results tables and a brief description of each table. In the tables, statistically significant changes in results between 1999–00 (or 2000–01 if relevant) and 2008–09 are marked. The national effect of significant change can be estimated by extrapolating the BEACH results to all GP Medicare claimed encounters. The method adopted for extrapolation of the effect of a change is described in Section 2.8. Examples of extrapolation of a measured change are also provided in each chapter, from Chapter 5 to 13 inclusive. The reader can apply this method to any significant change in the data presented, to gain an estimate of the size of the national change in frequency of an event, occurring as a result of changes in general practice.
In this report we do not investigate changes in (for example) the GP use of medications, referrals and investigations in the management of a specific problem, or changes in the problems presented by selected groups of patients. Such work was undertaken for morbidities classed in the National Health Priority Areas4 and published in July 2009 in General practice in Australia, health priorities and policies 1998 to 2008.5 
1.1	Background—general practice in Australia
•	In December 2008 the estimated population of Australia was 21.64 million people.6
•	GPs are the first port of call in the Australian health care system. 
•	There were 97 full-time equivalent practising primary care practitioners per 100,000 people in Australia in 2006.7 
•	About 88% of the Australian population visited a GP at least once in 2005–06.8
•	Payment is on a fee-for-service system, there being no patient lists or registration. 
•	People are free to visit multiple practitioners and multiple practices of their choice.
•	There is a universal medical insurance scheme (managed by Medicare Australia), which covers all or most of an individual’s costs for a GP visit. 
•	In 2008–09, 112 million general practitioner items of services were paid by Medicare Australia at an average rate of more than five visits per person per year.9 GPs provided an estimated additional 5.4 million services paid for by other funders (such as workers compensation, state government) or not charged for at all.10 In 2008–09, the primary cost to Medicare for GP items was over $4.5 billion.9 
BEACH gives us some understanding of the content of these encounters and of the services and treatments that GPs provide. The BEACH program aims to:
•	provide a reliable and valid data collection process for general practice that is responsive to the ever-changing needs of information users
•	establish an ongoing database of GP–patient encounter information
•	assess patient risk factors and health states, and the relationship these factors have with health service activity.
Users of the BEACH data might wish to consolidate information from multiple national data sources. Integration of data from multiple sources can provide a more comprehensive picture of the health and health care of the Australian community. It is therefore important that readers are aware of how the BEACH data differ from those drawn from other sources. A summary of differences between those data collected in BEACH compared with those in the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme and the National Health survey is available in General practice activity in Australia 2008–09 (see Section 1.3).1
The BEACH program has generated many papers on a wide range of topics in journals and professional magazines. Appendix 3 lists all published material from BEACH. 
2	Methods
In summary:
•	each year BEACH involves a random sample of approximately 1,000 GPs
•	each GP records details about 100 doctor–patient encounters of all types
•	the GP sample is a rolling (ever-changing) sample, with approximately 20 GPs participating in any one week, 50 weeks a year
•	each GP can be selected only once per quality assurance (QA) triennium (that is once every 3 years)
•	the encounter information is recorded by the GPs on structured paper encounter forms (Appendix 1)
•	each GP participant also completes a questionnaire about themselves and their practice (Appendix 2).
2.1	Sampling methods
The source population includes all vocationally registered GPs and all general practice registrars who claimed a minimum of 375 general practice A1 Medicare items in the most recently available 3-month Medicare data period (which equates to 1,500 A1 Medicare claims a year). This ensures inclusion of the majority of part-time GPs while excluding those who are not in private practice but claim for a few consultations a year.
On a quarterly basis the Primary and Ambulatory Care Division of the Department of Health and Ageing (DoHA) updates the sample frame from the Medicare records, leaving out of the sample frame any GPs already randomly sampled in the current triennium, and draws a new sample from those currently in the sample frame. This ensures the timely addition of new entries to the profession, and timely exclusion of those GPs who have stopped practising.
2.2	Recruitment methods
The randomly selected GPs are approached by letter posted to the address provided by DoHA.
•	Over the following 10 days the telephone numbers generated from the Medicare data are checked using the electronic white and yellow pages. This is necessary because many of the telephone numbers provided from the Medicare data are incorrect.
•	The GPs are then telephoned in the order they were approached and, referring to the approach letter, asked whether they will participate.
•	This initial telephone contact with the practice often indicates that the selected GP has moved elsewhere, but is still in practice. Where the new address and/or telephone number can be obtained, these GPs are followed up at their new address.
•	GPs who agree to participate are set an agreed recording date several weeks ahead.
•	A research pack is sent to each participant about 10 days before the planned start date.
•	Each GP receives a telephone reminder in the first days of the agreed recording period—this also provides the GP with an opportunity to ask questions about the recording process.
•	GPs can use a ‘freecall’ (1800) number to ring the research team with any questions during their recording period.
•	Non-returns are followed up by regular telephone calls for up to 3 months after the set recording time.
•	Participating GPs earn Clinical Audit points towards their QA requirements through the Royal Australian College of General Practitioners (RACGP). As part of this QA process, each receives an analysis of his or her results compared with those of nine other de-identified GPs who recorded at approximately the same time. Comparisons with the national average and with targets relating to the National Health Priority Areas are also provided. In addition, GPs receive some educational material related to the identification and management of patients who smoke or consume alcohol at hazardous levels. Additional points can be earned if the participant chooses to do a follow-up audit of smoking and alcohol consumption among a sample of patients about 6 months later.
2.3	Data elements
BEACH includes three interrelated data collections: encounter data, GP characteristics and patient health status. An example of the form used to collect the encounter data and the data on patient health status in 2008–09 is included in Appendix 1. The GP characteristics questionnaire (2008–09) is provided in Appendix 2. The data collected include the following:
•	Encounter data: date of consultation, type of consultation (direct/indirect), up to three MBS/DVA item numbers (where applicable) and other payment source (where applicable) (tick boxes).
•	Patient data: date of birth, sex and postcode of residence. Tick boxes are provided for Commonwealth concession cardholder, holder of a Repatriation health card (from DVA), non-English-speaking background (patient self-report—a language other than English is the primary language at home), Aboriginal person (self-identification) and Torres Strait Islander person (self-identification). Space is provided for up to three patient reasons for encounter (RFEs).
•	The problems managed at encounter (at least one and up to four). Tick boxes are provided to denote the status of each problem as new or continuing for the patient 
•	Management of each problem, including:
–	medications prescribed, supplied by the GP and advised for over-the-counter purchase including brand name, form (where required), strength, regimen, status (if new or continuing medication for this problem for this patient) and number of repeats
–	other treatments provided for each problem including counselling, advice and education, and procedures undertaken; and if other treatment was provided by practice nurse (tick box)
–	new referrals to medical specialists, allied health professionals and hospital
–	investigations including pathology tests, imaging and other investigations ordered at the encounter.
•	GP characteristics: age and sex, years in general practice, number of GP sessions worked per week, number of full-time equivalent GPs working in the practice, postcode of major practice address, country of graduation, postgraduate general practice training and Fellow of the RACGP status, after-hours care arrangements, use of computers in the practice, whether the practice is accredited, whether it is a teaching practice, work undertaken in other clinical settings and hours worked in direct patient care.
2.4	The BEACH relational database
The BEACH relational database is described diagrammatically in Figure 2.1.
Figure 2.1: The BEACH relational database
Flow chart showing GP and practice characteristics in relation to management of problems and other patient characteristics
Note: FTE—full-time equivalent; NESB—non-English-speaking background; SAND—Supplementary Analysis of Nominated Data.

Note that:
•	all variables can be directly related to GP and patient characteristics, and to the encounter
•	RFEs have only an indirect relationship with problems managed, as a patient may describe one RFE (such as ‘repeat prescriptions’) that is related to multiple problems managed, or several RFEs (such as ‘runny nose’ and ‘cough’) that relate to a single problem (such as upper respiratory tract infection) managed at the encounter
•	all types of management are directly related to the problem being treated.
2.5	Supplementary Analysis of Nominated Data 
A section at the bottom of each recording form investigates aspects of patient health or health care delivery in general practice not covered by the consultation-based data. These additional substudies are known as Supplementary Analysis of Nominated Data (SAND).
•	The year-long data period is divided into 10 blocks, each of 5 weeks with three substudies per block. The research team aims to include data from about 100 GPs in each block.
•	Each GP’s pack of 100 forms is made up of 40 forms that ask for the start and finish times of the encounter, and include questions about patient risk factors, patient height and weight (used to calculate body mass index (BMI)), alcohol intake and smoking status (patient self-report). The results of topics in the SAND substudies for alcohol consumption, smoking status and BMI are reported in Chapter 14. The start and finish times collected on these encounters is used to calculate the length of consultation. The length of consultation for Medicare-claimable encounters is reported in Chapter 5.
•	The remaining 60 forms in each pack are divided into two blocks of 30. Different questions are asked of the patient in each block and these vary throughout the year.
•	The order of SAND sections is rotated in the GP recording pack, so that 40 patient risk factor forms may appear first, second or third in the pad. Rotation of ordering ensures there was no order effect on the quality of the information collected.
Abstracts of results and the research tools used in all SAND substudies from April 1998 to March 2009 have been published. Those from:
•	April 1998–99 were published in Measures of health and health care delivery in general practice in Australia11
•	April 1999 to July 2006 were published in Patient-based substudies from BEACH: abstracts and research tools 1999–200612
•	August 2006 to March 2007 were published in General practice activity in Australia
 2006–0713
•	April 2007 to January 2008 were published in General practice activity in Australia
 2007–0810
•	February 2008 to January 2009 are included in Chapter 15 of General practice activity in Australia 2008–09.1
Abstracts of results for all SAND substudies are also available on the FMRC’s website <www.fmrc.org.au/publications/SAND_abstracts.htm>.
Patient risk factor substudy methods
Body mass index
Patient BMI was investigated for a subsample of 40 of the 100 patient encounters. Each GP was instructed to ask the patient (or their carer in the case of children):
•	What is your height in centimetres (without shoes)?
•	What is your weight in kilograms (unclothed)?
Metric conversion tables (feet and inches; stones and pounds) were provided to the GP.
The BMI for an individual was calculated by dividing weight (kilograms) by height (metres) squared. The recent World Health Organization (WHO) recommendations14 for BMI groups were used, which specify that an adult (18 years and over) with a BMI:
•	less than 18.5 is underweight
•	greater than or equal to 18.5 and less than 25 is normal
•	greater than or equal to 25 and less than 30 is overweight
•	of 30 or more is obese.
The reported height for adult patients was checked against sex-appropriate upper and lower height limits from the Australian Bureau of Statistics (ABS).15 Encounters with adults whose reported heights were outside the sex-appropriate limits were excluded from the analysis.
The division between underweight and normal was, in reports published before 2006, set at a BMI of 20. In tables 14.1 to 14.3 patient BMI have been recalculated for all years and are reported according to the current WHO criteria.
The standard BMI cut-offs described above are not appropriate in the case of children. Cole et al. (2000, 2007) developed a method which calculates the age–sex-specific BMI cut-off levels for overweight and obesity specific to children aged 2–17 years.16,17 This method, based on international data from developed Western cultures, is applicable in the Australian setting. The reported height of children was checked against age–sex-appropriate upper and lower height limits from the ABS and Centres for Disease Control (CDC).15,18 Encounters with children whose reported heights were outside either of the age–sex-appropriate limits were excluded from the analysis. In reports published prior to 2009 the BMI categories of underweight and normal were grouped together for children. In Table 14.1 the BMI have been recalculated for all years for children.
The BEACH data on BMI are presented separately for adults (aged 18 years and over) and children (aged 2–17 years). The standard BMI cut-offs have been applied for the adult sample, and the method described by Cole et al. (2000, 2007) has been used for defining overweight and obesity in children (aged 2–17 years).16,17 
Smoking
GPs were instructed to ask adult patients (18 years and over):
•	What best describes your smoking status? 	Smoke daily
	Smoker occasionally
	Previous smoker
	Never smoked
Respondents were limited to adults aged 18 years and over because there are ethical concerns about approaching the younger patient group to ask for information about smoking for survey purposes. In addition, the reliability of this information from patients aged less than 18 years may be compromised if a parent or carer is present at the consultation.
Alcohol consumption
To measure alcohol consumption, BEACH uses three items from the WHO Alcohol Use Disorders Identification Test (AUDIT)19, with scoring for an Australian setting.20 Together, these three questions assess ‘at-risk’ alcohol consumption. The scores for each question range from zero to four. A total (sum of all three questions) score of five or more for males or four or more for females suggests that the person’s drinking level is placing him or her at risk.20
GPs were instructed to ask adult patients (18 years and over):
•	How often do you have a drink containing alcohol?	Never
	Monthly or less
	Once a week/fortnight
	2–3 times a week
	4+ times a week
•	How many standard drinks do you have on a typical day when you are drinking? 			_____________
•	How often do you have six or more standard drinks on one occasion? 
	Never
	Less than monthly
	Monthly
	Weekly
	Daily or almost daily
A standard drinks chart was provided to each GP to help the patient identify the number of standard drinks consumed.
Respondents were limited to adults aged 18 years and over because there are ethical concerns about approaching the younger patient group to ask for information about alcohol consumption for survey purposes. In addition, the reliability of this information from patients aged less than 18 years may be compromised if a parent or carer is present at the consultation.
The wording of the responses to the first and third questions was changed from 2001–02 onwards to reflect exactly the AUDIT instrument from which the responses are derived. This update, along with a data entry change enabling more specific entry for the second question, slightly increased the rates of at-risk drinking. The data collected from 2001–02 onwards are a more accurate reflection of the alcohol consumption of general practice patients and these are the years compared in this report.

2.6	Statistical methods
The analysis of all BEACH data was conducted with Statistical Analysis System (SAS) version 9.1.3.21 When originally published, data from 1999–00 to 2004–05 were analysed using SAS version 6.1222 (with additional programming to adjust for the cluster sample study design). In this report (and others published since 2007) these data have been re-analysed using SAS version 9.1.3 (which adjusts for the cluster design without the need for additional programming). This has resulted in slightly tighter confidence intervals and minor variations in point estimates (of up to 0.1) when compared with data published in earlier annual reports for the 1998–04 data years.
BEACH is a single stage cluster sample study design, each 100 encounters forming a cluster around each GP participant. In cluster samples, variance needs to be adjusted to account for the correlation between observations within clusters. Procedures in SAS version 9.1.3 are used to calculate the intracluster correlation and adjust the confidence intervals accordingly.21 
Post-stratification weighting of encounter data adjusts for any variance in the characteristics of the participating GPs from those of the sample frame from which they were drawn, and for the varying activity level of each GP (measured by the number of claims each has made in the previous 12 months from Medicare Australia). The final sample of encounters shows excellent precision when the age–sex distribution of the patients is compared with the distribution in all Medicare-claimed services of this type.1
The encounter is the primary unit of inference. Proportions (%) are used when describing the distribution of an event that can arise only once at a consultation (for example, age, sex), or to describe the distribution of events within a class of events (for example, problem A as a percentage of total problems). Rates per 100 encounters are used when an event can occur more than once at the consultation (for example, RFEs, problems managed or medications).
Rates per 100 problems are also used when a management event can occur more than once per problem managed. In general, the results present the number of observations (n), the rate per 100 encounters and the 95% confidence interval.
The statistical significance of changes in characteristics of the GPs is tested using the 
chi-square test statistic. However, in general, the results for events occurring at GP–patient encounters present the rate per 100 encounters and the 95% confidence interval. 
•	Changes over time, in the frequency of these events are judged significant (that is, a real change has occurred) if the two sets of confidence intervals do not overlap. For example, Result A: 11.5 per 100 encounters (95% CI: 11.3–11.7) is significantly less than Result B: 11.9 per 100 encounters (95% CI: 11.8–12.0). 
•	If the two sets of confidence intervals butt together the difference is regarded as marginal. For example, Result A: 11.5 per 100 encounters (95% CI: 11.3–11.7) is marginally lower than Result B: 11.9 (95% CI: 11.7–12.1). 
•	If they overlap, then no change has been measured.

2.7	Changes over time
While in this report SAS version 9.1.321 was used for all analyses, changes in method or approach have occurred on occasion over the 10 years of results. Data presented in this report are comparable for each result across all data years. Where methodological changes have occurred, the data have either: 
•	been recalculated using the new method (for example, body mass index was recalculated due to a change in the World Health Organization body mass index groupings)
•	been regrouped for comparability (where this occurs, it is has been noted in the footnotes of the table) 
•	been omitted from this report (if recalculation or grouping was not possible). Where data are omitted, this is noted as not applicable (N/A) or not available (NAv), as appropriate.
Readers should be aware that there may be discrepancies between data in this report and data published in earlier BEACH reports.
In measuring changes over time, the 2008–09 results are compared with those from 1999–00 wherever possible. However, as in any long-term research program, changes occur over the years. For example, in response to requests from DoHA (then the Department of Health and Aged Care), more detailed coding systems for pharmaceuticals, pathology and imaging test orders were developed, and these were applied from year 3 (2000–01) onwards. In these cases, change is measured from 2000–01 because earlier years are not comparable. Practice nurse activity data were not collected until 2005–06, so the changes are only considered between 2005–06 and 2008–09.
Each table includes the most frequent events occurring in 2008–09 and the comparative results for each of the earlier years have been provided. In addition, each table includes data for events that were more frequent in past year(s) that are no longer as frequent in 2008–09. All results are presented in decreasing order of frequency by the 2008–09 data.
The direction and type of change between 1999–00 (or 2000–01 where appropriate) and 
2008–09 is indicated for each result in the far right column of the tables: 
•	/ indicates a statistically significant linear change 
•	/ indicates a marginally significant linear change 
•	§ indicates a non-linear significant or marginal change 
•	— indicates there was no change. 
2.8	Extrapolated national estimates
Extrapolations can be used to estimate the number of GP encounters in Australia involving a selected event at a single time point or to estimate the total national effect of changes. 
Where the results demonstrate a significant change over time, the estimated national change across total GP Medicare services from 1999–00 (or where appropriate 2000–01) to 2008–09 can be calculated using the method detailed below. An example of an extrapolated national change is given in each chapter in the report from chapters 5 to 13 inclusive.
•	The national estimates are calculated by dividing the rate per 100 encounters of the selected event for 1999–00 (or 2000–01 where appropriate) by 100, and then multiplying by the total number of GP services claimed through Medicare in that year (rounded to the nearest 100,000, see Table 2.1) to give the estimated annual number of events in 1999–00 (or 2000–01). The process is then repeated for 2008–09. The difference between the two estimates (to the nearest 10,000) gives the estimated national change in the rate of encounters for that event over the period of interest.
•	This is expressed as the estimated increase or decrease over the study period (between 1999–00 or 2000–01 and 2008–09), in the number of general practice contacts for that event. For example, an increase or decrease in the number of GP management contacts with problem X occurring in Australia in 2008–09 when compared with 1999–00 
(or 2000–01).
Table 2.1 provides the total number of general practice professional service items claimed from Medicare in each financial year from 1999–00 to 2008–09. In this report extrapolations are calculated using the number of GP Medicare items claimed rounded to the nearest 100,000. The rounded number is also provided in Table 2.1. Readers can use the method described above to calculate the national effect of any significant change in a single result over any two time points. Extrapolations can also be made using data from a single time point to estimate the number of GP encounters in Australia in a specific year that involve a selected event. 
Example of extrapolation
A significant increase in the number of problems managed at encounter (Chapter 7), from 146.7 per 100 encounters in 1999–00 to 154.6 in 2008–09: 
•	(146.7/100) x 101.5 million = 148.9 million problems managed in general practice nationally in 1999–00, and (154.6/100) x 112.3 million = 173.6 million problems managed in 2008–09. 
This suggests there were 24.7 million (173.6 million minus 148.9 million) more problems managed at GP encounters in Australia in 2008–09 than in 1999–00. 
Table 2.1: Number of general practice professional services claimed from Medicare Australia each financial year, 1999–00 to 2008–09 (‘000)
	1999–00	2000–01	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07	2007–08	2008–09(a)	
Number of GP MBS items 	101,517	100,645	99,921	96,919	96,330	98,180	101,095	103,433	109,518	112,275	
Rounded no. of GP MBS items	101,500	100,600	99,900	96,900	96,300	98,200	101,100	103,400	109,500	112,300	
(a)	Medicare data for the 2008–09 year included data from the March 2008 to April 2009 quarters because the 2008–09 financial year data were not available at the time of preparation of this report.
Source: Medicare statistics, Table B1 – Medicare: Number of services ('000) by quarter and financial year of processing by broad type of service. Available at <www.health.gov.au/internet/main/publishing.nsf/Content/Medicare+Statistics-1>.
Limitations of extrapolations
The extrapolations to the total encounters occurring nationally in any one year are only estimates. They are likely to provide:
•	an underestimate of the true ‘GP workload’ of a condition/treatment because the extrapolations are made to GP Medicare items claimed, not to the total number of GP encounters per year (approximately 5% of BEACH encounters annually which include indirect encounters and those paid by sources other than Medicare, such as DVA, state governments, work cover, employers)
•	an overestimate of the management rate of a group of conditions (for example, cardiovascular disease) because there is a chance that more than one problem of this type will be managed at a single encounter. In the extrapolations, two cardiovascular problems managed at one encounter will be counted as two encounters.
Further, the base numbers used in the extrapolations are rounded to the nearest 100,000 and extrapolation estimates are rounded to the nearest 100,000 if more than a million and to the nearest 10,000 if below a million. However, the rounding has been applied to all years, so the effect on measures of change will be very small. The extrapolations therefore still provide an indication of the size of the effect of measured change nationally.
2.9	Changes to data elements and reporting methods
Changes in data elements and reporting methods have occurred on occasion since the BEACH study began in April 1998: 
•	More detailed coding systems for pharmaceuticals, pathology and imaging test orders were developed, and these were applied from year 3 (2000–01) onwards. In these cases, change is measured from 2000–01 because earlier years are not comparable. 
•	Two changes were made to the BEACH form from 2005–06 onwards to capture practice nurse activity associated with the GP–patient consultations. From 2005–06 onwards: 
–	GPs could record multiple (up to three) Medicare item numbers
–	in the ‘other treatments’ section, for each problem managed, the GP was asked to tick the practice nurse box if the treatment recorded was provided by the practice nurse rather than by the GP. If the box was not ticked, the research team assumed that the GP gave the treatment.
These two changes have implications for the reporting of Medicare/DVA-claimable encounters (Chapter 5), practice nurse activity (Chapter 13) and other treatments (Chapter 10).
Medicare/DVA-claimable encounters
For the first 7 years of the BEACH program (1998–99 to 2004–05), where a Medicare item number was claimable for the encounter, the GP was instructed to record only one item number. Where multiple item numbers (for example, an A1 item such as ‘standard surgery consultation’ and a procedural item number) were claimable for an encounter, the GP was instructed to record the lower of these (usually an A1 item number). For reporting purposes Medicare-claimable encounters were broken down according to the item number recorded by the GP as claimable (either through Medicare or through DVA) for the encounter.
In this report the Medicare/DVA claimable encounters count only one item number per Medicare/DVA-claimable encounter for comparability with previous years (see Chapter 5). Practice nurse Medicare-claimable encounters are not reported in Chapter 5.
The selection of one item number was undertaken on a priority basis: consultation item numbers override incentive item numbers, which override procedural item numbers, which override other Medicare item numbers.
Practice nurse activity
The research team began to capture practice nurse activity (in 2005–06) due to the introduction of four new MBS item numbers in November 2004 which covered some selected activities conducted by a practice nurse on behalf of a medical practitioner.23
The primary aim of BEACH is to describe general practice activity. Before 2005–06, ‘general practice activity’ has been described in terms of GP–patient encounters and this was considered close to equivalent to ‘general practitioner activity’. However, the introduction of the practice nurse item numbers meant that, if practice nurse activity associated with the 
GP–patient encounter was not included, the content of the consultation was not fully described. 
Chapter 13 provides a breakdown of the practice nurse Medicare items claimed, the morbidity managed with the assistance of the practice nurse, and the other treatments given by the practice nurse as recorded by the GP participants from 2005–06 to 2008–09.
When viewing these results, it must be remembered that these practice nurse data do not include activities undertaken by the practice nurse during the GP’s BEACH recording period that were performed outside the recorded encounter. These could include Medicare-claimable activities (for example immunisations/vaccinations) provided under instruction from the GP but not provided at the time of the encounter recorded in BEACH, or provision of other activities not currently claimable from Medicare (for example dietary advice on a one-to-one basis, or in a group situation).
Other treatments
In the chapter on other treatments (Chapter 10), all recorded clinical and procedural treatments are included, irrespective of whether they were provided by the GP or by the practice nurse.
2.10	Classification of data
The following data elements are classified according to the International Classification of Primary Care—Version 2 (ICPC-2), a product of the World Organization of Family Doctors (Wonca)24:
•	patient reasons for encounter (RFEs)
•	problems managed
•	clinical treatments (for example, counselling, advice)
•	procedural treatments
•	referrals
•	investigations ordered (including pathology, imaging and other investigations).
The ICPC-2 is used in more than 45 countries as the standard for data classification in primary care. It is accepted by the World Health Organization (WHO) in the WHO Family of International Classifications25, and is the declared national standard in Australia for reporting of health data from general practice and patient self-reported health information.26

The ICPC-2 has a biaxial structure, with 17 chapters on one axis (each with an alphabetic code) and seven components on the other (numeric codes) (Figure 2.2). Chapters are based on body systems, with additional chapters for psychological and social problems. Component 1 includes symptoms and complaints. Component 7 covers diagnoses. These are independent in each chapter and both can be used for patient RFEs or problems managed.
Components 2 to 6 cover the process of care, and are common throughout all chapters. The processes of care, including referrals, other (non-pharmacological) treatments and orders for pathology and imaging, are classified in these process components of ICPC-2. Component 2 (diagnostic, screening and prevention) is also often applied in describing the problem managed (for example, check-up, immunisation).
The ICPC-2 is an excellent epidemiological tool. The diagnostic and symptomatic rubrics have been selected for inclusion on the basis of their relative frequency in primary care settings, or because of their relative importance in describing the health of the community. 
It has approximately 1,370 rubrics and these are sufficient for meaningful analyses. However, reliability of data entry, using ICPC-2 alone, requires a thorough knowledge of the classification for correct classification of a concept to be ensured.
Figure 2.2: The structure of the International Classification of Primary Care—Version 2 (ICPC–2)
Table showing seven components by numeric codes on one axis and 17 body systems by alphabetic codes on the other axis.

In 1995, recognising a need for a coding and classification system for general practice electronic health records, the FMRC (then the Family Medicine Research Unit) developed an extended vocabulary of terms classified according to the ICPC, now called ICPC-2 PLUS.27 This is an interface terminology, developed by the FMRC from all the terms used by GPs in studies such as the Australian Morbidity and Treatment Survey 1990–9128, the Morbidity and Therapeutic Index 1992–1998 (a clinical audit tool that was available to GPs), and BEACH 1998–2009, that together have included more than 1.5 million encounter records. These terms are classified according to ICPC-2 to ensure international standards for reporting. Readers interested in seeing how coding works can download the ICPC-2 PLUS Demonstrator at <www.fmrc.org.au/icpc2plus/demonstrator.htm>.
When the free-text data are received from the GPs, trained secondary coders (who are undergraduate students studying health information management or medical science) code the data in more specific terms using ICPC-2 PLUS. This ensures high coder reliability and automatic classification of the concept, and provides the ability to ‘ungroup’ such ICPC-2 rubrics as ‘other diseases of the circulatory system’ and select a specific disease from the terms within it. 
Presentation of data classified in ICPC-2
Statistical reporting is almost always at the level of the ICPC-2 classification (for example, acute otitis media/myringitis—ICPC-2 code H71). However, there are some exceptions where data are grouped either above the ICPC-2 level or across the ICPC-2 level. These grouped morbidity, pathology and imaging codes are defined in Appendix 4, and chronic morbidity groups are provided in Appendix 5. 
Reporting morbidity with groups of ICPC-2 codes
When recording problems managed, the GP may not always be very specific. For example, in recording the management of hypertension, they may simply record the problem as ‘hypertension’. In ICPC-2, ‘hypertension, unspecified’ is classified as ‘uncomplicated hypertension’ (code K86). There is another code for ‘complicated hypertension’ (K87). In some cases the GP may simply have failed to specify that the patient had hypertension with complications. The research team therefore feels that for national data reporting, it is more reliable to group the codes K86 and K87 and label this ‘Hypertension*’—the asterisk indicating that multiple ICPC-2 codes (as in this example) or ICPC-2 PLUS codes (see below) are included. Appendix 4 lists codes included in these groups.
Reporting morbidity with groups of ICPC-2 PLUS codes
In other cases a concept can be classified within (but be only part of) multiple ICPC-2 codes. For example, osteoarthritis is classified in ICPC-2 in multiple broader codes according to site, for example, L92—shoulder syndrome (includes bursitis, frozen shoulder, osteoarthritis of shoulder, rotator cuff syndrome). When reporting osteoarthritis in this publication, all the more specific osteoarthritis ICPC-2 PLUS terms are grouped within all the appropriate ICPC‑2 codes. This group is labelled ‘Osteoarthritis*’—the asterisk again indicating multiple codes, but in this case they are PLUS codes rather than ICPC-2 codes. Appendix 4 lists codes included in these groups.
Reporting chronic morbidity
Chronic conditions are medical conditions characterised by a combination of the following characteristics: duration that has lasted or is expected to last 6 months or more, a pattern of recurrence or deterioration, a poor prognosis, and consequences or sequelae that affect an individual’s quality of life. 
To identify chronic conditions, a chronic condition list29 classified according to ICPC-2 was applied to the BEACH data set. In general reporting, both chronic and non-chronic conditions (for example, diabetes and gestational diabetes) may have been grouped together when reporting (for example, diabetes—all*). When reporting chronic morbidity, only problems regarded as chronic have been included in the analysis. Where the group used for the chronic analysis differs from that used in other analyses in this report, they are marked with a double asterisk. Codes included in the chronic groups are provided in Appendix 5.
Reporting pathology and imaging test orders
All the pathology and imaging tests are coded very specifically in ICPC-2 PLUS, but ICPC-2 classifies pathology and imaging tests very broadly (for example, a test of cardiac enzymes is classified in K34—Blood test associated with the cardiovascular system; a CT scan of the lumbar spine is classified as L41—Diagnostic radiology/imaging of the musculoskeletal system). In Australia, the MBS classifies pathology and imaging tests in groups that are relatively well recognised. The team therefore regrouped all pathology and imaging ICPC-2 PLUS codes into MBS standard groups. This allows comparison of data between data sources. These groups are marked with an asterisk, and inclusions are provided in Appendix 4.
Classification of pharmaceuticals
Pharmaceuticals that are prescribed, provided by the GP or advised for over-the-counter purchase are coded and classified according to an in-house classification, the Coding Atlas for Pharmaceutical Substances (CAPS).
This is a hierarchical structure that facilitates analysis of data at a variety of levels, such as medication class, medication group, generic composition and brand name.
Strength and regimen are independent fields that, when combined with the CAPS code, give an opportunity to derive the prescribed daily dose for any prescribed medication or group of medications.
CAPS is mapped to the Anatomical Therapeutic Chemical (ATC)30 classification, which is the Australian standard for classifying medications at the generic level.
The ATC has a hierarchical structure with five levels. For example:
•	Level 1: C—Cardiovascular system
•	Level 2: C10—Serum lipid reducing agents
•	Level 3: C10A—Cholesterol and triglyceride reducers
•	Level 4:C10AA—HMG CoA reductase inhibitors
•	Level 5: C10AA01—Simvastatin (the generic drug).
Reporting pharmaceutical data 
For pharmaceutical data, there is the choice of reporting in terms of the CAPS coding scheme or the ATC. They each have advantages in different circumstances.
In the CAPS system, a new drug enters at the product and generic level, and is immediately allocated a generic code. Therefore, the CAPS classification uses a bottom–up approach.
In the ATC, a new generic drug type may initially enter the classification at any level (1 to 5), not necessarily always at the generic level. Reclassification to lower ATC levels may occur later. Therefore, the ATC uses a top–down approach.
When analysing medications across time, a generic medication that is initially classified to a higher ATC level will not be identifiable in that data period and may result in under‑enumeration of that drug during earlier data collection periods.
In measuring changes in medications over time, the team chose to report at Level 2 of the ATC (which is more stable over time than Level 3), and in CAPS for the generic-level drugs.
2.11	Quality assurance
All morbidity and therapeutic data elements were secondarily coded by staff entering key words or word fragments, and selecting the required term or label from a pick list. This was then automatically coded and classified by the computer. A quality assurance program to ensure reliability of data entry includes ongoing development of computer-aided error checks (‘locks’) at the data entry stage, and a physical check of samples of data entered versus those on the original recording form. Further logical data checks are conducted through SAS on a regular basis.
2.12	Validity and reliability
A discussion of the reliability and validity of the BEACH program has been published elsewhere.31 In this section we touch on some aspects of reliability and validity of active data collection from general practice that should be considered by the reader. 
In the development of a database such as BEACH, data gathering moves through specific stages: GP sample selection, cluster sampling around each GP, GP data recording, secondary coding and data entry. At each stage the data can be invalidated by the application of inappropriate methods. The methods adopted to ensure maximum reliability of coding and data entry have been described above. The statistical techniques adopted to ensure valid analysis and reporting of recorded data are described in Section 2.6. Previous work has demonstrated the extent to which a random sample of GPs recording information about a cluster of patients represents all GPs and all patients attending GPs.32 Other studies have reported the degree to which GP-reported patient RFEs and problems managed accurately reflect those recalled by the patient33 and the reliability of secondary coding of RFEs34 and problems managed.28 The validity of ICPC as a tool with which to classify the data has also been investigated in earlier work.35
However, the question of the extent to which the GP-recorded data are a reliable and valid reflection of the content of the encounter must also be considered. In many primary care consultations, a clear pathophysiological diagnosis is not reached. Bentsen36 and Barsky37 suggest that a firm and clear diagnosis is not apparent in about half of GPs’ consultations, and others suggest the proportion may be even greater.38 Further, studies of general ambulatory medical practice have shown that a large number of patients presenting to a primary care practitioner are without a serious physical disorder.39,40 As a result, it is often necessary for a practitioner to record a problem in terms of symptoms, signs, patient concerns, or the service that is requested, such as immunisation. For this reason, this report refers to patient ‘problems’ rather than ‘diagnoses’.
A number of studies have demonstrated wide variance in the way a GP perceives the patient’s RFE and the manner in which the GP describes the problem under management. In a direct observational study of consultations via a one-way mirror, Bentsen demonstrated differences in the way practitioners labelled problems, and suggested that clinical experience may be an important influence on the identification of problems within the consultation.36 Two other factors that might affect GPs’ descriptions of patient RFEs have been identified: even when individuals select the same stimuli, some label each stimulus separately whereas others cluster them under one label and individuals differ in the number of stimuli they select (selective perception).41
The extent to which therapeutic decisions may influence the diagnostic label selected has also been discussed. Howie42 and Anderson39 argue that, while it is assumed that the diagnostic process used in general practice is one of symptom diagnosis  management, the therapeutic method may well be selected on the basis of the symptom, and the diagnostic label chosen last. They suggest that the selection of the diagnostic label is therefore influenced by the management decision already made.
Anderson has also pointed out that the therapeutic decision may be influenced by fashion, and, in turn, this affects the selection of the problem label. He gives the example of a rise in the occurrence of neurotic depression in parallel with a decrease in the use of menopause as a diagnosis in the United Kingdom, and suggests this may be the result of a change in the preferred treatment from oestrogen therapy to antidepressants.39 This should be remembered when considering the changes in general practice described in this report.
Alderson contends that to many practitioners ‘diagnostic accuracy is only important to the extent that it will assist them in helping the patient’. He further suggests that if major symptoms are readily treatable, some practitioners may feel no need to define the problem in diagnostic terms.43 Crombie stated that in the second and third national morbidity surveys in the United Kingdom there was ‘enormous variability in the rates at which doctors perceive and record illnesses’. He concluded that the probable cause arose from the different ways in which GPs gave priority in their perceptions and recording of certain morbidities while discounting or ignoring others. He was unable to account statistically for this variation by the effect of geography, age, sex or class differences in the practice populations.44 Differences in the way male and female GPs label problems also appear to be independent of such influences.45
These problems are inherent in the nature of general practice. Knottnerus argues that the GP is confronted with a fundamentally different pattern of problems from the specialist, the GP often having to draw up general diagnostic hypotheses related to probability, severity and consequences.46 Anderson suggests that morbidity statistics from family practice should therefore be seen as ‘a reflection of the physician’s diagnostic opinions about the problems that patients bring to them rather than an unarguable statement of the problems managed’.39 In any case, doctors base their actions on problems as they perceive them.
While these findings regarding limitations in the reliability and validity of practitioner‑recorded morbidity should be kept in mind, they apply equally to data drawn from medical records, whether paper or electronic, as they do to active data collection methods.47,48 There is as yet no more reliable method of gaining detailed data about morbidity and its management in general practice. Further, irrespective of the differences between individual GPs in their labelling of the problems, morbidity data collected by GPs in active data collection methods have been shown to provide a reliable overview of the morbidity managed in general practice.49
3	The sample
Table 3.1 shows the number of encounters contained in each year of the BEACH program since April 1999, and the size of the total 10-year database for each variable (weighted), upon which all comparisons over time described in this report are based.
Table 3.1: Annual summary of data sets, 1999–00 to 2008–09 (final weighted data)
Variable	1999–00	2000–01	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07	2007–08	2008–09	Total 10 years	
General practitioners	1,047	999	983	1,008	1,000	953	1,017	930	953	1,011	9,901	
Encounters	104,856	99,307	96,973	100,987	98,877	94,386	101,993	91,805	95,898	96,688	981,770	
Reasons for encounter	155,690	149,962	144,654	152,352	144,674	141,215	153,309	138,434	146,696	151,282	1,478,268	
Problems managed	153,857	143,528	139,092	146,336	148,521	137,330	149,088	136,333	145,078	149,462	1,448,625	
Medications	115,432	107,400	101,350	104,813	103,210	95,816	106,493	93,193	98,439	102,737	1,028,883	
Other treatments	48,194	49,072	51,130	53,676	52,315	53,630	47,847	44,035	49,130	49,048	498,077	
Referrals	11,760	10,366	7,761	12,265	11,794	10,881	12,235	12,195	12,008	13,251	114,516	
Imaging	7,841	8,227	7,642	8,678	8,121	7,840	9,003	8,229	9,143	9,469	84,193	
Pathology	27,613	29,225	30,086	33,234	34,831	34,652	39,357	38,963	41,375	44,066	353,402	

4	The participating GPs
Part of the BEACH method involves the completion of a profile questionnaire by each GP participant (see Appendix 2). This questionnaire covers information about the GP and the major practice at which they are employed. Over the 10 years, the questions have occasionally been altered to improve the quality and clarity of the data collected, or to investigate topics not previously surveyed as they become relevant. Therefore, some characteristics have data over the full 10-year period, and some for shorter periods.
Since 1999–00 some trends have emerged in the characteristics of GP BEACH participants (Table 4.1). The most noticeable changes over the 10 years are listed below and some are presented in Figure 4.1. It should be noted, however, that in regard to the age and sex of GPs who participated in BEACH during 2008–09 (see section 3.2 in General practice activity in Australia 2008–09)1, the proportions reported in the 1998–99 to 2007–08 version of this report are more reliable indicators of changes over time for the GP and practice characteristics discussed below.50
•	The feminisation of the general practice workforce is reflected in the growing proportion of GP participants who are female. The proportion of female participants increased from 30.4% in 1999–00 to 32.5% in 2008–09. This change reflects that apparent in the sample frame of all recognised GPs claiming more than 375 general practice Medicare items of service in the previous quarter in Australia, as provided each year by DoHA, from Medicare claims data. 
•	There was a considerable decrease in the proportion of GPs aged 35–44 years (from 32.4% in 1999–00 to 14.0% in 2008–09), and an increase in the proportion aged 55 years and over (from 26.7% in 1999–00 to 45.9% in 2008–09). Again, these changes reflect the differences observed in the sample frame from Medicare data. 
•	Reflecting the change in age distribution, the proportion of GPs working in general practice for fewer than 2 years decreased, from 0.7% in 1999–00 to 0.1% in 2008–09, and the proportion practising for 20 years and over increased, from 43.5% to 71.9%. There was also a decrease in the proportion working in general practice for 11–19 years, from 31.9% in 1999–00 to 19.3% in 2008–09.
•	The proportion of GPs working fewer than six sessions per week increased considerably, and the proportion working 11 or more sessions per week decreased significantly. This was thought to partially reflect the larger proportion of female GPs working part-time in conjunction with motherhood. However, Charles et al. (2004) found that, while female GPs were much more likely than males to work fewer sessions, no significant change had occurred in the proportion of female GPs working part-time between 1999 and 2003. They found the proportion of males working fewer than six sessions per week rose from 6.1% in 1998–99 to 11.4% in 2002–03.51 Between 1999–00 and 2008–09 there was also a significant increase in the proportion of GPs working 6–10 sessions per week, from 66.0% in 1999–00 to 78.0% in 2008–09. The proportion of GPs working 11 or more sessions per week almost halved, from 18.3% to 9.6% over this period.
•	The proportion of participants in solo practice halved between 1999–00 and 2006–07, and the proportion in smaller practices of 2–4 GPs also decreased considerably. There was an associated significant increase in the proportion of GPs working in practices with five or more practitioners, from 35.8% in 1999–00 to 56.1% in 2006–07. From 2007–08, the question was altered to capture full-time equivalent GPs at the practice, so data are no longer comparable for the question in its original format.
•	The results for consultations in a language other than English reflect a change in question design. Between 1998–99 and 2000–01 GPs were asked only one question: ‘Do you conduct more than 50% of consultations in a language other than English?’ The question was removed for the following 2 years, but was replaced as the issue again became of interest. A new question was designed to collect more specific data. The recent results suggest that about one-quarter of participants provide some consultations in a language other than English, but few are doing so at more than 50% of their consultations. It would appear that, in the survey’s original format, those GPs who did consult in another language were keen to let that be known, and the ‘> 50%’ category was the only avenue available to them.
•	There was no significant change over the decade in the proportions of Australian trained GPs compared with those who had graduated outside Australia. However, there was a significant change in the geographic distribution of country of graduation for those trained overseas.
•	The proportion of GP participants holding Fellowship of the RACGP significantly increased, from 31.0% in 1999–00 to 39.7% in 2008–09.
•	There was a significant reduction in the proportion of GPs who provide their own after-hours services, from 45.5% in 2000–01 to 28.9% in 2008–09, and those who provided after-hours services in cooperation with other practices, from 19.3% in 2000–01 to 15.1% in 2008–09.
Figure 4.1: Summary of changes in GP characteristics, 1999–00 to 2008–09
Vertical bar chart showing proportions on y-axis and GP characteristics on x-axis
(a)	Data about after-hours services were only collected from 2000–01 onward. This figure refers to the results from 2000–01.
Note: Wk—week; FRACGP—Fellows of the Royal Australian College of General Practitioners; Own after-hours—the practice provides its own after-hours service for their patients; Co-op after-hours—the practice provides after-hours services in a cooperative arrangement with other practices.

Table 4.1: GP characteristics, BEACH, 1999–00 to 2008–09
	Per cent of GPs(a)	
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	
GP characteristic	(n = 1,047)		(n = 999)		(n = 983)		(n = 1,008)		(n = 1,000)		(n = 953)		(n = 1,017)		(n = 930)		(n = 953)		(n = 1,011)	
Sex 
(2 = 1.12, p = 0.289) (missing n)	(0)		(0)		(0)		(0)		(0)		(0)		(0)		(0)		(0)		(0)	
	Male	69.6		68.4		64.2		64.8		67.3		67.9		62.8		65.9		63.2		67.5	
	Female	30.4		31.6		35.8		35.2		32.7		32.1		37.2		34.1		36.8		32.5	
Age 
(2 = 161.59, p < 0.001) (missing n) 	(4)		(9)		(1)		(0)		(1)		(1)		(18)		(11)		(8)		(4)	
	< 35 years	8.4		6.7		7.1		7.3		5.8		8.9		4.7		6.7		7.8		2.6	
	35–44 years	32.4		28.4		26.8		26.6		24.9		25.5		22.3		22.6		22.2		14.0	
	45–54 years	32.4		34.2		36.5		35.2		36.5		31.8		34.2		35.6		36.4		37.5	
	55+ years	26.7		29.7		29.5		30.9		32.7		33.6		38.7		35.0		33.5		45.9	
Years in general practice 
(2 = 174.41, p < 0.001) (missing n)	(8)		(6)		(4)		(6)		(9)		(5)		(13)		(13)		(7)		(6)	
	< 2 years	0.7		0.5		0.3		0.6		1.3		0.4		0.6		0.5		0.6		0.1	
	2–5 years	8.0		6.4		7.2		7.5		5.3		10.3		4.9		7.9		9.9		3.4	
	6–10 years	15.9		13.7		13.4		13.5		10.7		12.6		12.1		11.1		12.9		5.7	
	11–19 years	31.9		29.9		28.4		28.0		28.1		25.4		24.0		23.4		20.6		19.3	
	20+ years	43.5		48.8		50.3		50.4		54.6		51.3		58.5		57.0		55.9		71.5	
Currently in a general practice vocational training program 
(2 = 1.44, p = 0.229)	2.2		2.5		2.5		2.9		4.4		3.5		2.6		2.9		2.8		1.5	
Fellow of RACGP 
(2 = 16.01, p < 0.001)	31.0		31.4		35.1		35.5		33.5		42.3		40.7		46.3		50.2		39.7	
 (continued)

Table 4.1 (continued): GP characteristics, BEACH, 1999–00 to 2008–09
	Per cent of GPs(a)	
GP characteristic	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	
	(n = 1,047)		(n = 999)		(n = 983)		(n = 1,008)		(n = 1,000)		(n = 953)		(n = 1,017)		(n = 930)		(n = 953)		(n = 1,011)	
Sessions per week 
(2 = 40.7, p < 0.001) (missing n)	(6)		(16)		(15)		(8)		(7)		(8)		(6)		(7)		(9)		(6)	
	< 6 per week	15.3		15.9		16.0		18.7		17.2		14.4		17.3		17.0		15.4		12.4	
	6–10 per week	66.0		66.3		67.8		67.9		68.2		71.2		70.7		73.3		73.9		78.0	
	11+ per week	18.3		16.2		14.8		13.4		13.6		11.4		12.0		9.6		10.9		9.6	
Size of practice—Number of GPs 
(2 = 93.49, p < 0.001) (missing n) 	(5)		(28)		(4)		(8)		(10)		(6)		(9)		(6)					
	Solo	18.1		19.3		15.3		13.7		10.6		12.2		13.1		8.2		NAv		NAv	
	2–4 GPs	46.1		38.6		39.7		38.4		37.8		36.4		35.2		35.7		NAv		NAv	
	5+ GPs	35.8		42.1		44.7		47.9		51.6		51.3		51.7		56.1		NAv		NAv	
Size of practice—Full-time equivalents 
(missing n) 	..		..		..		..		..		..		..		..		(23)		(8)	
	< 2	NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		17.6		19.6	
	2– < 5 GPs	NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		41.2		42.9	
	5– < 10 GPs	NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		31.9		29.4	
	10+ GPs	NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		9.2		8.1	
Consultations in languages other than English(b) (missing n)	..		..		..		..		(6)		(1)		(10)		(0)		(4)		(3)	
	< 25%	NAv		NAv		NAv		NAv		17.8		21.7		21.0		18.1		20.4		17.5	
	25–50%	NAv		NAv		NAv		NAv		2.9		2.4		3.6		2.7		3.0		3.5	
	> 50%	10.6		13.5		NAv		NAv		2.4		3.4		3.4		2.9		3.6		1.5	
(continued)

Table 4.1 (continued): GP characteristics, BEACH, 1999–00 to 2008–09
	Per cent of GPs(a)	
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	
GP characteristic	(n = 1,047)		(n = 999)		(n = 983)		(n = 1,008)		(n = 1,000)		(n = 953)		(n = 1,017)		(n = 930)		(n = 953)		(n = 1,011)	
Place of graduation(c) 
(2 = 0.23, p = 0.630) (missing n)	(2)		(0)		(0)		(0)		(1)		(1)		(6)		(1)		(3)		(2)	
	Australia	73.3		72.7		76.1		72.6		73.5		69.8		72.0		73.6		73.5		74.3	
	Overseas	26.7		27.3		23.9		27.4		26.5		30.2		28.0		26.4		26.8		25.7	
	United Kingdom	8.5		8.2		7.6		9.1		7.2		7.6		8.1		7.3		6.8		10.3	
	Asia	9.4		4.7		8.6		9.9		9.5		10.9		10.9		10.1		9.8		8.3	
	Europe	1.9		1.9		1.8		1.6		2.3		3.8		2.1		1.7		2.6		1.9	
	Africa	2.4		1.5		3.7		4.3		5.4		5.4		4.5		5.1		4.3		3.8	
	New Zealand	1.5		1.5		0.5		2.2		1.0		1.3		1.9		1.4		1.4		1.2	
	Other	2.8		9.5		1.6		0.9		1.0		1.3		0.6		0.8		0.5		0.3	
Practice location by RRMA 
(2 = 9.94, p = 0.127) (missing n)	(0)		(0)		(1)		(0)		(2)		(1)		(1)		(0)		(1)		(0)	
	Capital	65.2		68.1		69.3		64.7		62.4		64.9		69.1		63.9		67.8		66.8	
	Other metropolitan	7.4		6.9		8.1		8.5		6.4		6.7		6.8		7.3		7.0		10.0	
	Large rural	7.6		5.6		5.9		5.1		7.0		5.4		5.7		7.9		6.9		5.5	
	Small rural	6.2		5.6		4.9		7.7		7.0		6.9		6.0		5.4		4.7		6.1	
	Other rural	12.2		12.2		10.5		12.0		14.2		13.0		11.1		13.6		11.3		10.3	
	Remote central	0.4		1.0		0.5		0.6		0.9		1.3		0.5		1.0		0.7		0.4	
	Other remote, offshore	1.0		0.7		0.8		1.4		2.0		1.8		0.8		1.1		1.5		0.9	
(continued)
Table 4.1 (continued): GP characteristics, BEACH, 1999–00 to 2008–09
	Per cent of GPs(a)	
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	
GP characteristic	(n = 1,047)		(n = 999)		(n = 983)		(n = 1,008)		(n = 1,000)		(n = 953)		(n = 1,017)		(n = 930)		(n = 953)		(n = 1,011)	
Practice location by ASGC 
(2 = 8.98, p = 0.061) (missing n)	(0)		(1)		(0)		(0)		(2)		(2)		(0)		(0)		(1)		(0)	
	Major cities	68.6		70.9		71.4		69.4		65.4		67.6		72.1		66.3		72.2		73.4	
	Inner regional	20.3		18.9		17.3		19.1		21.8		20.1		18.8		22.7		17.4		18.0	
	Outer regional	9.7		8.4		10.1		9.3		10.1		10.1		7.8		9.4		8.6		7.2	
	Remote	1.2		1.4		0.9		1.6		1.6		1.5		0.8		1.3		1.3		0.9	
	Very remote	0.2		0.3		0.3		0.7		1.0		0.7		0.6		0.3		0.5		0.5	
After-hours arrangements(d) 
(2 = 2.57, p = 0.108) (missing n)	NAv		(0)		(0)		(10)		(5)		(8)		(14)		(3)		(6)		(6)	
	Practice does its own	NAv		45.5		41.6		42.8		43.6		35.9		34.6		34.6		33.2		28.9	
	Cooperative with other practices	NAv		19.3		19.4		16.7		20.0		16.2		15.7		15.5		11.3		15.1	
	Other than own/cooperative	NAv		39.5		44.0		45.2		59.6		50.1		52.6		52.1		55.6		57.4	
Computer use at practice(e)
(2 = 95.92, p < 0.001)	NAv		87.4		89.7		91.3		95.0		93.7		96.4		96.6		96.7		NAv	
Computer use by individual GPs(f)	NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		NAv		94.7	
(a)	Missing data removed.
(b)	Data for all three groupings only available from 2003–04 onward.
(c)	p = 0.630—no significant difference when comparing Australia with all overseas countries of GP origin; p < 0.001—significant difference in the distribution of overseas countries of GP origin.
(d)	Multiple responses were allowed. 
(e)	Data refer to computer use at the major practice and may not reflect the use of computers by individual GPs.
(f)	Data refer to computer use by individual GPs.
Note: RACGP—Royal Australian College of General Practitioners; NAv—not available; RRMA—Rural, Remote and Metropolitan Areas classification; ASGC—Australian Standard Geographical Classification.

5	The encounters
This chapter includes details about the encounters in general practice from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in the content of encounters between 1999–00 and 2008–09. An example of an extrapolated change is given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8. 
5.1	Content of the encounters
Table 5.1 provides an overview of the changes over time for data collected in BEACH between 1999–00 and 2008–09. As the table shows, many changes have occurred over the 10‑year period, representing the changes occurring in Australian general practice over this time. 
The number of reasons for encounter given by the patient and recorded by the GP increased significantly over the decade, from 148.5 RFEs per 100 encounters to 156.5 per 100 encounters. Changes in types of RFEs are investigated in Chapter 6. 
A significant increase in the rate of problems managed was first detected in 2007–08 and continued to rise in 2008–09 to a rate of 154.6 problems managed per 100 encounters. The rate in 1999–00 was 146.7 per 100 encounters, indicating an additional 24.7 million problems managed in general practice in 2008–09 compared with a decade earlier.
Reflecting the increase in problems managed was an increase in the rate of chronic problems managed, which shows a linear increase between 1999–00 and 2008–09, from 47.2 chronic problems per 100 encounters to 55.1 per 100 encounters. This represents an estimated additional 14.0 million chronic problems managed in general practice nationally in 2008–09 compared with 1999–00. 
There was also a significant increase in the rate of new problems managed, from 45.3 per 100 encounters to 57.4 per 100 encounters, representing an increase of 18.5 million new problems managed over the 10-year period.
Although there was no change since 1999–00 in the overall rate of medications recorded, changes in the form of supply of medications occurred. There was a significant decline in the rate of medications prescribed to patients, representing 1.8 million fewer prescriptions written in 2008–09 than in 1999–00. However, the rate of GP-supplied medications increased from 6.9 per 100 encounters to 11.0 per 100, indicating an additional 5.3 million medications supplied by GPs to patients in 2008–09. More detailed analysis of these results can be found in Chapter 9. 
Other areas that demonstrated an increase over time included procedures, referrals (overall, and to specialists and allied health professionals), pathology and imaging orders, and orders for other investigations (Table 5.1). These changes are reported in more detail in their respective chapters.
As a proportion of all Medicare/DVA-claimable encounters recorded in BEACH, long surgery consultations decreased, from 8.7% in 1999–00 to 7.3% in 2008–09 (Table 5.2). This was primarily due to a decrease in long surgery consultations from 2007–08 (9.9%) to 7.3% in 2008–09. Home visits also decreased as a proportion of MBS-claimable encounters, from 1.5% in 1999–00 to 0.9% in 2008–09. This equates to approximately 510,000 fewer home visits in 2008–09 than 10 years earlier.
In the subsample study for length of consultation that included start and finish times for 
A1 Medicare/DVA-claimable encounters, there was no significant change in mean length of consultation between 2000–01 and 2008–09. There was also no significant change in mean consultation length when all encounters with a GP Medicare item number were considered (Table 5.3).

Table 5.1: Summary of morbidity and management, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Variable	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Reasons for encounter	148.5
(146.7–150.2)		151.0
(149.2–152.8)		149.2
(147.4–150.9)		150.9
(149.0–152.7)		150.2
(148.4–152.0)		149.6
(147.8–151.5)		150.3
(148.4–152.2)		150.8
(148.9–152.7)		153.0
(151.1–154.8)		156.5
(154.7–158.2)		
Problems managed	146.7
(144.9–148.6)		144.5
(142.8–146.3)		143.4
(141.7–145.2)		144.9
(143.0–146.8)		146.3
(144.4–148.2)		145.5
(143.6–147.4)		146.2
(144.2–148.2)		148.5
(146.4–150.6)		151.3
(149.2–153.4)		154.6
(152.6–156.5)		
	New problems	45.3
(43.6–46.9)		47.4
(45.7–49.0)		55.1
(53.8–56.5)		57.0
(55.6–58.3)		55.9
(54.5–57.3)		55.2
(53.8–56.5)		56.9
(55.5–58.2)		56.5
(55.1–57.9)		57.7
(56.3–59.1)		57.4
(56.0–58.7)		
	Chronic problems	47.2
(45.5–49.0)		46.9
(45.3–48.4)		48.0
(46.4–49.5)		47.7
(46.1–49.4)		50.4
(48.6–52.1)		50.4
(48.7–52.1)		50.6
(48.8–52.5)		50.6
(48.8–52.5)		52.4
(50.5–54.3)		55.1
(53.4–56.8)		
	Work-related	3.2
(2.9–3.5)		3.3
(3.1–3.5)		3.0
(2.7–3.2)		NAv		NAv		3.1
(2.8–3.5)		2.8
(2.6–3.1)		2.9
(2.6–3.1)		2.8
(2.6–3.1)		2.8
(2.6–3.0)	—	
Medications	110.1
(107.8–112.4)		108.2
(105.7–110.6)		104.5
(102.2–106.9)		103.8
(101.4–106.2)		104.4
(102.1–106.7)		101.5
(99.3–103.8)		104.4
(101.8–107.0)		101.5
(99.2–103.9)		102.7
(100.3–105.0)		106.3
(104.0–108.5)	—	
	Prescribed	93.8
(91.5–96.2)		92.3
(89.9–94.7)		88.0
(85.6–90.4)		84.3
(81.8–86.9)		86.0
(83.6–88.5)		83.4
(81.2–85.5)		85.8
(83.3–88.4)		83.3
(81.0–85.5)		82.4
(80.3–84.6)		86.4
(84.1–88.6)		
	GP-supplied	6.9
(6.0–7.7)		6.9
(5.9–7.9)		7.6
(6.6–8.7)		9.3
(8.0–10.6)		8.6
(7.6–9.6)		8.1
(7.3–8.8)		8.8
(8.2–9.5)		8.9
(8.2–9.6)		10.1
(9.5–10.7)		11.0
(10.2–11.8)		
	Advised OTC	9.4
(8.7–10.1)		9.0
(8.2–9.7)		8.9
(8.2–9.6)		10.2
(9.3–11.1)		9.8
(9.0–10.5)		10.1
(9.2–10.9)		9.8
(9.0–10.5)		9.4
(8.7–10.1)		10.1
(9.3–10.9)		8.9
(8.3–9.4)	—	
Other treatments	46.0
(44.1–47.8)		49.4
(47.1–51.7)		51.9
(49.5–54.2)		51.8
(49.3–54.3)		51.4
(48.9–53.8)		54.7
(52.1–57.3)		43.6
(41.5–45.8)		44.7
(42.3–47.0)		51.2
(48.9–53.6)		50.7
(48.5–52.9)		
	Clinical	33.5
(31.8–35.2)		37.2
(35.1–39.3)		38.1
(36.1–40.1)		37.2
(35.0–39.4)		36.6
(34.5–38.8)		39.2
(37.1–41.4)		29.2
(27.3–31.1)		29.5
(27.6–31.4)		34.5
(32.5–36.5)		34.0
(32.1–35.9)	—	
	Procedural	12.5
(11.9–13.0)		12.2
(11.6–12.8)		13.8
(13.1–14.5)		14.6
(13.9–15.3)		14.7
(14.0–15.5)		15.5
(14.6–16.4)		14.4
(13.7–15.1)		15.2
(14.4–16.0)		16.7
(15.9–17.5)		16.7
(16.0–17.5)		
(continued)

Table 5.1 (continued): Summary of morbidity and management, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Variable	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Referrals	11.1
(10.7–11.6)		10.4
(10.0–10.8)		10.5
(10.1–10.9)		11.1
(10.7–11.6)		11.6
(11.1–12.1)		11.5
(11.1–12.0)		12.0
(11.5–12.5)		12.2
(11.7–12.7)		12.5
(12.0–13.0)		13.7
(13.2–14.2)		
	Specialist	7.3
(7.0–7.6)		7.4
(7.1–7.7)		7.3
(7.0–7.6)		7.7
(7.3–8.0)		7.9
(7.5–8.2)		7.7
(7.4–8.0)		8.2
(7.8–8.5)		8.0
(7.7–8.4)		8.0
(7.6–8.3)		9.0
(8.7–9.3)		
	Allied health services	3.1
(2.9–3.3)		2.3
(2.2–2.5)		2.3
(2.1–2.4)		2.5
(2.3–2.7)		2.6
(2.4–2.8)		2.7
(2.5–2.9)		2.9
(2.7–3.1)		3.1
(2.9–3.3)		3.4
(3.2–3.7)		3.9
(3.6–4.1)		
	Hospital	0.7
(0.6–0.8)		0.5
(0.4–0.6)		0.4
(0.4–0.5)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		
	Emergency department	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
	Other referrals/other medical services(b)	0.0Ŧ
(0.0–0.0)		0.2
(0.1–0.2)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.3
(0.2–0.4)		
Pathology(c)	NAv		29.7
(28.4–30.9)		31.0
(29.7–32.4)		32.9
(31.5–34.4)		35.2
(33.7–36.7)		36.7
(35.2–38.2)		38.6
(36.9–40.3)		42.4
(40.7–44.2)		43.2
(41.3–45.0)		45.6
(43.8–47.4)		
Imaging(d)	NAv		7.7
(7.3–8.0)		7.9
(7.6–8.2)		8.6
(8.2–9.0)		8.2
(7.8–8.6)		8.3
(8.0–8.6)		8.8
(8.4–9.2)		9.0
(8.6–9.3)		9.5
(9.2–9.9)		9.8
(9.4–10.2)		
Other investigations(d)	NAv		0.6
(0.5–0.7)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(1.0–1.1)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, and — indicates there was no change. 
(b)	Other referrals and other medical services have been reported together for comparability. The ‘other medical services’ group was introduced in 2003–04. Previously these were grouped with ‘other referrals’.
(c)	In the 2000–01 BEACH year the data collection and data coding system for pathology changed. Changes over time are calculated using the 2000–01 data to ensure comparability.
(d)	In the 1999–00 BEACH year ‘imaging’ and ‘other investigations’ were grouped and reported together.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval; NAv—not available; OTC—over-the-counter.

Table 5.2: Type of encounter, summary of annual results (most frequent events), BEACH, 1999–00 to 2008–09
	Percentage distribution of Medicare/DVA-claimable encounters (95% CI)	 (a)
 	
MBS/DVA consultation category	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09		
	(n = 93,698)		(n = 82,113)		(n = 84,196)		(n = 89,068)		(n = 86,244)		(n = 81,582)		(n = 89,011)		(n = 79,847)		(n = 83,376)		(n = 86,069)		
Short surgery consultations	1.4
(1.1–1.8)		1.6
(0.3–2.0)		1.1
(0.9–1.3)		1.2
(1.0–1.4)		1.2
(0.9–1.4)		1.0
(0.8–1.3)		1.0
(0.8–1.1)		1.1
(0.9–1.4)		1.2
(1.0–1.4)		1.5
(1.3–1.8)	—	
Standard surgery consultations	84.1
(83.2–84.9)		83.9
(82.9–84.9)		84.1
(83.1–85.0)		82.8
(81.8–83.9)		82.4
(81.2–83.6)		82.3
(81.0–83.5)		83.7
(82.7–84.7)		83.4
(82.4–84.3)		82.1
(80.1–83.3)		79.8
(78.9–80.8)		
Long surgery consultations	8.7
(8.0–9.3)		8.8
(8.2–9.5)		8.7
(8.0–9.3)		9.6
(8.9–10.2)		9.7
(9.0–10.4)		10.5
(9.7–11.2)		9.8
(9.1–10.5)		10.0
(9.3–10.6)		9.9
(9.2–10.5)		7.3
(6.8–7.8)	§	
Prolonged surgery consultations	0.6
(0.5–0.7)		0.7
(0.5–0.8)		0.7
(0.5–0.8)		0.8
(0.6–0.9)		0.7
(0.6–0.9)		0.8
(0.6–0.9)		0.7
(0.5–0.8)		0.6
(0.5–0.7)		0.7
(0.5–0.8)		0.4
(0.3–0.6)	—	
Home visits	1.5
(1.3–1.7)		1.5
(1.2–1.9)		1.6
(1.3–1.9)		1.3
(1.1–1.6)		1.4
(1.0–1.8)		1.0
(0.8–1.2)		1.2
(0.9–1.5)		0.9
(0.7–1.1)		1.0
(0.6–1.4)		0.9
(0.7–1.0)		
Hospital	0.5
(0.3–0.7)		0.2
(0.1–0.3)		0.2
(0.1–0.3)		0.4
(0.2–0.6)		0.4
(0.3–0.5)		0.2
(0.1–0.3)		0.2
(0.1–0.3)		0.2
(0.1–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.3)		
Residential aged care facility	1.0
(0.8–1.2)		0.7
(0.5–1.0)		1.0
(0.7–1.3)		1.2
(0.9–1.6)		1.2
(0.9–1.4)		1.2
(0.8–1.6)		1.3
(0.9–1.6)		1.3
(1.0–1.6)		1.2
(0.9–1.5)		1.2
(0.9–1.5)	—	
Chronic disease management	N/A		0.0Ŧ
(0.0–0.0)		0.1
(0.1–0.3)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.2–0.4)		0.4
(0.3–0.5)		0.5
(0.4–0.6)		0.9
(0.8–1.0)		
Case conference	N/A		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0 Ŧ
(0.0–0.0)		0.0
(0.0–0.0)	—	
Health assessment	0.0Ŧ
(0.0–0.0)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		
Incentive payments	N/A		N/A		N/A		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		
GP mental health care	NAv		NAv		NAv		0.0
(0.0–0.0)		0.0
(0.0–0.0)		0.0
(0.0–0.0)		0.0
(0.0–0.0)		0.4
(0.3–0.5)		0.8
(0.7–0.9)		1.0
(0.8–1.1)		
Other items	2.3
(2.0–2.6)		2.5
(2.0–3.0)		2.5
(1.9–3.0)		2.4
(1.8–3.0)		2.7
(2.0–3.5)		2.6
(1.7–3.4)		1.6
(1.3–1.8)		1.4
(1.1–1.7)		2.0
(1.5–2.4)		1.5
(1.2–1.8)		
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, / indicates a marginally significant linear change, § indicates a non-linear significant change, 
and — indicates there was no change. 
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: Includes encounters that were recorded as claimable through the Department of Veterans’ Affairs (DVA). CI—confidence interval; MBS—Medicare Benefits Schedule; N/A—not applicable; NAv—not available.
Table 5.3: Consultation length (minutes), BEACH, 2000–01 to 2008–09
	Consultation length (minutes)	
Variable	2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	
A1 Medicare/DVA items (A,B,C,D)(a)	(n = 30,961)		(n = 35,104)		(n = 34,886)		(n = 31,844)		(n = 30,683)		(n = 32,830)		(n = 33,756)		(n = 29,956)		(n = 33,025)	
	Mean	14.8
(14.5–15.1)		14.9
(14.7–15.2)		14.8
(14.5–15.1)		15.0
(14.7–15.3)		15.1
(14.8–15.4)		14.9
(14.6–15.1)		14.9
(14.7–15.2)		14.8
(14.6–15.1)		14.4
(14.2–14.6)	
	Median	13.0		13.0		13.0		13.0		13.0		13.0		13.0		13.0		13.0	
	Mode	10.0		10.0		10.0		10.0		10.0		10.0		10.0		10.0		10.0	
	Range	1–106		1–155		1–165		1–120		1–120		1–110		1–155		1–110		1–120	
All Medicare/DVA-claimable encounters (GP items)	(n = 31,734)		(n = 36,142)		(n = 35,861)		(n = 32,839)		(n = 31,510)		(n = 34,111)		(n = 35,201)		(n = 31,722)		(n = 34,783)	
	Mean	14.9
(14.6–15.2)		15.0
(14.8–15.3)		14.9
(14.6–15.2)		15.1
(14.9–15.4)		15.2
(14.9–15.5)		15.0
(14.7–15.2)		15.1
(14.8–15.3)		15.1
(14.8–15.3)		14.6
(14.4–14.9)	
	Median	13.0		13.0		13.0		14.0		13.0		13.0		13.0		13.0		13.0	
	Mode	10.0		10.0		10.0		10.0		10.0		10.0		10.0		10.0		10.0	
	Range	1–150		1–180		1–165		1–175		1–180		1–110		1–155		1–110		1–120	
(a)	A1 Medicare items—Group A includes: 3, 4, 13, 19, 20; Group B includes: 23, 24, 25, 33, 35; Group C includes: 36, 37, 38, 40, 43; Group D includes: 44, 47, 48, 50, 51.
Note: DVA—Australian Government Department of Veterans’ Affairs. Results for the 1999–00 BEACH year are not presented, as data are not comparable for this year.

6	The patients
This chapter includes data about the patients who participated in the BEACH study, including the patient characteristics and reasons for the encounter (RFEs), from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates that there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in patient characteristics or RFEs between 1999–00 and 2008–09. An example of an extrapolation is given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8.
6.1	Age–sex distribution of patients at encounter
Table 6.1 shows the age–sex distribution of patients at BEACH encounters between 1999–00 and 2008–09. Over this time period the proportion of encounters with patients aged less than 45 years decreased from 51.4% to 41.3%, which equates to approximately 5.8 million fewer encounters nationally. Over the same period, the proportion of encounters with patients aged 45 years and over increased from 48.6% to 58.7%, which equates to an additional 16.6 million encounters. The relationship between patient age, general practice attendance rates and the age distribution of the Australian population is reported in Chapter 4 of General practice in Australia, health priorities and policies 1998 to 2008.52 
6.2	Other patient characteristics
Table 6.1 shows that the proportion of encounters with patients holding a Commonwealth concession card has increased significantly from 38.6% in 1999–00 to 45.7% in 2008–09. The increase equates to about 12.1 million more encounters with Commonwealth concession cardholders in 2008–09 compared with 10 years earlier.
6.3	Patient reasons for encounter
RFEs are those concerns and expectations that patients bring to the GP. International interest in reasons for encounter has been developing over the past three decades. RFEs reflect the patient’s demand for care and can provide an indication of service use patterns, which may benefit from intervention on a population level.53 
Participating GPs were asked to record at least one and up to three patient RFEs in words as close as possible to those used by the patient, before the diagnostic or management process had begun. RFEs can be expressed in terms of one or more symptoms (for example ‘itchy eyes’, ‘chest pain’), in diagnostic terms (for example ‘about my diabetes’, ‘for my hypertension’), a request for a service (‘I need more scripts’, ‘I want a referral’), an expressed fear of disease, or a need for a check-up.
Patient RFEs can have a one-to-one, one-to-many, many-to-one and many-to-many relationship to problems managed. That is, the patient may describe a single RFE that relates to a single problem managed at the encounter, one RFE that relates to multiple problems, multiple symptoms that relate to a single problem managed at the encounter, or multiple RFEs that relate to multiple problems managed at the encounter.
Number of reasons for encounter
Table 6.2 shows there was a decrease in the proportion of patients giving a single RFE, from 62.0% in 1999–00 to 56.6% in 2008–09. To balance this there was an increase in the proportion of encounters at which two RFEs or three RFEs were recorded, from 27.5% in 
1999–00 to 30.3% in 2008–09 for two RFEs, and from 10.5% in 1999–00 to 13.1% in 2008–09 for three RFEs. This suggests that there were 6.1 million more encounters nationally where two RFEs were reported and 4 million more where three RFEs were reported in 2008–09 than in 1999–00.
Reasons for encounter by ICPC-2 chapter
Table 6.3 shows that between 1999–00 and 2008–09, there was:
•	a significant increase in the overall rate of RFEs, from 148.5 per 100 encounters in 
1999–00 to 156.5 per 100 encounters in 2008–09. This increase equates to about 25 million extra RFEs nationally in 2008–09 than in 1999–00
•	a 40% increase in the rate of general and unspecified RFEs, equating to an approximate increase of 16.2 million general and unspecified RFEs from 1999–00 to 2008–09 nationally
•	a significant decrease in RFEs relating to respiratory problems from 25.3 per 100 encounters in 1999–00 to 22.0 per 100 encounters in 2008–09
•	a significant increase across the decade in RFEs relating to male genital systems and endocrine & metabolic systems
•	a significant decrease across the decade in RFEs relating to neurological problems, ear problems and pregnancy & family planning.
Distribution of reasons for encounter by ICPC-2 component
Table 6.4 shows that between 1999–00 and 2008–09:
•	RFEs expressed in terms of a symptom or complaint (for example, ‘tired’, ‘feeling anxious’) were the most frequent. However, the presentation rate of symptoms or complaints decreased significantly since 1999–00 from 73.4 per 100 encounters to 68.8 per 100 encounters in 2008–09
•	the rate of patient attendance to request test results nearly doubled, equating to an increase of over 4.7 million encounters with an RFE of this type in 2008–09 compared with 1999–00
•	requests for an administrative procedure (such as a medical certificate) also nearly doubled, equating to an increase of approximately 1.4 million requests for an administrative procedure nationally
•	patient requests for medications, treatments and therapeutics (such as repeat prescriptions) increased by 27.5%, equating to an increase of approximately 5.0 million such requests in 2008–09 compared with 1999–00
•	patient requests for diagnostic and preventative treatments (such as immunisation) also increased from 22.9 per 100 encounters in 1999–00 to 26.9 per 100 encounters in 2008–09.
Most frequent patient reasons for encounter
Table 6.5 shows that between 1999–00 and 2008–09:
•	the rate at which patients cited a need for prescription(s) as an RFE increased by nearly one-third, equating to an increase of about 4.4 million encounters with this RFE in 
2008–09 compared with 1999–00
•	the rate of immunisations/vaccinations, depression and hypertension as RFEs all increased by about one-quarter
•	the rate of requests for general blood tests and RFEs relating to diabetes both increased by 50%, equating to an additional 540,000 for both these RFEs 
•	the rate of request for referrals trebled over the decade, equating to an additional 800,000 of such requests in 2008–09 compared with 1999–00
•	the presentation rate of ear pain, throat complaint, headache each decreased by about one-quarter.

Table 6.1: Characteristics of patients at encounters, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Patient characteristics	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Sex (missing n)(b)	(1,182)		(1,111)		(809)		(911)		(932)		(809)		(788)		(765)		(876)		(867)		
Male	42.7
(42.0–43.5)		42.9
(42.2–43.6)		42.6
(41.9–43.3)		42.2
(41.4–42.9)		42.6
(41.8–43.3)		43.5
(42.7–44.3)		44.0
(43.2–44.7)		43.7
(42.9–44.5)		42.9
(42.1–43.7)		42.4
(41.5–43.3)	—	
Female	57.3
(56.5–58.0)		57.1
(56.4–57.8)		57.4
(56.7–58.1)		57.8
(57.0–58.6)		57.4
(56.7–58.2)		56.5
(55.7–57.3)		56.0
(55.3–56.8)		56.3
(55.5–57.1)		57.1
(56.3–57.9)		57.6
(56.7–58.5)	—	
Age group (missing n)(b)	(804)		(846)		(760)		(895)		(905)		(925)		(769)		(779)		(784)		(704)		
	< 1 year	2.4
(2.2–2.5)		2.1
(1.9–2.3)		2.0
(1.9–2.1)		1.9
(1.8–2.1)		1.8
(1.7–1.9)		1.9
(1.8–2.1)		2.1
(1.9–2.2)		1.8
(1.7–2.0)		2.0
(1.8–2.1)		2.0
(1.8–2.1)		
	1–4 years	5.2
(4.9–5.5)		5.4
(5.1–5.7)		4.9
(4.6–5.2)		5.0
(4.7–5.3)		4.6
(4.3–4.8)		4.3
(4.0–4.7)		4.3
(4.0–4.5)		4.1
(3.9–4.4)		4.3
(4.1–4.6)		4.2
(4.0–4.4)		
	5–14 years	7.2
(6.9–7.5)		6.8
(6.4–7.2)		6.4
(6.1–6.7)		6.6
(6.3–6.9)		5.9
(5.6–6.3)		5.8
(5.5–6.1)		6.0
(5.7–6.3)		5.6
(5.3–5.9)		5.5
(5.2–5.8)		5.3
(5.1–5.6)		
	15–24 years	10.4
(9.9–10.8)		10.3
(9.8–10.7)		9.5
(9.1–10.0)		10.1
(9.7–10.4)		9.6
(9.2–10.1)		9.0
(8.6–9.4)		9.4
(9.0–9.8)		9.1
(8.6–9.5)		9.5
(9.0–9.9)		8.4
(8.0–8.9)		
	25–44 years	26.3
(25.5–27.0)		26.3
(25.6–27.0)		25.8
(25.1–26.5)		25.7
(24.9–26.4)		24.1
(23.4–24.8)		24.4
(23.7–25.1)		23.9
(23.2–24.7)		23.3
(22.6–24.0)		23.4
(22.7–24.1)		21.4
(20.7–22.1)		
	45–64 years	24.5
(24.0–25.0)		26.1
(25.5–26.7)		26.3
(25.7–26.8)		26.5
(25.9–27.0)		27.2
(26.7–27.7)		28.0
(27.4–28.6)		27.6
(27.0–28.2)		28.2
(27.6–28.7)		28.1
(27.5–28.6)		29.1
(28.5–29.6)		
	65–74 years	12.0
(11.5–12.5)		11.7
(11.2–12.2)		12.3
(11.8–12.8)		11.6
(11.1–12.0)		12.4
(11.9–12.9)		12.6
(12.1–13.2)		12.2
(11.7–12.6)		12.7
(12.2–13.2)		12.6
(12.1–13.1)		13.4
(12.9–13.9)		
	75+ years	12.1
(11.4–12.9)		11.3
(10.7–12.0)		12.8
(12.0–13.5)		12.7
(11.9–13.4)		14.4
(13.6–15.2)		13.9
(13.1–14.7)		14.6
(13.7–15.4)		15.2
(14.4–16.0)		14.7
(13.9–15.5)		16.2
(15.4–17.0)		
(continued)

Table 6.1 (continued): Characteristics of patients at encounters, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Patient characteristics	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Other characteristics(c)																					
	New patient to practice	7.3
(6.7–7.9)		8.0
(7.2–8.7)		8.9
(8.2–9.5)		9.7
(8.9–10.5)		9.1
(8.4–9.8)		8.9
(8.1–9.6)		8.9
(8.2–9.7)		8.4
(7.7–9.2)		8.5
(7.7–9.3)		5.8
(5.4–6.2)	§	
	Commonwealth concession 	card	38.6
(37.0–40.2)		36.7
(35.1–38.3)		41.9
(40.4–43.3)		40.4
(38.8–41.9)		42.5
(41.0–44.0)		43.2
(41.8–44.7)		42.1
(40.6–43.7)		41.5
(39.9–43.0)		41.8
(40.3–43.3)		42.3
(41.0–43.6)		
	Repatriation health card(d)	2.9
(2.6–3.1)		3.1
(2.9–3.4)		3.3
(3.0–3.5)		3.3
(3.0–3.6)		3.5
(3.2–3.8)		3.2
(2.9–3.4)		3.1
(2.8–3.3)		3.1
(2.8–3.3)		2.8
(2.5–3.0)		2.8
(2.6–3.1)	—	
	Non-English-speaking 	background	8.0
(6.5–9.5)		8.0
(7.2–8.7)		9.3
(7.6–11.0)		10.6
(9.0–12.2)		9.7
(7.8–11.6)		10.8
(9.0–12.6)		9.8
(8.2–11.4)		7.1
(5.8–8.5)		9.9
(8.2–11.5)		9.4
(7.9–10.9)	—	
	Aboriginal person and/or Torres Strait Islander	0.7
(0.5–0.9)		0.8
(0.5–1.1)		1.0
(0.8–1.3)		1.0
(0.8–1.3)		1.6
(1.2–2.0)		1.3
(1.0–1.7)		0.9
(0.6–1.1)		0.9
(0.6–1.2)		0.9
(0.7–1.2)		0.8
(0.5–1.0)	—	
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, § indicates a non-linear significant or marginal change, and — indicates there was no change. 
(b)	Missing data removed.
(c)	Missing data for each of the listed ‘other’ patient characteristics were counted as a ‘no’ response.
(d)	The 1999–00 results published here include patients who held either a gold or white Repatriation health card; some previously published figures only included patients who held the gold card.
Note: CI—confidence interval.

Table 6.2: Number of patient reasons for encounter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
Number of reasons 
for encounter	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
One RFE	62.0 
(60.8–63.1)		60.4
(59.2–61.6)		61.8
(60.6–63.0)		60.7
(59.5–61.9)		61.0
(59.9–62.2)		61.4
(60.2–62.6)		60.9
(59.7–62.2)		60.6
(59.4–61.9)		58.9
(57.7–60.2)		56.6
(55.5–57.8)		
Two RFEs	27.5 
(26.9–28.2)		28.2
(27.6–28.9)		27.2
(26.5–28.0)		27.8
(27.1–28.4)		27.7
(27.0–28.4)		27.6
(26.9–28.3)		27.8
(27.1–28.5)		27.9
(27.2–28.7)		29.1
(28.5–29.8)		30.3
(29.6–30.9)		
Three RFEs	10.5 
(9.8–11.1)		11.4
(10.7–12.1)		11.0
(10.3–11.6)		11.6
(10.8–12.3)		11.3
(10.5–12.0)		11.0
(10.3–11.7)		11.2
(10.5–11.9)		11.4
(10.7–12.2)		11.9
(11.2–12.6)		13.1
(12.4–13.8)		
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change. 
Note: CI—confidence interval; RFE—reason for encounter.
Table 6.3: Rate of patient reasons for encounter by ICPC-2 chapter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC-2 Chapter	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
General & unspecified	29.0
(28.1–29.9)		28.3
(27.5–29.1)		30.9
(29.9–31.8)		34.6
(33.6–35.6)		36.2
(35.2–37.2)		36.5
(35.5–37.6)		36.3
(35.2–37.4)		37.7
(36.7–38.8)		40.1
(39.0–41.2)		40.6
(39.6–41.7)		
Respiratory	25.3
(24.3–26.2)		24.6
(23.7–25.4)		23.4
(22.6–24.2)		23.0
(22.0–24.0)		21.4
(20.6–22.2)		20.6
(19.8–21.4)		21.9
(21.1–22.7)		20.7
(19.9–21.6)		20.6
(19.7–21.5)		22.0
(21.2–22.9)		
Musculoskeletal	16.6
(16.1–17.1)		17.7
(17.1–18.2)		16.7
(16.1–17.3)		17.7
(17.2–18.3)		16.3
(15.7–16.9)		16.7
(16.0–17.3)		16.4
(15.8–16.9)		16.1
(15.6–16.6)		15.4
(14.9–15.9)		16.1
(15.5–16.6)	—	
Skin	15.1
(14.7–15.6)		15.5
(15.0–16.0)		14.4
(13.9–14.9)		14.7
(14.3–15.2)		15.1
(14.5–15.7)		15.6
(15.0–16.2)		15.0
(14.5–15.6)		15.7
(15.1–16.3)		15.4
(14.8–16.1)		15.1
(14.6–15.6)	—	
Cardiovascular	11.2
(10.6–11.8)		11.7
(11.1–12.2)		11.4
(10.8–11.9)		10.6
(10.0–11.1)		10.7
(10.1–11.2)		10.5
(10.0–11.0)		10.8
(10.2–11.3)		11.2
(10.7–11.8)		11.2
(10.6–11.8)		11.5
(10.9–12.0)	—	
Digestive	10.4
(10.0–10.7)		11.1
(10.7–11.5)		10.6
(10.2–11.0)		10.4
(10.0–10.8)		10.7
(10.3–11.2)		9.9
(9.5–10.3)		9.9
(9.5–10.3)		10.1
(9.7–10.5)		10.3
(10.0–10.7)		9.8
(9.4–10.1)	§	
(continued)
Table 6.3 (continued): Rate of patient reasons for encounter by ICPC-2 chapter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC-2 Chapter	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Psychological	7.2
(6.8–7.6)		8.1
(7.7–8.6)		7.8
(7.3–8.3)		7.3
(6.9–7.8)		7.3
(6.9–7.7)		7.6
(7.2–8.0)		7.8
(7.3–8.3)		7.5
(7.1–7.8)		7.8
(7.5–8.2)		8.7
(8.2–9.1)	§	
Endocrine & metabolic	5.4
(5.1–5.7)		6.2
(5.9–6.5)		6.4
(6.1–6.7)		6.0
(5.7–6.3)		6.2
(5.8–6.5)		6.2
(5.8–6.5)		6.2
(5.8–6.5)		6.4
(6.1–6.8)		6.5
(6.1–6.8)		6.9
(6.5–7.3)		
Female genital system	5.3
(4.9–5.7)		5.5
(5.1–5.9)		5.5
(5.1–5.9)		6.1
(5.7–6.6)		5.1
(4.8–5.5)		5.0
(4.6–5.4)		5.1
(4.8–5.5)		5.1
(4.7–5.4)		5.2
(4.8–5.6)		5.3
(4.9–5.6)	—	
Neurological	5.6
(5.4–5.8)		5.8
(5.5–6.0)		5.4
(5.2–5.6)		5.7
(5.5–6.0)		5.3
(5.1–5.6)		5.1
(4.9–5.4)		4.9
(4.7–5.2)		4.9
(4.7–5.2)		4.8
(4.6–5.0)		4.8
(4.6–5.0)		
Ear	4.2
(4.0–4.4)		4.2
(4.0–4.3)		4.2
(4.0–4.4)		4.0
(3.8–4.1)		3.7
(3.6–3.9)		3.9
(3.7–4.1)		3.9
(3.7–4.1)		3.6
(3.4–3.7)		3.6
(3.4–3.8)		3.7
(3.5–3.9)		
Pregnancy & family planning	3.8
(3.5–4.2)		3.5
(3.2–3.8)		3.5
(3.2–3.8)		3.6
(3.3–3.9)		3.7
(3.4–4.0)		3.4
(3.1–3.7)		3.4
(3.1–3.6)		3.3
(3.0–3.6)		3.2
(3.0–3.5)		3.1
(2.8–3.3)		
Urology	2.6
(2.5–2.8)		2.4
(2.3–2.6)		2.5
(2.4–2.7)		2.5
(2.3–2.6)		2.5
(2.4–2.7)		2.5
(2.4–2.7)		2.6
(2.5–2.8)		2.6
(2.4–2.7)		2.5
(2.4–2.7)		2.7
(2.5–2.8)	—	
Eye	2.8
(2.7–3.0)		2.7
(2.5–2.8)		2.5
(2.4–2.7)		2.7
(2.6–2.9)		2.7
(2.6–2.9)		2.7
(2.6–2.9)		2.8
(2.6–2.9)		2.5
(2.4–2.7)		2.5
(2.4–2.6)		2.6
(2.4–2.7)	—	
Blood	2.1
(1.9–2.3)		2.0
(1.8–2.2)		1.1
(0.9–1.2)		1.0
(0.8–1.2)		1.3
(1.1–1.4)		1.2
(1.0–1.5)		1.2
(1.0–1.3)		1.2
(1.1–1.4)		1.4
(1.2–1.5)		1.4
(1.3–1.6)	§	
Male genital system	1.0
(0.9–1.1)		1.1
(1.0–1.3)		1.0
(0.9–1.1)		1.0
(0.9–1.2)		1.1
(0.9–1.2)		1.2
(1.1–1.4)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		
Social problems	1.0
(0.8–1.1)		0.9
(0.7–1.1)		1.0
(0.8–1.1)		1.0
(0.8–1.2)		0.9
(0.8–1.1)		1.0
(0.8–1.1)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.1
(1.0–1.2)		1.0
(0.9–1.0)	—	
Total RFEs	148.5
(146.7–150.2)		151.0
(149.2–152.8)		149.2
(147.4–150.9)		150.9
(149.0–152.7)		150.2
(148.4–152.0)		149.6
(147.8–151.5)		150.3
(148.4–152.2)		150.8
(148.9–152.7)		153.0
(151.1–154.8)		156.5
(154.7–158.2)		
(a)	Figures do not total 100, as more than one RFE can be recorded for each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, § indicates a non-linear significant or marginal change, and — indicates there was no change. 
Note: CI—confidence interval; RFE—reason for encounter.

Table 6.4: Rate of patient reasons for encounter by ICPC-2 component, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC component	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Symptoms & complaints	73.4
(71.5–75.3)		76.6
(74.6–78.6)		74.1
(72.3–75.9)		74.0
(72.0–76.1)		71.7
(69.8–73.5)		71.3
(69.4–73.2)		69.7
(67.9–71.5)		67.9
(66.1–69.8)		67.7
(65.8–69.6)		68.8
(67.1–70.5)		
Diagnosis, diseases	27.7
(26.2–29.2)		29.0
(27.6–30.5)		27.3
(25.9–28.7)		26.0
(24.6–27.4)		25.1
(23.9–26.4)		24.5
(23.3–25.7)		26.8
(25.4–28.2)		27.9
(26.2–29.5)		27.8
(26.3–29.3)		27.8
(26.4–29.2)	§	
Diagnostic & preventive procedures	22.9
(22.0–23.8)		22.3
(21.4–23.2)		22.7
(21.7–23.6)		23.8
(22.8–24.7)		24.0
(23.1–25.0)		23.4
(22.5–24.3)		24.4
(23.4–25.3)		24.8
(23.8–25.7)		25.6
(24.7–26.5)		26.9
(26.0–27.8)		
Medications, treatments & therapeutics	12.0
(11.4–12.6)		11.2
(10.6–11.8)		11.9
(11.3–12.4)		13.0
(12.4–13.6)		14.4
(13.7–15.1)		14.5
(13.8–15.3)		14.4
(13.7–15.1)		14.2
(13.5–14.8)		15.1
(14.3–15.8)		15.3
(14.6–15.9)		
Results	4.0
(3.7–4.3)		4.2
(3.9–4.6)		4.7
(4.4–5.1)		5.4
(5.0–5.7)		6.0
(5.6–6.4)		6.8
(6.4–7.2)		6.5
(6.1–6.9)		6.9
(6.5–7.3)		7.6
(7.2–8.1)		7.8
(7.4–8.2)		
Referral & other RFEs	7.2
(6.7–7.7)		6.5
(6.0–7.0)		7.2
(6.7–7.7)		7.0
(6.6–7.5)		7.2
(6.8–7.6)		7.4
(6.9–7.9)		6.9
(6.5–7.4)		7.3
(6.9–7.8)		6.8
(6.4–7.2)		7.5
(7.0–7.9)	—	
Administrative	1.3
(1.1–1.4)		1.1
(0.9–1.3)		1.3
(1.1–1.5)		1.6
(1.4–1.8)		1.8
(1.6–1.9)		1.7
(1.5–1.8)		1.7
(1.5–1.8)		1.9
(1.7–2.0)		2.4
(2.2–2.5)		2.4
(2.2–2.6)		
Total RFEs	148.5
(146.7–150.2)		151.0
(149.2–152.8)		149.2
(147.4–150.9)		150.9
(149.0–152.7)		150.2
(148.4–152.0)		149.6
(147.8–151.5)		150.3
(148.4–152.2)		150.8
(148.9–152.7)		153.0
(151.1–154.8)		156.5
(154.7–158.2)		
(a)	Figures do not total 100, as more than one RFE can be recorded for each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, and § indicates a non-linear significant or marginal change. 
Note: CI—confidence interval; RFE—reason for encounter.

Table 6.5: Most frequent patient reasons for encounter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Patient reason 
for encounter	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Check-up—all*	14.2
(13.5–14.9)		13.2
(12.5–13.9)		13.4
(12.7–14.0)		13.6
(12.9–14.2)		14.1
(13.4–14.8)		13.4
(12.8–14.0)		14.1
(13.4–14.8)		14.6
(13.9–15.2)		14.5
(13.8–15.1)		15.2
(14.5–15.8)	—	
Prescription—all*	9.6
(9.1–10.2)		9.2
(8.7–9.8)		9.8
(9.2–10.3)		10.8
(10.2–11.3)		12.1
(11.5–12.7)		12.2
(11.5–12.8)		12.1
(11.4–12.7)		11.8
(11.2–12.4)		12.5
(11.9–13.2)		12.6
(12.0–13.2)		
Test results*	4.0
(3.7–4.2)		4.3
(3.9–4.6)		4.7
(4.4–5.0)		5.4
(5.0–5.7)		6.0
(5.7–6.4)		6.8
(6.4–7.2)		6.5
(6.1–6.9)		6.9
(6.5–7.3)		7.6
(7.2–8.1)		7.8
(7.4–8.2)		
Cough	7.0
(6.5–7.4)		7.0
(6.5–7.4)		6.5
(6.1–6.9)		6.7
(6.3–7.2)		6.2
(5.8–6.6)		5.9
(5.5–6.2)		6.4
(6.0–6.8)		5.8
(5.4–6.2)		6.2
(5.8–6.7)		6.8
(6.3–7.2)	—	
Immunisation/vaccination—all*	4.2
(3.9–4.6)		4.4
(4.0–4.8)		4.6
(4.2–5.0)		4.7
(4.3–5.1)		4.4
(4.0–4.9)		4.3
(3.9–4.8)		4.8
(4.4–5.2)		4.3
(3.9–4.7)		4.8
(4.4–5.1)		5.3
(4.8–5.7)		
Throat complaint	4.2
(3.8–4.5)		4.0
(3.7–4.3)		3.8
(3.5–4.0)		3.8
(3.5–4.1)		3.4
(3.1–3.6)		3.5
(3.3–3.8)		3.3
(3.0–3.5)		3.3
(3.1–3.6)		3.3
(3.0–3.6)		3.2
(2.9–3.5)		
Back complaint*	3.6
(3.4–3.8)		3.8
(3.5–4.0)		3.8
(3.6–4.1)		3.5
(3.3–3.8)		3.5
(3.2–3.7)		3.4
(3.2–3.6)		3.5
(3.2–3.7)		3.2
(3.0–3.4)		3.2
(3.0–3.4)		3.1
(2.9–3.3)		
Rash*	2.7
(2.6–2.9)		2.9
(2.8–3.1)		2.8
(2.6–3.0)		2.8
(2.7–3.0)		2.8
(2.6–2.9)		2.9
(2.7–3.1)		2.6
(2.5–2.8)		2.8
(2.6–3.0)		2.5
(2.3–2.6)		2.6
(2.5–2.8)	—	
Upper respiratory infection	2.7
(2.4–3.0)		2.6
(2.3–2.9)		2.3
(2.1–2.6)		2.2
(1.9–2.4)		1.9
(1.7–2.1)		1.8
(1.5–2.0)		2.4
(2.0–2.7)		2.4
(2.1–2.7)		2.2
(2.0–2.5)		2.3
(2.0–2.6)	§	
Hypertension*	1.7
(1.4–1.9)		2.2
(1.9–2.4)		2.1
(1.8–2.3)		1.8
(1.6–2.0)		1.9
(1.6–2.1)		1.7
(1.5–1.9)		1.9
(1.6–2.1)		2.1
(1.8–2.5)		2.1
(1.8–2.3)		2.1
(1.9–2.4)		
Administrative procedure NOS	1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.2
(1.0–1.3)		1.4
(1.3–1.6)		1.5
(1.4–1.7)		1.4
(1.3–1.5)		1.4
(1.3–1.6)		1.6
(1.5–1.8)		2.0
(1.8–2.1)		2.1
(1.9–2.3)		
Depression*	1.7
(1.6–1.8)		2.1
(2.0–2.3)		1.9
(1.8–2.0)		1.9
(1.7–2.0)		1.8
(1.7–1.9)		1.9
(1.7–2.0)		1.9
(1.7–2.0)		1.9
(1.8–2.1)		2.0
(1.9–2.2)		2.1
(1.9–2.2)		
Fever	2.2
(1.9–2.5)		2.3
(2.0–2.5)		2.0
(1.8–2.2)		2.2
(1.9–2.5)		1.9
(1.7–2.1)		1.8
(1.6–2.0)		2.2
(1.9–2.5)		1.8
(1.6–2.0)		2.1
(1.8–2.5)		1.9
(1.7–2.1)	—	
(continued)
Table 6.5 (continued): Most frequent patient reasons for encounter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Patient reason 
for encounter	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Abdominal pain*	2.1
(1.9–2.2)		2.3
(2.1–2.4)		2.1
(2.0–2.2)		1.9
(1.8–2.1)		2.0
(1.9–2.2)		1.9
(1.8–2.0)		1.8
(1.7–1.9)		1.8
(1.7–1.9)		1.8
(1.6–1.9)		1.7
(1.6–1.9)		
Headache	2.2
(2.0–2.3)		2.2
(2.0–2.3)		2.0
(1.9–2.2)		2.1
(1.9–2.3)		1.8
(1.6–1.9)		1.7
(1.6–1.8)		1.7
(1.6–1.8)		1.6
(1.4–1.7)		1.6
(1.5–1.8)		1.6
(1.4–1.7)		
Skin complaint	1.2
(1.1–1.4)		1.5
(1.4–1.6)		1.3
(1.1–1.5)		1.3
(1.2–1.5)		1.4
(1.2–1.5)		1.5
(1.3–1.6)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.5
(1.4–1.6)		
Weakness/tiredness	1.5
(1.4–1.6)		1.7
(1.5–1.8)		1.5
(1.4–1.6)		1.5
(1.3–1.6)		1.5
(1.4–1.6)		1.7
(1.5–1.8)		1.3
(1.2–1.4)		1.4
(1.2–1.5)		1.4
(1.2–1.5)		1.5
(1.4–1.6)	—	
Ear pain	1.9
(1.7–2.0)		1.8
(1.7–1.9)		1.7
(1.6–1.9)		1.7
(1.5–1.8)		1.6
(1.4–1.7)		1.6
(1.5–1.7)		1.6
(1.5–1.7)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.4
(1.3–1.6)		
Shoulder complaint	1.0
(1.0–1.1)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.3
(1.1–1.4)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.0
(0.9–1.1)		1.4
(1.3–1.5)		
Knee complaint	1.3
(1.2–1.4)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.3
(1.2–1.4)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.3
(1.2–1.4)	—	
Diarrhoea	1.3
(1.2–1.4)		1.5
(1.4–1.6)		1.4
(1.3–1.5)		1.6
(1.4–1.7)		1.5
(1.3–1.6)		1.4
(1.3–1.5)		1.3
(1.2–1.4)		1.3
(1.2–1.5)		1.4
(1.3–1.6)		1.3
(1.2–1.4)	—	
Diabetes—all*	0.8
(0.7–0.9)		1.0
(0.8–1.1)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.3
(1.1–1.4)		1.2
(1.1–1.4)		
Blood test NOS	0.8
(0.7–0.9)		0.8
(0.7–1.0)		0.8
(0.7–1.0)		1.0
(0.9–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.3)		1.2
(1.0–1.3)		1.2
(1.1–1.4)		1.2
(1.0–1.3)		1.2
(1.0–1.3)		
Vertigo/dizziness	1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.1–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.2
(1.1–1.3)	—	
Anxiety*	1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.2
(1.0–1.3)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.1
(1.0–1.3)	—	
Swelling*	1.1
(1.0–1.1)		1.1
(0.9–1.1)		1.1
(1.0–1.2)		1.1
(1.0–1.1)		1.2
(1.0–1.3)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)	—	
(continued)
Table 6.5 (continued): Most frequent patient reasons for encounter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Patient reason 
for encounter	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Sleep disturbance	1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.2
(1.0–1.3)		1.2
(1.0–1.3)		1.2
(1.1–1.4)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.1
(1.0–1.2)	—	
Foot/toe complaint	1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.2
(1.1–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)	—	
Leg/thigh complaint	1.0
(0.9–1.0)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.0
(1.0–1.1)		0.9
(0.8–1.0)		1.0
(1.0–1.1)	—	
Referrals NOS	0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.5
(0.4–0.5)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0
(0.9–1.0)		
Neck complaint	1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		0.9
(0.9–1.0)		1.0
(0.9–1.2)		0.9
(0.8–1.1)		0.9
(0.8–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		
Chest pain NOS	1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.3
(1.2–1.4)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.1
(1.0–1.1)		0.9
(0.8–1.0)		
Advice/education	0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.6
(0.6–0.7)		0.7
(0.7–0.8)		0.8
(0.7–1.0)		0.7
(0.7–0.8)		0.8
(0.8–0.9)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		
Trauma/injury NOS	0.7
(0.7–0.8)		0.8
(0.7–0.9)		0.6
(0.6–0.7)		0.8
(0.7–0.9)		0.9
(0.8–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.8–0.9)	—	
Vomiting	1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.3)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		0.8
(0.7–0.9)		
Total RFEs	148.5
(146.7–150.2)		151.0
(149.2–152.8)		149.2
(147.4–150.9)		150.9
(149.0–152.7)		150.2
(148.4–152.0)		149.6
(147.8–151.5)		150.3
(148.4–152.2)		150.8
(148.9–152.7)		153.0
(151.1–154.8)		156.5
(154.7–158.2)		
(a)	Figures do not total 100, as more than one RFE can be recorded for each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant change, and — indicates there was no change. 
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NOS—not otherwise specified; RFE—reason for encounter.

7	Problems managed
A ‘problem managed’ is a formal statement of the provider’s understanding of a health problem presented by the patient, family or community, and can be described in terms of a disease, symptom or complaint, social problem, or ill-defined condition managed at the encounter. As GPs were instructed to record each problem at the most specific level possible from the information available, the problem managed may at times be limited to the level of a presenting symptom.
At each patient encounter, up to four problems could be recorded by the GP. A minimum of one problem was compulsory. The status of each problem to the patient—new (first presentation to a medical practitioner) or old (follow-up of previously managed problem)—was also indicated. The concept of a principal diagnosis, which is often used in hospital statistics, is not adopted in studies of general practice where multiple problem management is the norm rather than the exception. Further, the range of problems managed at the encounter often crosses multiple body systems and may include undiagnosed symptoms, psychosocial problems or chronic disease, which makes the designation of a principal diagnosis difficult. Thus the order in which the problems were recorded by the GP is not significant. 
This chapter includes data about the problems managed in general practice from each of the last 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in the management rate of a problem between 1999–00 and 2008–09. An example of an extrapolated change is given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8.
There are two ways to describe the relative frequency of problems managed: as a percentage of all problems managed in the study, or as a rate of problems managed per 100 encounters. Where groups of problems are reported (for example cardiovascular problems), it must be remembered that more than one of that type of problem (such as hypertension and heart failure) may have been managed at a single encounter. In considering these results, the reader must be mindful that although a rate per 100 encounters for a single ungrouped problem (for example, asthma, 1.4 per 100 encounters) can be regarded as equivalent to ‘asthma is managed at 1.4% of encounters’, such a statement cannot be made for grouped concepts (ICPC-2 chapters and those marked with asterisks in the tables).
7.1	Number of problems managed
GPs are asked to record information about the management of up to four problems at each encounter. Table 7.1 shows the number of problems managed at each encounter over time. 
There were increases in the number of encounters where two, three and four problems were managed, and a decrease in encounters where only one problem was managed. When extrapolated to all GP encounters in Australia this indicates there were about 4.9 million more occasions where two problems were managed, 3.1 million more occasions where three problems were managed, and 910,000 more occasions where four problems were managed by GPs in Australia in 2008–09 than in 1999–00.
There was a significant increase in the number of problems managed at encounter, from 146.7 per 100 encounters in 1999–00 to 154.6 in 2008–09 (Table 7.2). This suggests there were an additional 24.7 million problems managed at GP encounters in Australia in 2008–09 than in 1999–00. This was reflected in significant increases in the management rate of new problems (Table 7.5), and the management rate of chronic conditions (Table 7.6).
7.2	Distribution of problems managed by ICPC-2 component
As shown in Table 7.2, there were significant increases in the management rate of problems described and classified as ‘diagnoses and diseases’, ‘diagnostic and preventive procedures’, ‘results’ and ‘administrative procedures’ between 1999–00 and 2008–09. The increase in the management of diagnoses and diseases represents an extrapolated national increase of 15.8 million encounters for this type of problem, the increase in the rate of diagnostic and preventive procedures represents an additional 3.5 million contacts for this problem and the increase in the management of test results represents an extrapolated increase of 870,000 contacts in Australia in 2008–09 when compared with 1999–00.
There were no significant changes in the management rate of problems described in terms of symptoms and complaints, nor those described and classified as ‘medications, treatments and therapeutics’ and ‘referrals and other reasons for encounters’ between 1999–00 and 2008–09. 
7.3	Problems managed by ICPC-2 chapter and individual problems managed
Problems managed at general practice encounters by ICPC chapter are described in Table 7.3 for all years from 1999–00 to 2008–09. Problems related to the respiratory system have remained the most common type of problem managed since 1999–00. However, the management rate of respiratory problems has decreased significantly from 24.2 per 100 encounters in 1999–00 to 20.8 per 100 in 2008–09. This represents a national decrease of approximately 1.2 million occasions where a respiratory problem was managed in 2008–09 when compared with 1999–00.
The most common individual problems managed are described in Table 7.4 for all years from 1999–00 to 2008–09. Hypertension has remained the most common individual problem managed in general practice in Australia since 1999–00. Its management rate increased significantly between 1999–00 and 2008–09, from 8.4 to 10.1 per 100 encounters. This represents an estimated national increase of 2.8 million occasions where hypertension was managed in 2008–09 compared with 1999–00. 
7.4	Most common new problems 
Table 7.5 shows the most frequently managed new problems between 1999–00 and 2008–09. There was a significant increase in the management rate of new problems over the 10 years of the study from 45.3 per 100 encounters in 1999–00 to 57.4 in 2008–09, suggesting approximately 18.5 million more GP contacts with management of new problems than in 1999–00. The majority of this increase occurred between 1999–00 and 2001–02, increasing from 45.3 to 55.1 in 2001–02. The rate remained relatively stable from 2001–02 to 2008–09.
The most common new problems managed in general practice over the decade were upper respiratory tract infection, immunisation/vaccination and acute bronchitis/bronchiolitis. The management of general check-ups as a new problem increased significantly from 0.5 per 100 encounters in 1999–00 to 1.1 per 100 encounters in 2008–09, representing an additional 730,000 occasions where general check-ups were managed in 2008–09 compared with 
1999–00 (Table 7.5). 
7.5	Most frequently managed chronic problems 
Table 7.6 shows the most frequently managed chronic problems between 1999–00 and 
2008–09. The management rate of chronic conditions significantly increased from 47.2 per 100 encounters in 1999–00 to 55.1 per 100 in 2008–09, suggesting approximately 14.0 million more GP contacts in Australia in 2008–09 with chronic problems than in 1999–00. 
The most common chronic problems managed were non-gestational hypertension, depressive disorder, non-gestational diabetes and lipid disorders. These problems all increased significantly over the decade. For example, lipid disorders increased from 2.6 to 3.7 per 100 encounters, representing an increase in management of 1.5 million lipid problems from 1999–00 to 2008–09 (Table 7.6).

Table 7.1: Number of problems managed at an encounter, BEACH, 1999–00 to 2008–09
	Per cent of encounters (95% CI)		
Number of problems managed at encounter	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
One problem	65.4
(64.3–66.5)		66.5
(65.4–67.5)		67.7
(66.6–68.8)		66.9
(65.8–68.1)		66.2
(65.0–67.3)		66.5
(65.3–67.7)		66.4
(65.1–67.6)		65.0
(63.7–66.2)		63.0 
(61.7–64.3)		60.8
(59.6–61.9)		
Two problems	24.7
(24.0–25.3)		24.4
(23.8–25.1)		23.1
(22.4–23.7)		23.4
(22.6–24.1)		23.8
(23.1–24.5)		23.6
(22.9–24.3)		23.4
(22.7–24.1)		24.0
(23.3–24.8)		25.4 
(24.7–26.2)		26.7
(26.1–27.4)		
Three problems	7.7
(7.3–8.1)		7.3
(6.9–7.7)		7.3
(6.9–7.7)		7.6
(7.2–8.0)		7.7
(7.2–8.1)		7.7
(7.3–8.2)		7.9
(7.4–8.4)		8.5
(8.1–9.0)		8.8 
(8.3–9.3)		9.7 
(9.2–10.1)		
Four problems	2.2
(1.9–2.5)		1.9
(1.5–2.2)		1.9
(1.6–2.2)		2.1
(1.7–2.5)		2.4
(2.0–2.8)		2.2
(1.8–2.5)		2.3
(2.1–2.6)		2.5
(2.2–2.7)		2.7 
(2.4–3.0)		2.8 
(2.6–3.1)		
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change.
Note: CI—confidence interval.

Table 7.2: Distribution of problems managed, by ICPC-2 component, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC-2 component	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Diagnosis, diseases	96.1
(94.4–97.8)		95.2
(93.6–96.7)		93.7
(92.1–95.2)		93.1
(91.5–94.8)		94.8
(93.0–96.5)		94.2
(94.2–96.0)		95.5
(93.6–97.3)		96.6
(94.8–98.3)		98.1
(96.2–99.9)		100.9
(99.1–102.6)		
Symptoms & complaints	32.0
(31.2–32.8)		31.7
(30.9–32.5)		31.4
(30.6–32.2)		31.4
(30.6–32.2)		30.8
(30.0–31.6)		31.1
(30.2–31.9)		30.4
(29.6–31.2)		31.4
(30.6–32.2)		32.3 
(31.5–33.1)		32.1
(31.3–32.9)	—	
Diagnostic & preventive procedures	13.1
(12.4–13.7)		12.6
(11.9–13.2)		12.4
(11.8–13.0)		13.5
(12.8–14.2)		13.6
(12.9–14.4)		13.3
(12.5–14.0)		13.7
(13.1–14.4)		13.8
(13.0–14.5)		14.2 
(13.5–14.8)		15.0
(14.2–15.7)		
Medications, treatments & therapeutics	3.1
(2.9–3.3)		2.9
(2.7–3.1)		3.3
(3.0–3.6)		3.6
(3.3–3.8)		4.0
(3.6–4.3)		3.7
(3.4–3.9)		3.2
(3.0–3.5)		3.2
(2.9–3.5)		2.9 
(2.7–3.2)		3.3
(3.0–3.6)	—	
Results	0.8
(0.7–0.9)		0.8
(0.7–0.9)		1.1
(0.9–1.2)		1.1
(0.9–1.2)		1.2
(1.1–1.4)		1.4
(1.3–1.5)		1.4
(1.3–1.6)		1.6
(1.4–1.7)		1.8 
(1.6–1.9)		1.5
(1.4–1.7)		
Referral & other RFE	1.3
(1.2–1.4)		1.1
(1.0–1.2)		1.1
(1.0–1.3)		1.7
(1.5–1.9)		1.3
(1.1–1.4)		1.4
(1.2–1.5)		1.2
(1.1–1.4)		1.3
(1.2–1.5)		1.2 
(1.1–1.3)		1.0
(0.9–1.1)	—	
Administrative	0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.4–0.5)		0.5
(0.5–0.6)		0.6
(0.6–0.7)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.9 
(0.8–1.0)		0.9
(0.8–1.0)		
Total problems 	146.7
(144.9–148.6)		144.5
(142.8–146.3)		143.4
(141.7–145.2)		144.9
(143.0–146.8)		146.3
(144.4–148.2)		145.5
(143.6–147.4)		146.2
(144.2–148.2)		148.5
(146.4–150.6)		151.3 
(149.2–153.4)		154.6
(152.6–156.5)		
(a)	Figures do not total 100, as more than one problem can be recorded for each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, and — indicates there was no change.
Note: CI—confidence interval; RFE—reason for encounter.

Table 7.3: Distribution of problems managed, by ICPC-2 chapter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC-2 Chapter	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Respiratory	24.2
(23.5–24.9)		22.5
(21.9–23.2)		21.4
(20.7–22.0)		20.6
(20.0–21.3)		20.1
(19.5–20.7)		19.2
(18.6–19.9)		20.6
(19.9–21.3)		19.6
(18.9–20.3)		19.4 
(18.8–20.1)		20.8
(20.2–21.4)		
Cardiovascular	16.3
(15.5–17.0)		16.0
(15.3–16.7)		16.1
(15.5–16.8)		16.0
(15.3–16.7)		16.8
(16.1–17.5)		16.2
(15.5–16.9)		16.6
(16.1–17.7)		17.4
(16.7–18.1)		17.6 
(16.8–18.3)		18.6
(17.8–19.3)		
Musculoskeletal	16.9
(16.4–17.4)		17.4
(16.9–18.0)		17.5
(17.0–18.0)		17.1
(16.5–17.6)		17.1
(16.6–17.6)		17.7
(17.1–18.3)		17.2
(16.7–17.7)		17.1
(16.6–17.6)		17.3 
(16.7–17.8)		17.3
(16.9–17.8)	—	
General & unspecified	13.9
(13.4–14.5)		14.2
(13.7–14.7)		14.7
(14.0–15.5)		15.8
(15.2–16.3)		15.0
(14.5–15.5)		15.1
(14.5–15.7)		15.1
(14.5–15.7)		16.2
(15.6–16.8)		17.8 
(17.1–18.5)		17.1
(16.4–17.7)		
Skin	17.0
(16.6–17.5)		16.7
(16.2–17.3)		16.1
(15.6–16.6)		16.5
(16.0–17.0)		16.9
(16.2–17.6)		17.2
(16.6–17.9)		16.6
(16.1–17.2)		17.5
(16.9–18.2)		17.2 
(16.5–17.9)		17.0
(16.5–17.5)	—	
Endocrine & metabolic	9.1
(8.7–9.6)		9.8
(9.3–10.2)		10.4
(10.0–10.9)		10.6
(10.2–11.0)		11.3
(10.8–11.8)		11.8
(11.2–12.3)		11.6
(11.0–12.1)		12.1
(11.6–12.6)		12.9 
(12.3–13.5)		13.5
(12.9–14.0)		
Psychological	10.5
(10.0–11.1)		10.8
(10.2–11.3)		10.6
(10.1–11.2)		10.3
(9.8–10.8)		10.8
(10.3–11.4)		11.4
(10.8–12.0)		11.1
(10.5–11.7)		11.0
(10.5–11.4)		11.5 
(10.9–12.0)		12.4
(11.9–12.9)		
Digestive	10.1
(9.7–10.3)		9.9
(9.6–10.2)		9.9
(9.6–10.2)		10.1
(9.8–10.4)		10.5
(10.2–10.8)		9.9
(9.6–10.2)		10.1
(9.8–10.4)		10.4
(10.1–10.7)		10.7 
(10.4–11.1)		10.5
(10.2–10.8)	—	
Female genital system	6.2
(5.8–6.5)		6.1
(5.7–6.4)		6.1
(5.8–6.5)		6.7
(6.2–7.1)		5.9
(5.5–6.3)		5.7
(5.3–6.1)		5.8
(5.4–6.2)		5.7
(5.3–6.1)		5.8 
(5.4–6.2)		6.1
(5.7–6.6)	—	
Ear	4.5
(4.3–4.7)		4.4
(4.2–4.6)		4.2
(4.0–4.4)		4.0
(3.8–4.2)		4.0
(3.8–4.1)		4.1
(3.9–4.2)		4.0
(3.8–4.1)		3.8
(3.6–3.9)		3.8 
(3.6–3.9)		3.9
(3.7–4.1)		
Neurological	3.9
(3.7–4.1)		3.8
(3.6–3.9)		3.7
(3.5–3.9)		4.2
(4.0–4.4)		3.9
(3.8–4.1)		3.6
(3.5–3.8)		3.6
(3.4–3.8)		3.8
(3.6–3.9)		3.6 
(3.4–3.7)		3.8
(3.6–3.9)	—	
Pregnancy & family planning	4.3
(4.0–4.6)		3.9
(3.6–4.2)		4.0
(3.7–4.2)		4.2
(3.9–4.5)		4.2
(3.9–4.5)		3.8
(3.6–4.1)		3.8
(3.6–4.1)		3.9
(3.6–4.2)		3.9 
(3.6–4.2)		3.7
(3.4–3.9)		
Urology	3.0
(2.9–3.2)		2.7
(2.5–2.8)		2.8
(2.7–3.0)		2.8
(2.7–3.0)		3.0
(2.9–3.2)		3.0
(2.9–3.2)		3.1
(2.9–3.2)		3.2
(3.0–3.3)		3.1 
(3.0–3.3)		3.3
(3.2–3.5)		
(continued)
Table 7.3 (continued): Distribution of problems managed, by ICPC-2 chapter, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ICPC-2 Chapter	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Eye	2.7
(2.6–2.9)		2.6
(2.5–2.7)		2.5
(2.4–2.6)		2.6
(2.5–2.7)		2.7
(2.6–2.9)		2.7
(2.5–2.8)		2.8
(2.6–2.9)		2.7
(2.5–2.8)		2.6 
(2.4–2.7)		2.7
(2.6–2.8)	—	
Male genital system	1.4
(1.3–1.5)		1.5
(1.3–1.6)		1.3
(1.2–1.4)		1.4
(1.3–1.6)		1.6
(1.5–1.7)		1.8
(1.6–1.9)		1.9
(1.7–2.0)		1.9
(1.7–2.0)		1.8 
(1.7–1.9)		2.1
(1.9–2.2)		
Blood	1.7
(1.6–1.8)		1.7
(1.5–1.8)		1.3
(1.2–1.4)		1.4
(1.3–1.5)		1.7
(1.5–1.8)		1.6
(1.4–1.8)		1.5
(1.4–1.6)		1.7
(1.5–1.8)		1.6 
(1.5–1.8)		1.5
(1.3–1.6)	§	
Social problems	0.9
(0.8–1.0)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.6
(0.5–0.7)		0.7
(0.6–0.7)		0.7 
(0.6–0.8)		0.6
(0.5–0.7)		
Total problems	146.7
(144.9–148.6)		144.5
(142.8–146.3)		143.4
(141.7–145.2)		144.9
(143.0–146.8)		146.3
(144.4–148.2)		145.5
(143.6–147.4)		146.2
(144.2–148.2)		148.5
(146.4–150.6)		151.3 
(149.2–153.4)		154.6
(152.6–156.5)		
(a)	Figures do not total 100, as more than one problem can be managed at each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Note: CI—confidence interval.

Table 7.4: Most frequently managed problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Hypertension*	8.4
(7.9–8.9)		8.6
(8.2–9.1)		9.0
(8.5–9.5)		8.8
(8.4–9.3)		9.2
(8.7–9.7)		8.9
(8.4–9.4)		9.4
(8.9–10.0)		9.6
(9.1–10.0)		9.9 
(9.4–10.5)		10.1
(9.6–10.6)		
Check-up—all*	6.4
(6.0–6.8)		5.9
(5.5–6.2)		5.8
(5.4–6.1)		6.4
(6.0–6.8)		6.4
(5.9–6.9)		6.3
(5.9–6.7)		6.4
(6.0–6.8)		6.6
(6.2–7.0)		6.3 
(6.0–6.7)		6.7
(6.3–7.1)	—	
	General check-up*	1.8
(1.6–1.9)		1.6
(1.5–1.8)		1.8
(1.6–1.9)		1.9
(1.8–2.1)		1.8
(1.7–2.0)		2.1
(1.9–2.2)		2.1
(1.9–2.2)		2.4
(2.2–2.6)		2.5
(2.3–2.7)		2.5
(2.3–2.7)		
	Female genital 
check-up*	1.6
(1.4–1.7)		1.5
(1.3–1.6)		1.6
(1.4–1.7)		1.8
(1.6–2.0)		1.8
(1.6–2.0)		1.8
(1.6–2.0)		1.8
(1.6–2.0)		1.7
(1.5–1.9)		1.8
(1.6–2.0)		2.0
(1.8–2.3)		
	Cardiac check-up*	1.3
(1.2–1.5)		1.3
(1.2–1.4)		1.1
(1.0–1.3)		1.1
(0.9–1.2)		1.2
(1.0–1.3)		1.0
(0.9–1.1)		1.2
(1.0–1.3)		1.3
(1.1–1.5)		1.2
(1.0–1.4)		1.3
(1.1–1.5)	—	
Upper respiratory 
tract infection	7.2
(6.7–7.7)		6.9
(6.5–7.3)		6.2
(5.8–6.6)		6.4
(6.0–6.8)		5.5
(5.1–5.8)		5.6
(5.2–5.9)		6.2
(5.8–6.6)		5.8
(5.3–6.2)		6.2 
(5.7–6.7)		6.1
(5.7–6.6)		
Immunisation/
vaccination—all*	4.6
(4.2–5.0)		4.6
(4.2–4.9)		4.7
(4.3–5.1)		4.6
(4.3–5.0)		4.7
(4.3–5.2)		4.6
(4.2–5.1)		5.0
(4.6–5.4)		4.7
(4.3–5.2)		5.2 
(4.8–5.6)		5.7
(5.2–6.2)		
Depression*	3.4
(3.2–3.6)		3.7
(3.4–3.9)		3.4
(3.2–3.6)		3.5
(3.3–3.7)		3.6
(3.4–3.9)		3.7
(3.5–3.9)		3.6
(3.4–3.8)		3.7
(3.5–3.9)		4.0 
(3.8–4.2)		4.3
(4.0–4.5)		
Diabetes—all*	2.7
(2.5–2.9)		2.8
(2.6–3.0)		3.1
(2.9–3.3)		2.9
(2.7–3.1)		3.3
(3.1–3.5)		3.2
(3.0–3.4)		3.5
(3.3–3.8)		3.7
(3.5–3.9)		3.9 
(3.6–4.1)		4.1
(3.9–4.3)		
Lipid disorders*	2.6
(2.4–2.8)		2.9
(2.7–3.1)		2.9
(2.7–3.1)		3.0
(2.8–3.2)		3.1
(2.9–3.4)		3.3
(3.1–3.6)		3.4
(3.1–3.7)		3.5
(3.2–3.7)		3.7 
(3.4–4.0)		3.9
(3.7–4.2)		
Arthritis—all*	3.6
(3.3–3.8)		3.9
(3.7–4.1)		3.8
(3.5–4.0)		3.7
(3.5–3.9)		4.0
(3.8–4.2)		3.9
(3.7–4.2)		3.8
(3.5–4.0)		3.7
(3.5–3.9)		3.6 
(3.4–3.8)		3.8
(3.6–4.0)	—	
	Osteoarthritis*	2.2
(2.1–2.4)		2.5
(2.3–2.7)		2.6
(2.4–2.8)		2.6
(2.4–2.7)		2.8
(2.6–3.0)		2.8
(2.6–3.0)		2.7
(2.5–2.9)		2.6
(2.4–2.8)		2.6
(2.4–2.8)		2.8
(2.6–2.9)		
Back complaint*	2.8
(2.6–2.9)		2.6
(2.4–2.8)		2.6
(2.4–2.8)		2.6
(2.4–2.8)		2.7
(2.5–2.8)		2.8
(2.6–3.0)		2.6
(2.5–2.8)		2.6
(2.5–2.8)		2.7 
(2.6–2.9)		2.7
(2.6–2.9)	—	
 (continued)
Table 7.4 (continued): Most frequently managed problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Acute bronchitis/
bronchiolitis	3.2
(3.0–3.4)		2.7
(2.5–2.9)		2.7
(2.5–2.9)		2.6
(2.4–2.8)		2.4
(2.2–2.6)		2.4
(2.2–2.6)		2.5
(2.3–2.7)		2.2
(2.1–2.4)		2.4 
(2.2–2.6)		2.6
(2.4–2.8)		
Oesophageal disease	1.6
(1.5–1.8)		1.5
(1.4–1.6)		1.8
(1.7–2.0)		1.9
(1.8–2.1)		2.2
(2.0–2.4)		2.1
(1.9–2.2)		2.4
(2.2–2.5)		2.3
(2.1–2.5)		2.3 
(2.2–2.5)		2.5
(2.3–2.7)		
Asthma	3.2
(3.0–3.4)		2.8
(2.7–3.0)		2.8
(2.7–3.0)		2.7
(2.6–2.9)		2.6
(2.4–2.7)		2.3
(2.2–2.5)		2.3
(2.1–2.4)		2.3
(2.1–2.4)		2.2 
(2.0–2.3)		2.2
(2.1–2.3)		
Prescription—all*	1.8
(1.6–2.0)		1.7
(1.5–1.8)		1.9
(1.6–2.1)		2.0
(1.8–2.2)		2.3
(2.0–2.6)		2.1
(1.8–2.3)		2.0
(1.7–2.2)		2.2
(1.9–2.4)		2.0 
(1.7–2.2)		2.1
(1.9–2.4)	—	
Anxiety*	1.7
(1.6–1.9)		1.7
(1.5–1.8)		1.6
(1.5–1.8)		1.6
(1.4–1.7)		1.7
(1.6–1.9)		1.7
(1.6–1.9)		1.8
(1.6–2.0)		1.7
(1.6–1.9)		1.8 
(1.6–1.9)		1.9
(1.8–2.1)	—	
Contact dermatitis	1.9
(1.8–2.0)		2.1
(1.9–2.2)		1.9
(1.8–2.0)		1.9
(1.8–2.0)		1.8
(1.6–1.9)		1.9
(1.8–2.0)		1.8
(1.7–1.9)		1.9
(1.8–2.0)		1.8 
(1.7–1.9)		1.9
(1.8–2.0)	—	
Urinary tract infection*	1.8
(1.7–1.9)		1.5
(1.4–1.6)		1.6
(1.5–1.7)		1.7
(1.6–1.8)		1.7
(1.6–1.8)		1.7
(1.6–1.8)		1.8
(1.6–1.9)		1.6
(1.5–1.8)		1.6 
(1.5–1.7)		1.7
(1.6–1.8)	—	
Sleep disturbance	1.5
(1.4–1.7)		1.6
(1.4–1.7)		1.6
(1.5–1.8)		1.6
(1.4–1.7)		1.6
(1.5–1.7)		1.7
(1.5–1.9)		1.6
(1.5–1.7)		1.6
(1.4–1.7)		1.6 
(1.5–1.7)		1.6
(1.4–1.7)	—	
Test results*	0.8
(0.7–0.9)		0.8
(0.7–0.9)		1.1
(0.9–1.2)		1.1
(0.9–1.2)		1.2
(1.1–1.4)		1.4
(1.3–1.5)		1.4
(1.3–1.6)		1.6
(1.4–1.7)		1.8 
(1.6–1.9)		1.5
(1.4–1.7)		
Sprain/strain*	1.8
(1.7–2.0)		2.0
(1.9–2.2)		1.8
(1.7–1.9)		1.7
(1.5–1.8)		1.6
(1.5–1.7)		1.7
(1.5–1.9)		1.8
(1.6–1.9)		1.5
(1.4–1.7)		1.6 
(1.4–1.7)		1.4
(1.3–1.5)		
Gastroenteritis*	1.6
(1.4–1.7)		1.6
(1.5–1.8)		1.6
(1.5–1.7)		1.7
(1.6–1.9)		1.7
(1.5–1.8)		1.5
(1.4–1.7)		1.5
(1.4–1.7)		1.7
(1.5–1.8)		1.7 
(1.5–1.8)		1.4
(1.3–1.5)	—	
Sinusitis acute/chronic	1.6
(1.4–1.7)		1.5
(1.4–1.6)		1.4
(1.3–1.5)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.4
(1.3–1.5)		1.2 
(1.0–1.4)		1.4
(1.2–1.5)	—	
Atrial fibrillation/flutter	0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.1 
(1.0–1.2)		1.3
(1.2–1.4)		
 (continued)
Table 7.4 (continued): Most frequently managed problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Problem managed	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Pregnancy*	0.7
(0.6–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.7–1.0)		0.8
(0.7–0.9)		0.8
(0.7–0.8)		0.9
(0.8–1.0)		1.3
(1.1–1.4)		1.3 
(1.2–1.5)		1.3
(1.1–1.4)		
Ischaemic heart disease*	1.6
(1.4–1.7)		1.3
(1.2–1.4)		1.3
(1.1–1.4)		1.2
(1.1–1.3)		1.4
(1.2–1.5)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.2 
(1.0–1.4)		1.3
(1.2–1.4)		
Solar keratosis/sunburn	1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.0
(0.9–1.2)		1.2
(1.0–1.3)		1.3
(1.1–1.5)		1.3
(1.1–1.6)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.4 
(1.1–1.6)		1.2
(1.1–1.4)	—	
Malignant neoplasm, skin	0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.7–1.0)		0.8
(0.7–0.9)		1.1
(0.9–1.3)		1.2
(1.0–1.4)		1.0
(0.9–1.1)		1.1
(1.0–1.3)		1.3 
(1.2–1.4)		1.2
(1.1–1.4)		
Viral disease, other/NOS	1.5
(1.3–1.7)		1.6
(1.4–1.8)		1.5
(1.3–1.7)		1.4
(1.2–1.6)		1.3
(1.2–1.5)		1.2
(1.1–1.4)		1.2
(1.0–1.4)		1.1
(0.9–1.2)		1.3 
(1.2–1.4)		1.2
(1.0–1.4)	—	
Oral contraception*	1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.4
(1.2–1.5)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.3 
(1.2–1.4)		1.1
(1.0–1.3)	—	
Vitamin/nutritional deficiency	0.3
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.5
(0.4–0.6)		0.6
(0.5–0.7)		0.5 
(0.4–0.6)		0.6 
(0.5–0.7)		0.9 
(0.8–1.0)		1.1
(1.0–1.2)		
Acute otitis media/
myringitis	1.6
(1.5–1.7)		1.5
(1.4–1.6)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.2
(1.0–1.3)		1.1
(1.0–1.2)		1.1 
(1.0–1.2)		1.1
(1.0–1.2)		
Abnormal test results*	0.5
(0.5–0.6)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8 
(0.7–0.8)		0.9 
(0.8–1.0)		1.0 
(0.9–1.1)		1.0
(1.0–1.1)		
Fracture*	1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.0
(1.0–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(1.0–1.1)		1.0 
(0.9–1.1)		0.9
(0.9–1.0)	—	
Osteoporosis	0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0 
(0.9–1.1)		0.9
(0.8–1.0)		
Tonsillitis*	1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.1
(1.0–1.3)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(0.9–1.2)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.0 
(0.9–1.1)		0.9
(0.8–1.0)		
Menopausal complaint	1.4
(1.2–1.5)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.5
(1.3–1.6)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.9
(0.8–0.9)		0.9
(0.8–1.0)		0.8 
(0.7–0.9)		0.8
(0.7–0.9)		
(continued)
Table 7.4 (continued): Most frequently managed problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Problem managed	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Allergic rhinitis	1.1
(0.9–1.2)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.9)		0.6
(0.5–0.7)		0.5
(0.5–0.6)		0.6 
(0.5–0.7)		0.6
(0.5–0.6)		
Pre-postnatal check-up*	1.1
(1.0–1.3)		0.7
(0.6–0.9)		0.7
(0.6–0.9)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.4
(0.3–0.5)		0.1 
(0.1–0.2)		0.2
(0.1–0.2)		
Total problems	146.7
(144.9–148.6)		144.5
(142.8–146.3)		143.4
(141.7–145.2)		144.9
(143.0–146.8)		146.3
(144.4–148.2)		145.5
(143.6–147.4)		146.2
(144.2–148.2)		148.5
(146.4–150.6)		151.3 
(149.2–153.4)		154.6
(152.6–156.5)		
(a)	Figures do not total 100, as more than one problem can be managed at each encounter. Also only the most frequent problems are included.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change.
*	Includes multiple ICPC–2 or ICPC–2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NOS—not otherwise specified. This table includes individual problems which were managed at >= 1.0 per 100 encounters in any year, and any other statistically significant differences of interest.
Table 7.5: Most frequently managed new problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
New problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Upper respiratory tract infection	4.5
(4.1–4.9)		4.4
(4.1–4.8)		4.7
(4.4–5.1)		5.1
(4.7–5.5)		4.2
(3.8–4.5)		4.3
(4.0–4.6)		4.8
(4.4–5.2)		4.4
(4.1–4.8)		4.8 
(4.4–5.2)		4.7
(4.4–5.0)	—	
Immunisation/
vaccination—all*	1.3
(1.1–1.5)		1.5
(1.3–1.8)		2.7
(2.4–3.0)		2.9
(2.6–3.2)		2.9
(2.6–3.3)		2.7
(2.4–3.1)		2.7
(2.5–3.0)		2.8
(2.5–3.1)		2.8 
(2.5–3.0)		2.8
(2.5–3.1)		
Acute bronchitis/
bronchiolitis	1.7
(1.6–1.9)		1.6
(1.5–1.7)		1.9
(1.7–2.0)		1.9
(1.7–2.1)		1.8
(1.6–1.9)		1.7
(1.5–1.9)		1.9
(1.7–2.1)		1.6
(1.5–1.7)		1.7 
(1.6–1.9)		1.9
(1.8–2.1)	—	
General check-up*	0.5
(0.4–0.5)		0.4
(0.3–0.5)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.0
(0.8–1.1)		1.2
(1.1–1.3)		1.2 
(1.1–1.3)		1.1
(1.0–1.3)		
Gastroenteritis*	1.0
(0.9–1.2)		1.1
(1.0–1.2)		1.2
(1.1–1.4)		1.3
(1.2–1.5)		1.3
(1.2–1.5)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.3 
(1.2–1.5)		1.1
(1.0–1.2)	—	
(continued)
Table 7.5 (continued): Most frequently managed new problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
New problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Urinary tract infection*	0.8
(0.8–0.9)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.1
(1.0–1.1)		1.1
(1.0–1.1)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.0 
(0.9–1.1)		1.0
(1.0–1.1)		
Sinusitis acute/chronic	0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.7
(0.7–0.8)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9 
(0.8–1.0)		0.9
(0.8–1.0)	—	
Viral disease, other/NOS	1.0
(0.8–1.1)		1.1
(0.9–1.2)		1.0
(0.9–1.2)		1.1
(0.9–1.2)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9 
(0.8–1.1)		0.9
(0.7–1.0)	—	
Sprain/strain*	0.9
(0.8–1.0)		1.1
(0.9–1.2)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.0)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		0.9
(0.8–1.0)		0.9 
(0.8–1.0)		0.9
(0.8–0.9)	—	
Acute otitis media/
myringitis	0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0
(0.9–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.8–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.8 
(0.7–0.8)		0.8
(0.7–0.8)		
Tonsillitis*	0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.8
(0.7–1.0)		0.8
(0.7–0.9)		0.7 
(0.6–0.8)		0.6
(0.6–0.7)		
Abnormal test results	0.1
(0.1–0.2)		0.2
(0.2–0.3)		0.3
(0.3–0.3)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		
Test results*	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		
Total new problems	45.3
(43.6–46.9)		47.4
(45.7–49.0)		55.1
(53.8–56.5)		57.0
(55.6–58.3)		55.9
(54.5–57.3)		55.2
(53.8–56.5)		56.9
(55.5–58.2)		56.5
(55.1–57.9)		57.7
(56.3–59.1)		57.4
(56.0–58.7)		
(a)	Figures do not total 100, as more than one problem can be managed at each encounter. Also only the most frequent new problems are included.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change.
*	Includes multiple ICPC–2 or ICPC–2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NOS—not otherwise specified. This table includes individual new problems which were managed at >= 1.0 per 100 encounters in any year, and any other statistically significant differences of interest.

Table 7.6: Most frequently managed chronic problems, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters(a) (95% CI)		
Chronic problem managed	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Hypertension (non-gestational)**	8.4
(7.9–8.9)		8.6
(8.1–9.1)		9.0
(8.5–9.5)		8.8
(8.3–9.3)		9.2
(8.7–9.7)		9.2
(8.7–9.7)		9.4
(8.9–10.0)		9.5
(9.0–10.0)		9.9
(9.3–10.4)		10.1
(9.6–10.6)		
Depressive disorder**	3.4
(3.2–3.6)		3.6
(3.4–3.9)		3.4
(3.2–3.6)		3.5
(3.3–3.7)		3.6
(3.4–3.8)		3.6
(3.4–3.8)		3.6
(3.4–3.8)		3.7
(3.5–3.9)		4.0
(3.7–4.2)		4.2
(4.0–4.4)		
Diabetes (non-gestational)**	2.7
(2.5–2.9)		2.8
(2.6–3.0)		3.1
(2.9–3.3)		2.9
(2.7–3.1)		3.3
(3.1–3.5)		3.3
(3.1–3.5)		3.5
(3.3–3.8)		3.7
(3.5–3.9)		3.9
(3.6–4.1)		4.1
(3.8–4.3)		
Lipid disorders**	2.6
(2.4–2.8)		2.9
(2.7–3.1)		2.9
(2.7–3.1)		3.0
(2.8–3.2)		3.1
(2.9–3.4)		3.1
(2.9–3.4)		3.4
(3.1–3.7)		3.5
(3.2–3.7)		3.7
(3.4–4.0)		3.9
(3.7–4.2)		
Chronic arthritis**	3.6
(3.3–3.8)		3.9
(3.7–4.1)		3.8
(3.5–4.0)		3.7
(3.5–3.9)		4.0
(3.8–4.2)		4.0
(3.8–4.2)		3.8
(3.5–4.0)		3.7
(3.5–3.9)		3.6
(3.4–3.8)		3.8
(3.6–4.0)	—	
Oesophageal disease	1.6
(1.5–1.8)		1.5
(1.4–1.6)		1.8
(1.7–1.9)		1.9
(1.8–2.0)		2.2
(2.0–2.3)		2.2
(2.0–2.3)		2.4
(2.2–2.5)		2.3
(2.1–2.5)		2.3
(2.2–2.5)		2.5
(2.3–2.7)		
Asthma	3.2
(3.0–3.4)		2.8
(2.7–3.0)		2.8
(2.7–3.0)		2.7
(2.6–2.9)		2.6
(2.4–2.7)		2.6
(2.4–2.7)		2.3
(2.1–2.4)		2.3
(2.1–2.4)		2.2
(2.0–2.3)		2.2
(2.1–2.3)		
Atrial fibrillation/flutter	0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.3
(1.2–1.4)		
Ischaemic heart disease**	1.6
(1.4–1.7)		1.3
(1.2–1.4)		1.3
(1.1–1.4)		1.2
(1.1–1.3)		1.4
(1.2–1.5)		1.4
(1.2–1.5)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.1
(1.0–1.2)		1.3
(1.2–1.4)	§	
Malignant neoplasm of skin	0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.7–1.0)		0.8
(0.7–0.9)		1.1
(0.9–1.3)		1.1
(0.9–1.3)		1.0
(0.9–1.1)		1.1
(1.0–1.3)		1.2
(1.0–1.4)		1.2
(1.1–1.4)		
Back syndrome with radiating pain**	1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)	—	
Osteoporosis	0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		
Chronic obstructive pulmonary disease	0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		0.7
(0.7–0.8)		0.7
(0.6–0.8)		0.8
(0.8–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)	—	
(continued)
Table 7.6 (continued): Most frequently managed chronic problems, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
Chronic problem managed	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Hypothyroidism/
myxoedema	0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.7
(0.6–0.7)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		
Heart failure	0.9
(0.8–1.0)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		0.7
(0.7–0.8)		0.7
(0.7–0.8)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		
Migraine	0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.8–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		
Obesity (BMI > 30)	0.5
(0.4–0.6)		0.6
(0.6–0.7)		0.8
(0.6–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.6
(0.5–0.6)		0.8
(0.6–0.9)		0.7
(0.6–0.8)		0.6
(0.5–0.7)	—	
Dementia (including senile, Alzheimer's)	0.4
(0.3–0.5)		0.3
(0.2–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.5)		0.6
(0.4–0.7)	—	
Shoulder syndrome (excluding arthritis)**	0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.4–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.6
(0.5–0.6)		
Gout	0.6
(0.5–0.7)		0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.5
(0.5–0.6)	—	
Schizophrenia	0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		
Anxiety disorder**	0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.3–0.5)		0.5
(0.4–0.5)	—	
Chronic acne**	0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.3
(0.3–0.4)		
Total chronic problems	47.2
(45.5–49.0)		46.9
(45.3–48.4)		48.0
(46.4–49.5)		47.7
(46.1–49.4)		50.4
(48.6–52.1)		50.4
(48.7–52.1)		50.6
(48.8–52.5)		50.6
(48.8–52.5)		52.4
(50.5–54.3)		55.1
(53.4–56.8)		
(a)	Figures do not total 100, as more than one problem can be managed at each encounter. Also only the most frequent chronic problems are included.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
**	Indicates that this group differs from that used for analysis in other sections of this chapter, as only chronic conditions have been included in this analysis (see Appendix 5).
Note: CI—confidence interval; BMI—body mass index. This table includes individual chronic problems which were managed at > 0.5 per 100 encounters in any year, and any other statistically significant differences of interest.

8	Overview of management
This chapter includes an overview of management in general practice from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates that there was no change.
Since 1999–00, some trends emerged in management of actions at patient encounters (Table 8.1). Most noticeably, over these 10 years:
•	the rate of prescribed medications significantly decreased, from 93.8 per 100 encounters in 1999–00 to 86.4 per 100 encounters in 2008–09
•	the rate of GP supplied medications significantly increased, from 6.9 per 100 encounters in 1999–00 to 11.0 per 100 encounters in 2008–09
•	the rate of clinical treatments increased significantly from 33.5 per 100 encounters in 1999–00 to 39.2 in 2004–05, decreased to 29.2 in 2005–06 with the introduction of the practice nurse provider numbers, but then increased again to 34.0 per 100 in 2008–09 
•	there was an increase in the rate of procedural treatments undertaken in general practice, from 12.5 per 100 encounters in 1999–00 to 16.7 per 100 encounters in 2008–09 
•	the rate of referrals to other health providers significantly increased, from 11.1 to 13.7 per 100 encounters between 1999–00 and 2008–09 
•	since 2000–01, the rate of pathology tests ordered significantly increased by 53%, from 29.7 orders per 100 encounters to 45.6 per 100 encounters in 2008–09 
•	there was a significant increase in the rate of imaging tests ordered, from 7.7 per 100 encounters in 2000–01 to 9.8 per 100 in 2008–09, and in the rate of other investigations, from 0.6 per 100 in 2000–01 to 1.0 per 100 encounters in 2008–09.
Similar changes can be observed for each of these areas, in the percentage of encounters where at least one management type was provided (Table 8.2). This reflects a change in the likelihood of each action eventuating at an encounter.
•	There was a significant reduction in the likelihood of patients being provided with at least one medication (from 68.5% in 1999–00 to 65.1% in 2008–09), particularly prescribed medications, decreasing from 60.1% to 54.6% over this time. The latter reflects the reduction in the rate of prescribed medications reported above and shown in Table 8.1.
•	There was an increase in the likelihood of patients receiving at least one GP‑supplied medication, from 5.1% in 1999–00 to 8.5% of encounters in 2008–09.
•	The likelihood of patients receiving at least one other (non-pharmacological) treatment increased from 36.2% of encounters in 1999–00 to 39.6% in 2008–09. 
•	The likelihood of patients receiving at least one procedural treatment at the encounter continually and significantly increased from 11.4% in 1999–00 to 15.0% in 2008–09.
•	The likelihood of patients being referred increased significantly (from 10.4% of encounters in 1999–00 to 12.8% in 2008–09), particularly to specialists (from 6.9% in 
1999–00 to 8.6% in 2008–09), to allied health practitioners (from 3.0% in 1999–00 to 3.7% in 2008–09), and to emergency departments (from 0.1% in 1999–00 to 0.2% in 2008–09). 
•	Contributing to the increase in the rates of pathology and imaging tests ordered per 100 encounters shown in Table 8.1, there was an increase in the likelihood of the GP ordering at least one investigation at the encounter, from 18.9% in 1999–00 to 24.6% in 2008–09. In 1999–00 the likelihood of at least one pathology test being ordered was 13.8%, and that of at least one imaging test being ordered was 6.7%. By 2008–09 these proportions had significantly increased to 18.2% and 8.5% of encounters, respectively (Table 8.2).

Table 8.1: Summary of management, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Management type	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Medications	110.1
(107.8–112.4)		108.2
(105.7–110.6)		104.5
(102.2–106.9)		103.8
(101.4–106.2)		104.4
(102.1–106.7)		101.5
(99.3–103.8)		104.4
(101.8–107.0)		101.5
(99.2–103.9)		102.7
(100.3–105.0)		106.3
(104.0–108.5)	—	
	Prescribed	93.8
(91.5–96.2)		92.3
(89.9–94.7)		88.0
(85.6–90.4)		84.3
(81.8–86.9)		86.0
(83.6–88.5)		83.4
(81.2–85.5)		85.8
(83.3–88.4)		83.3
(81.0–85.5)		82.4
(80.3–84.6)		86.4
(84.1–88.6)		
	GP-supplied	6.9
(5.8–7.9)		6.9
(5.7–8.1)		7.6
(6.3–9.0)		9.3
(7.6–11.0)		8.6
(7.4–9.8)		8.1
(7.3–8.9)		8.8
(8.2–9.5)		8.9
(8.2–9.6)		10.1
(9.5–10.7)		11.0
(10.2–11.8)		
	Advised OTC	9.4
(8.6–10.2)		9.0
(8.1–9.8)		8.9
(8.1–9.6)		10.2
(9.2–11.1)		9.8
(9.0–10.6)		10.1
(9.1–11.0)		9.8
(9.0–10.5)		9.4
(8.7–10.1)		10.0
(9.3–10.9)		8.9
(8.3–9.4)	—	
Other treatments	46.0
(44.1–47.8)		49.4
(47.1–51.7)		51.9
(49.6–54.2)		51.8
(49.3–54.3)		51.4
(48.9–53.8)		54.7
(52.1–57.3)		43.6
(41.5–45.8)		44.7
(42.3–47.0)		51.2
(48.9–53.6)		50.7
(48.5–52.9)		
	Clinical	33.5
(31.8–35.2)		37.2
(35.1–39.3)		38.1
(36.1–40.1)		37.2
(35.0–39.4)		36.6
(34.5–38.8)		39.2
(37.1–41.4)		29.2
(27.3–31.1)		29.5
(27.6–31.4)		34.5
(32.5–36.5)		34.0
(32.1–35.9)	—	
	Procedural	12.5
(11.9–13.0)		12.2
(11.6–12.8)		13.8
(13.1–14.5)		14.6
(13.9–15.3)		14.7
(14.0–15.5)		15.5
(14.6–16.4)		14.4
(13.7–15.1)		15.2
(14.4–16.0)		16.7
(15.9–17.5)		16.7
(16.0–17.5)		
Referrals	11.1
(10.7–11.6)		10.4
(10.0–10.8)		10.5
(10.1–10.9)		11.1
(10.7–11.6)		11.6
(11.1–12.1)		11.5
(11.1–12.0)		12.0
(11.5–12.5)		12.2
(11.7–12.7)		12.5
(12.0–13.0)		13.7
(13.2–14.2)		
	Specialist	7.2
(6.9–7.5)		7.4
(7.0–7.7)		7.3
(7.0–7.6)		7.7
(7.3–8.0)		7.9
(7.5–8.2)		7.7
(7.4–8.0)		8.2
(7.8–8.5)		8.0
(7.7–8.4)		8.0
(7.6–8.3)		9.0
(8.7–9.3)		
	Allied health service	3.1
(2.9–3.3)		2.3
(2.2–2.5)		2.3
(2.1–2.4)		2.5
(2.3–2.7)		2.6
(2.4–2.8)		2.7
(2.5–2.9)		2.9
(2.7–3.1)		3.1
(2.9–3.3)		3.5
(3.2–3.7)		3.9
(3.6–4.1)		
	Hospital	0.7
(0.6–0.8)		0.5
(0.4–0.6)		0.4
(0.4–0.5)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.3
(0.4–0.4)		
	Emergency department	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
	Other referrals/other
	medical services(b)	0.0Ŧ
(0.0–0.0)		0.2
(0.1–0.2)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.3
(0.2–0.3)		
(continued)
Table 8.1 (continued): Summary of management, BEACH, 1999–00 to 2008–09 (rate per 100 encounters)
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Management type	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Pathology(c)	NAv		29.7
(28.4–30.9)		31.0
(29.7–32.4)		32.9
(31.5–34.4)		35.2
(33.7–36.7)		36.7
(35.2–38.2)		38.6
(36.9–40.3)		42.4
(40.7–44.2)		43.2
(41.3–45.0)		45.6
(43.8–47.4)		
Imaging(c)	NAv		7.7
(7.3–8.0)		7.9
(7.6–8.2)		8.6
(8.2–9.0)		8.2
(7.8–8.6)		8.3
(8.0–8.6)		8.8
(8.4–9.2)		9.0
(8.6–9.3)		9.5
(9.2–9.9)		9.8
(9.4–10.2)		
Other investigations(c)	NAv		0.6
(0.5–0.7)		0.9
(0.8–1.0)		1.0
(0.8–1.2)		1.0
(0.9–1.2)		1.1
(0.9–1.3)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, and — indicates there was no change. 
(b)	Other referrals and other medical services have been grouped for comparability. In 1999–00 ‘other medical services’ and ‘other referrals’ were grouped and reported together.
(c)	In the 2000–01 BEACH year, the data collection and data coding system for pathology, imaging and other investigations changed. Data from 1999–00 are not comparable to those from 2000–01 onward.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval; OTC—over-the-counter; NAv—not available.

Table 8.2: Encounters for which at least one management was recorded, BEACH, 1999–00 to 2008–09
	Per cent of encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
At least one…	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Management type	92.2
(91.7–92.7)		91.6
(91.0–92.2)		91.8
(91.3–92.3)		91.3
(90.6–92.0)		91.5
(90.9–92.0)		91.9
(91.3–92.5)		91.2
(90.6–91.8)		90.4
(89.8–91.0)		91.9
(91.3–92.4)		92.2
(91.7–92.7)	—	
	Medication or other 	treatment	83.8
(83.1–84.5)		83.5
(82.7–84.2)		83.2
(82.5–84.0)		82.5
(81.6–83.3)		82.3
(81.5–83.1)		82.4
(81.6–83.2)		81.4
(80.6–82.1)		79.9
(79.1–80.8)		82.2
(81.4–82.9)		82.4
(81.7–83.1)		
		Medication 	68.5
(67.6–69.3)		68.0
(67.1–68.9)		66.6
(65.7–67.5)		65.8
(64.9–66.8)		65.6
(64.7–66.5)		64.3
(63.4–65.2)		65.2
(64.3–66.2)		63.9
(63.0–64.9)		64.4
(63.4–65.3)		65.1
(64.3–65.9)		
			Prescription	60.1
(59.1–61.1)		59.8
(58.7–60.8)		57.4
(56.4–58.5)		54.9
(53.7–56.1)		55.7
(54.6–56.9)		54.8
(53.8–55.8)		55.6
(54.5–56.6)		54.1
(53.2–55.1)		53.6
(52.6–54.5)		54.6
(53.7–55.5)		
			GP-supplied	5.1
(4.5–5.6)		5.1
(4.5–5.7)		5.8
(5.1–6.5)		6.8
(6.0–7.7)		6.5
(5.8–7.3)		6.2
(5.7–6.7)		6.4
(6.0–6.9)		6.8
(6.3–7.3)		7.9
(7.4–8.4)		8.5
(7.9–9.1)		
			Advised OTC	8.3
(7.7–8.9)		8.0
(7.3–8.6)		8.0
(7.4–8.6)		9.0
(8.3–9.8)		8.7
(8.0–9.3)		8.7
(8.1–9.4)		8.6
(8.0–9.2)		8.4
(7.8–8.9)		8.9
(8.3–9.6)		8.0
(7.5–8.5)	—	
		Other treatment	36.2
(35.0–37.4)		37.6
(36.2–39.1)		39.5
(38.1–41.0)		39.4
(37.8–40.9)		39.3
(37.8–40.8)		41.2
(39.7–42.8)		35.1
(33.7–36.6)		35.3
(33.8–36.9)		39.9
(38.3–41.4)		39.6
(38.3–41.0)		
			Clinical treatment	27.0
(25.8–28.2)		29.0
(27.6–30.3)		29.7
(28.4–31.1)		29.2
(27.7–30.6)		28.9
(27.4–30.3)		30.5
(29.1–32.0)		24.0
(22.7–25.4)		23.8
(22.5–25.2)		27.5
(26.1–28.9)		27.3
(26.3–28.6)	—	
			Procedural 
			treatment	11.4
(11.0–11.9)		11.1
(10.6–11.7)		12.7
(12.0–13.3)		13.2
(12.6–13.8)		13.3
(12.7–13.9)		13.8
(13.1–14.6)		13.2
(12.6–13.8)		13.8
(13.2–14.5)		15.0
(14.3–15.7)		15.0
(14.4–15.6)		
	Referral	10.4
(10.0–10.8)		9.9
(9.6–10.3)		10.0
(9.6–10.4)		10.6
(10.2–11.0)		11.0
(10.5–11.5)		10.9
(10.5–11.3)		11.3
(10.9–11.8)		11.5
(11.0–11.9)		11.8
(11.3–12.2)		12.8
(12.3–13.2)		
		Specialist	6.9
(6.6–7.2)		7.1
(6.8–7.4)		7.0
(6.7–7.3)		7.4
(7.0–7.7)		7.6
(7.3–8.0)		7.5
(7.2–7.8)		7.9
(7.5–8.2)		7.7
(7.4–8.0)		7.7
(7.4–8.0)		8.6
(8.3–8.9)		
		Allied health	3.0
(2.8–3.2)		2.3
(2.1–2.4)		2.2
(2.1–2.4)		2.4
(2.2–2.6)		2.5
(2.3–2.7)		2.6
(2.5–2.8)		2.8
(2.6–3.0)		3.0
(2.8–3.1)		3.3
(3.1–3.5)		3.7
(3.5–3.9)		
		Hospital	0.7
(0.6–0.8)		0.5
(0.4–0.6)		0.4
(0.4–0.5)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		
(continued)
Table 8.2 (continued): Encounters for which at least one management was recorded, BEACH, 1999–00 to 2008–09 
	Per cent of encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
At least one…	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
		Emergency 
		department	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
		Other referral/other 		medical service(c)	0.0Ŧ
(0.0–0.0)		0.2
(0.1–0.2)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.3
(0.2–0.3)		
	Investigation	18.9
(18.3–19.5)		19.3
(18.7–19.9)		19.7
(19.1–20.3)		20.8
(20.2–21.5)		21.3
(20.7–22.0)		21.8
(21.1–22.4)		22.6
(21.9–23.3)		23.5
(22.8–24.2)		23.8
(23.1–24.5)		24.6
(23.9–25.9)		
		Pathology order(d)	13.8
(13.3–14.3)		13.8
(13.3–14.3)		14.0
(13.5–14.5)		14.7
(14.2–15.3)		15.5
(14.9–16.1)		15.7
(15.2–16.3)		16.4
(15.8–16.9)		17.4
(16.8–18.0)		17.4
(16.7–18.0)		18.2
(17.6–18.8)		
		Imaging order(d)	6.7
(6.4–7.0)		7.2
(6.9–7.5)		6.9
(6.6–7.2)		7.5
(7.1–7.8)		7.2
(6.9–7.5)		7.3
(7.0–7.6)		7.8
(7.4–8.1)		7.9
(7.6–8.2)		8.3
(8.0–8.6)		8.5
(8.1–8.8)		
		Other investigation(d)	NAv		0.6
(0.5–0.7)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		
(a)	Figures will not total 100, as multiple events may occur in one encounter or in the management of one problem at encounter.
(b)	The direction and type of change is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change. 
(c)	Other referrals and other medical services have been grouped for comparability. In 1999–00 ‘other medical services’ and ‘other referrals’ were grouped and reported together.
(d)	While the coding system for pathology and imaging changed in the 2000–01 BEACH year, the presence or absence of a test at the encounter was still recorded. These figures are therefore comparable with data 
from subsequent years.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval; OTC—over-the-counter; NAv—not available.

9	Medications
This chapter includes data about the medications prescribed, advised or supplied by general practitioners from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in the prescribed, supplied, or advised medication rate between 1999–00 and 2008–09. Some examples of extrapolated changes are given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8. 
GPs could record up to four medications for each of four problems—a maximum of 16 medications per encounter. Each medication could be recorded as prescribed (the default), supplied by the GP or recommended for over-the-counter (OTC) purchase.
There was no significant change in total medication rates per 100 encounters between 
1999–00 and 2008–09 (Table 9.1a). However, Table 9.1b shows that between the two data periods, total medication rates decreased significantly per 100 problems managed. 
9.1	Prescribed medications 
The rate of prescribed medications fell from 93.8 per 100 encounters in 1999–00 to 86.4 per 100 in 2008–09. This significant decrease in prescription rate means that 7.4 fewer prescriptions were being written on average for every 100 GP–patient encounters in 2008–09 than 10 years earlier (Table 9.1a). The extrapolated national effect of this change is 1.8 million fewer prescriptions given by GPs in 2008–09 than in 1999–00.
Table 9.2 shows prescribing rates of common drug groups at ATC drug group Level 2 over the 10-year period. There were approximately 2.4 million fewer drugs for obstructive airways disease prescribed in 2008–09 than in 1999–00 and 930,000 fewer sex hormones such as systemic contraceptives and hormone replacement therapy. Conversely, extrapolations showed 2.4 million more prescriptions for lipid reducing agents and over 1 million more prescriptions for acid-related digestive disorder drugs in 2008–09 than in 1999–00. 
Table 9.3 shows prescribed medication rates at the individual generic level. Some medications that were prescribed more often in 2008–09 than in 1999–00 were oxycodone, which showed extrapolated estimates of 1.1 million more times prescribed, tramadol (800,000 more) and warfarin sodium (640,000 more).
Number of repeats ordered
The pattern of the number of repeat prescriptions recorded by GPs changed between 1999–00 and 2008–09, although no change occurred in the percentage of prescriptions with three, four or six or more repeats (Table 9.4). There was a significant decrease in the proportion of prescribed medications for which one or two repeats were ordered and a significant increase in the proportion of prescriptions for which five repeats were recorded. In 1999–00, 26.8% of prescriptions were given five repeats whereas, in 2008–09, 34.8% of prescribed medications had five repeats, an increase of 30.0% from the 1999–00 results.

Table 9.1a: Rates of medications prescribed, advised for over-the-counter purchase, supplied, per 100 encounters, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters (95% CI)(a)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Medications	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Prescribed	93.8
(91.5–96.2)		92.3
(89.9–94.7)		88.0
(85.6–90.4)		84.3
(81.8–86.9)		86.0
(83.6–88.5)		83.4
(81.2–85.5)		85.8
(83.3–88.4)		83.3
(81.0–85.5)		82.4
(80.3–84.6)		86.4
(84.1–88.6)		
GP-supplied 	6.9
(6.0–7.7)		6.9
(5.9–7.9)		7.6
(6.6–8.7)		9.3
(8.0–10.6)		8.6
(7.6–9.6)		8.1
(7.3–8.8)		8.8
(8.2–9.5)		8.9
(8.2–9.6)		10.1
(9.5–10.7)		11.0
(10.2–11.8)		
Advised OTC	9.4
(8.7–10.1)		9.0
(8.2–9.7)		8.9
(8.2–9.6)		10.2
(9.3–11.1)		9.8
(9.0–10.5)		10.1
(9.2–10.9)		9.8
(9.0–10.5)		9.4
(8.7–10.1)		10.1
(9.3–10.9)		8.9
(8.3–9.4)	—	
Total medications	110.1
(107.8–112.4)		108.2
(105.7–110.6)		104.5
(102.2–106.9)		103.8
(101.4–106.2)		104.4
(102.1–106.7)		101.5
(99.3–103.8)		104.4
(101.8–107.0)		101.5
(99.2–103.9)		102.7
(100.3–105.0)		106.3
(104.0–108.5)	—	
(a)	Missing data removed.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, and — indicates there was no change.
Note: CI—confidence interval.
Table 9.1b: Rates of medications prescribed, advised for over-the-counter purchase, supplied per 100 problems, BEACH, 1999–00 to 2008–09
	Rate per 100 problems (95% CI)(a)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Medications	(n = 153,857)		(n = 143,528)		(n = 139,092)		(n = 146,336)		(n = 148,521)		(n = 137,330)		(n = 149,088)		(n = 136,333)		(n = 145,078)		(n = 149,462)		
Prescribed	63.9
(62.5–65.4)		63.9
(62.4–65.4)		61.4
(59.8–62.9)		58.2
(56.6–59.8)		58.8
(57.3–60.3)		57.3
(55.9–58.7)		58.7
(57.2–60.3)		56.1
(54.7–57.4)		54.5
(53.2–55.8)		55.9
(54.5–57.2)		
GP-supplied 	4.7
(4.0–5.4)		4.8
(3.9–5.6)		5.3
(4.4–6.3)		6.4
(5.3–7.5)		5.9
(5.1–6.7)		5.5
(5.0–6.1)		6.0
(5.6–6.5)		6.0
(5.5–6.5)		6.7
(6.3–7.1)		7.1
(6.6–7.6)		
Advised OTC	6.4
(5.8–7.0)		6.2
(5.6–6.8)		6.2
(5.7–6.7)		7.0
(6.3–7.7)		6.7
(6.1–7.2)		6.9
(6.3–7.5)		6.7
(6.2–7.2)		6.3
(5.8–6.8)		6.7
6.2–7.2)		5.7
(5.3–6.1)	—	
Total medications	75.0
(73.6–76.4)		74.8
(73.3–76.3)		72.9
(71.4–74.3)		71.6
(70.1–73.1)		71.3
(70.0–72.7)		69.8
(68.9–71.2)		71.4
(69.9–72.9)		68.4
(67.0–69.7)		67.9
(66.5–69.2)		68.7
(67.5–70.0)		
(a)	Missing data removed.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, and — indicates there was no change.
Note: CI—confidence interval.

Table 9.2: Distribution of prescribed medications (by ATC Level 2), BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ATC Level 2	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Antibacterials for systemic use	15.7
(15.2–16.3)		15.4
(14.8–16.0)		13.9
(13.4–14.4)		13.3
(12.8–13.9)		13.6
(13.1–14.2)		14.0
(13.5–14.6)		14.6
(14.0–15.2)		14.0
(13.4–14.5)		13.8
(13.2–14.3)		14.6
(14.1–15.1)		
Analgesics	9.6
(9.1–10.2)		8.9
(8.4–9.4)		8.5
(8.1–9.0)		8.5
(8.0–9.1)		8.5
(8.0–9.0)		8.3
(7.8–8.7)		9.0
(8.4–9.5)		8.6
(8.1–9.0)		8.5
(8.0–8.9)		8.5
(8.1–8.9)		
Agents acting on the renin-angiotensin system	4.1
(3.8–4.3)		4.6
(4.3–4.8)		5.0
(4.7–5.3)		4.9
(4.6–5.2)		5.5
(5.1–5.8)		5.5
(5.2–5.8)		6.1
(5.7–6.5)		6.5
(6.1–6.9)		6.6
(6.2–7.0)		7.1
(6.7–7.4)		
Psycholeptics	5.4
(5.0–5.7)		5.2
(4.9–5.5)		5.1
(4.8–5.5)		4.7
(4.4–5.0)		5.0
(4.7–5.4)		4.9
(4.6–5.2)		5.0
(4.6–5.3)		4.8
(4.5–5.2)		4.7
(4.4–5.0)		5.0
(4.7–5.3)	—	
Serum lipid reducing agents	2.2
(2.0–2.4)		2.4
(2.2–2.5)		2.4
(2.3–2.6)		2.4
(2.2–2.6)		2.8
(2.6–3.0)		3.0
(2.8–3.2)		3.3
(3.0–3.6)		3.4
(3.2–3.7)		3.7
(3.5–4.0)		4.1
(3.8–4.3)		
Drugs for obstructive airway diseases	6.6
(6.1–7.0)		5.6
(5.2–5.9)		5.1
(4.8–5.5)		4.6
(4.3–4.9)		4.1
(3.9–4.4)		3.8
(3.6–4.1)		3.9
(3.6–4.1)		3.8
(3.5–4.0)		3.6
(3.3–3.8)		3.8
(3.6–4.0)		
Psychoanaleptics	3.0
(2.8–3.1)		3.1
(2.9–3.3)		3.0
(2.8–3.2)		3.0
(2.8–3.2)		3.3
(3.1–3.5)		3.1
(3.0–3.3)		3.3
(3.1–3.5)		3.5
(3.3–3.7)		3.5
(3.3–3.6)		3.7
(3.5–3.9)		
Anti-inflammatory and antirheumatic products	4.6
(4.4–4.9)		5.8
(5.5–6.0)		5.3
(5.1–5.6)		4.8
(4.6–5.1)		4.8
(4.5–5.0)		4.5
(4.2–4.7)		3.9
(3.7–4.2)		3.6
(3.3–3.7)		3.5
(3.2–3.7)		3.4
(3.2–3.5)		
Drugs for acid-related disorders	2.6
(2.4–2.8)		2.4
(2.2–2.5)		2.5
(2.4–2.7)		2.5
(2.4–2.7)		2.9
(2.7–3.0)		2.7
(2.5–2.9)		3.1
(2.9–3.2)		3.0
(2.8–3.2)		3.1
(2.9–3.2)		3.3
(3.1–3.4)		
Drugs used in diabetes	1.8
(1.6–2.0)		2.0
(1.8–2.2)		2.2
(2.0–2.4)		1.9
(1.7–2.1)		2.2
(2.0–2.4)		2.1
(1.9–2.2)		2.5
(2.2–2.7)		2.4
(2.2–2.6)		2.5
(2.3–2.7)		2.9
(2.6–3.2)		
Sex hormones and modulators of the genital system	3.9
(3.7–4.1)		3.9
(3.7–4.1)		3.8
(3.6–4.0)		3.7
(3.5–3.9)		3.5
(3.3–3.7)		3.1
(2.9–3.3)		3.0
(2.8–3.2)		3.0
(2.7–3.3)		2.9
(2.7–3.0)		2.7
(2.5–2.9)		
Corticosteroids, dermatological preparations	2.8
(2.7–3.0)		3.1
(2.8–3.3)		2.8
(2.7–3.0)		2.6
(2.5–2.8)		2.6
(2.4–2.7)		2.8
(2.6–2.9)		2.5
(2.4–2.7)		2.6
(2.4–2.8)		2.6
(2.4–2.7)		2.6
(2.5–2.8)	—	
(continued)
Table 9.2 (continued): Distribution of prescribed medications (by ATC Level 2), BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
ATC Level 2	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Calcium channel blockers	2.5
(2.3–2.7)		2.3
(2.1–2.5)		2.2
(2.0–2.4)		2.0
(1.8–2.1)		2.2
(2.0–2.3)		2.0
(1.8–2.1)		2.2
(2.0–2.4)		2.1
(2.0–2.3)		2.1
(1.9–2.3)		2.3
(2.1–2.4)	—	

Beta-blocking agents	1.9
(1.7–2.1)		1.7
(1.5–1.8)		1.8
(1.6–1.9)		1.6
(1.5–1.7)		1.8
(1.7–2.0)		1.7
(1.5–1.8)		1.9
(1.8–2.1)		1.8
(1.7–2.0)		1.7
(1.6–1.9)		2.0
(1.8–2.1)	—	
Anti-thrombotic agents	0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.1
(1.0–1.3)		1.1
(1.0–1.2)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.3
(1.2–1.4)		1.5
(1.3–1.6)		1.5
(1.4–1.7)		1.8
(1.6–1.9)		
Ophthalmologicals	1.7
(1.6–1.8)		1.6
(1.5–1.7)		1.5
(1.4–1.6)		1.6
(1.5–1.7)		1.7
(1.5–1.8)		1.7
(1.6–1.8)		1.9
(1.7–2.0)		1.7
(1.6–1.8)		1.7
(1.5–1.8)		1.7
(1.6–1.8)	—	
Vaccines	4.2
(3.8–4.6)		3.8
(3.5–4.2)		3.9
(3.5–4.2)		4.2
(3.8–4.5)		3.3
(3.0–3.6)		2.9
(2.6–3.3)		2.5
(2.2–2.8)		1.7
(1.5–1.9)		1.6
(1.4–1.8)		1.6
(1.4–1.8)		
Corticosteroids for systemic use	1.4
(1.3–1.5)		1.2
(1.1–1.3)		1.3
(1.2–1.5)		1.1
(1.0–1.2)		1.3
(1.1–1.4)		1.2
(1.1–1.4)		1.3
(1.2–1.4)		1.3
(1.2–1.5)		1.2
(1.1–1.3)		1.3
(1.2–1.4)	—	
Diuretics	2.1
(1.9–2.3)		1.9
(1.7–2.0)		1.7
(1.5–1.9)		1.6
(1.4–1.7)		1.5
(1.4–1.7)		1.4
(1.2–1.5)		1.4
(1.3–1.5)		1.4
(1.3–1.5)		1.3
(1.1–1.4)		1.3
(1.2–1.4)		
Cardiac therapy	1.7
(1.5–1.8)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.0
(0.8–1.1)		1.0
(0.9–1.2)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.9
(0.8–1.0)		
Thyroid therapy	0.5
(0.4–0.5)		0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		
Nasal preparations	1.6
(1.5–1.7)		1.5
(1.3–1.6)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		
Otologicals	0.9
(0.8–1.0)		1.0
(0.9–1.0)		0.9
(0.8–1.0)		0.8
(0.8–0.9)		0.8
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.7–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.8
(0.7–0.9)	—	
Total prescribed medications	93.8
(91.5–96.2)		92.3
(89.9–94.7)		88.0
(85.6–90.4)		84.3
(81.8–86.9)		86.0
(83.6–88.5)		83.4
(81.2–85.5)		85.8
(83.3–88.4)		83.3
(81.0–85.5)		82.4
(80.3–84.6)		86.4
(84.1–88.6)		
(a)	Column will not add to 100, as multiple prescriptions could be written at each encounter. Also, only the most frequent medications are included.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change and — indicates there was no change. 
Note: CI—confidence interval.
Table 9.3: Most frequently prescribed medications (by CAPS generic), BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Generic drug	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Amoxycillin 	3.1
(2.9–3.4)		3.2
(3.0–3.5)		2.9
(2.7–3.1)		3.1
(2.8–3.4)		3.3
(3.0–3.5)		3.5
(3.2–3.8)		3.6
(3.3–3.8)		3.3
(3.0–3.6)		3.5
(3.2–3.7)		3.5
(3.3–3.8)	—	
Cephalexin 	2.1
(1.9–2.2)		2.2
(2.0–2.4)		2.0
(1.9–2.2)		1.9
(1.8–2.0)		2.0
(1.9–2.2)		2.4
(2.2–2.6)		2.5
(2.3–2.7)		2.3
(2.2–2.5)		2.4
(2.3–2.6)		2.5
(2.3–2.6)		
Paracetamol 	4.1
(3.7–4.4)		3.9
(3.6–4.3)		3.1
(2.8–3.4)		3.1
(2.8–3.5)		2.9
(2.5–3.2)		2.7
(2.4–2.9)		3.0
(2.7–3.3)		2.6
(2.3–2.9)		2.5
(2.2–2.7)		2.3
(2.1–2.5)		
Paracetamol–codeine 	2.4
(2.2–2.6)		2.2
(2.0–2.4)		2.2
(2.1–2.4)		2.0
(1.8–2.2)		2.1
(1.9–2.3)		2.0
(1.8–2.2)		2.0
(1.8–2.2)		2.0
(1.8–2.1)		1.9
(1.7–2.1)		1.9
(1.8–2.0)		
Atorvastatin	0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(1.0–1.2)		1.2
(1.1–1.3)		1.4
(1.3–1.5)		1.6
(1.4–1.8)		1.7
1.5–1.8)		1.7
(1.6–1.9)		1.9
(1.7–2.0)		
Amoxycillin/potassium clavulanate 	1.6
(1.5–1.8)		1.7
(1.5–1.9)		1.6
(1.4–1.7)		1.6
(1.4–1.7)		1.7
(1.5–1.8)		1.7
(1.5–1.8)		1.7
(1.5–1.8)		1.7
(1.5–1.9)		1.7
(1.6–1.9)		1.8
(1.7–2.0)	—	
Roxithromycin 	1.8
(1.7–2.0)		1.6
(1.4–1.8)		1.4
(1.3–1.5)		1.3
(1.2–1.5)		1.1
(1.0–1.2)		1.1
(1.0–1.3)		1.5
(1.3–1.7)		1.4
(1.2–1.5)		1.2
(1.1–1.4)		1.4
(1.3–1.5)		
Metformin	0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.8–0.9)		1.0
(0.9–1.1)		1.0
(0.9–1.0)		1.2
(1.0–1.3)		1.1
(1.0–1.3)		1.2
(1.1–1.3)		1.4
(1.3–1.5)		
Salbutamol 	2.4
(2.2–2.6)		2.1
(1.9–2.2)		2.0
(1.8–2.1)		1.7
(1.6–1.9)		1.5
(1.4–1.6)		1.4
(1.3–1.5)		1.5
(1.4–1.6)		1.4
(1.3–1.5)		1.3
(1.2–1.5)		1.4
(1.3–1.5)		
Perindopril	0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.7
(0.7–0.8)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.4
(1.2–1.5)		
Esomeprazole	N/A		N/A		N/A		0.3
(0.2–0.3)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.2
(1.1–1.3)		1.3
(1.3–1.4)		
Warfarin sodium	0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.1)		0.9
(0.8–1.0)		1.0
(0.9–1.2)		1.1
(0.9–1.2)		1.2
(1.1–1.4)		
Oxycodone	0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.5
(0.5–0.6)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.2)		1.2
(1.1–1.3)		
(continued)
Table 9.3 (continued): Most frequently prescribed medications (by CAPS generic), BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Generic drug	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Temazepam 	1.4
(1.3–1.6)		1.4
(1.3–1.6)		1.3
(1.2–1.5)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		
Diazepam 	1.1
(1.0–1.2)		1.0
(0.9–1.2)		1.0
(0.9–1.2)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.1
(1.0–1.2)		1.2
(1.0–1.3)	—	
Irbesartan	0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.1
(1.0–1.2)		1.0
0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		
Chloramphenicol eye	0.9
(0.8–1.0)		0.9
(0.8–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.9–1.0)		1.1
(1.0–1.1)		1.0
(0.9–1.1)		0.9
(0.9–1.0)		1.0
(0.9–1.1)	—	
Atenolol 	1.0
(0.9–1.2)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		1.0
(0.9–1.1)	—	
Meloxicam	N/A		N/A		0.0Ŧ
(0.0–0.1)		0.3
(0.3–0.4)		0.4
(0.3–0.5)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.7
(0.7–0.8)		0.9
(0.8–1.1)		0.9
(0.8–1.0)		
Simvastatin 	0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		1.0
(1.0–1.1)		1.1
(1.0–1.2)		1.2
(1.0–1.3)		1.1
(1.0–1.2)		0.9
(0.8–1.0)		0.9
(0.8–1.0)	—	
Fluticasone/salmeterol	N/A		0.2
(0.2–0.3)		0.6
(0.5–0.7)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		
Levonorgestrel/
ethinyloestradiol 	1.3
(1.2–1.4)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.8
(0.8–0.9)		
Cefaclor monohydrate 	1.6
(1.3–2.0)		1.6
(1.4–1.8)		1.1
(1.0–1.2)		1.0
(0.9–1.2)		0.8
(0.7–0.9)		0.8
(0.7–1.0)		0.8
(0.6–1.0)		0.8
(0.6–0.9)		0.6
(0.5–0.7)		0.8
(0.7–0.9)		
Tramadol	0.1
(0.0–1.1)		0.2
(0.1–0.2)		0.7
(0.6–0.8)		1.0
(0.9–1.1)		0.9
(0.9–1.1)		1.0
(0.9–1.1)		1.0
(0.9–1.0)		0.9
(0.8–1.1)		0.9
(0.8–0.9)		0.8
(0.7–0.9)		
Doxycycline hydrochloride	0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		0.8
(0.7–0.9)		0.7
(0.7–0.9)		0.7
(0.7–0.8)		0.8
(0.7–0.9)	—	
Ramipril	0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.6
(0.5–0.7)		0.7
(0.6–0.7)		0.7
(0.7–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		
(continued)
Table 9.3 (continued): Most frequently prescribed medications (by CAPS generic), BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Generic drug	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Irbesartan/
hydrochlorothiazide	N/A		0.3
(0.2–0.4)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.7
(0.7–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.8)		
Thyroxine	0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.7–0.8)		
Betamethasone topical	0.9
(0.8–0.9)		1.0
(0.9–1.2)		0.9
(0.8–1.0)		0.7
(0.6–0.8)		0.8
(0.8–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.7–0.8)		
Diclofenac sodium systemic 	1.3
(1.1–1.4)		1.2
(1.0–1.3)		0.9
(0.8–1.0)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		1.0
(0.8–1.1)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		
Amlodipine	0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)	—	
Mometasone	0.6
(0.6–0.7)		0.7
(0.6–0.7)		0.8
(0.7–0.9)		0.6
(0.6–0.7)		0.5
(0.5–0.6)		0.8
(0.7–0.9)		0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.8
(0.7–0.8)		0.7
(0.6–0.7)	—	
Aspirin	0.8
(0.8–1.0)		0.8
(0.7–0.9)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.7–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		
Venlafaxine	0.2
(0.0–0.4)		0.3
(0.1–0.5)		0.3
(0.1–0.5)		0.3
(0.1–0.5)		0.4
(0.2–0.6)		0.4
(0.2–0.6)		0.4
(0.4–0.5)		0.7
(0.6–0.7)		0.6
(0.5–0.6)		0.6
(0.6–0.7)		
Gliclazide	0.4
(0.2–0.7)		0.5
(0.2–0.8)		0.9
(0.8–1.1)		0.4
(0.2–0.6)		0.5
(0.3–0.7)		0.4
(0.2–0.6)		0.6
(0.5–0.6)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.7)	—	
Oxazepam	0.8
(0.6–1.1)		0.7
(0.6–0.9)		0.7
0.5–0.9)		0.6
(0.5–0.8)		0.7
0.5–0.9)		0.6
(0.4–0.8)		0.7
(0.6–0.8)		0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.6
(0.5–0.7)	—	
Frusemide	0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.6
(0.5–0.7)		0.6
(0.6–0.7)		0.6
(0.6–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		
Sertraline	0.8
(0.7–0.9)		0.8
(0.7–0.8)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		
Candesartan cilexetil	0.1
(0.1–0.1)		0.2
(0.2–0.2)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		
(continued)
Table 9.3 (continued): Most frequently prescribed medications (by CAPS generic), BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Generic drug	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Pantoprazole	0.1
(0.0–0.4)		0.1
(0.0–0.4)		0.4
(0.2–0.6)		0.4
(0.2–0.5)		0.4
(0.2–0.6)		0.4
(0.3–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.7)		
Influenza virus vaccine 	1.5
(1.3–1.7)		1.5
(1.3–1.8)		1.5
(1.2–1.7)		1.4
(1.2–1.7)		1.2
(1.0–1.4)		0.9
(0.7–1.1)		1.1
(0.9–1.3)		0.6
(0.5–0.8)		0.4
(0.3–0.5)		0.6
(0.4–0.7)		
Rosuvastatin	N/A		N/A		N/A		N/A		N/A		N/A		N/A		0.0
(0.0–0.1)		0.4
(0.3–0.4)		0.6
(0.5–0.7)		
Generic medication frequently prescribed in previous years		
Naproxen systemic	0.8
(0.7–0.9)		0.6
(0.5–0.6)		0.4
(0.4–0.5)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.3
(0.2–0.3)		
Budesonide topical nasal	0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.5
(0.4–0.5)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.3
(0.2–0.4)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		
Ranitidine	1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.6
(0.6–0.7)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		
Enalapril maleate	0.7
(0.6–0.8)		0.5
(0.5–0.6)		0.4
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		
Budesonide inhaled	0.7
(0.7–0.8)		0.6
(0.5–0.6)		0.5
(0.4–0.5)		0.3
(0.3–0.4)		0.3
(0.2–0.3)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		
Beclomethasone inhaled	0.6
(0.5–0.7)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		0.2
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		
Total prescribed medications	93.8
(91.5–96.2)		92.3
(89.9–94.7)		88.0
(85.6–90.4)		84.3
(81.8–86.9)		86.0
(83.6–88.5)		83.4
(81.2–85.5)		85.8
(83.3–88.4)		83.3
(81.0–85.5)		82.4
(80.3–84.6)		86.4
(84.1–88.6)		
(a)	Column will not add to 100, as multiple prescriptions could be written at each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change and — indicates there was no change. 
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters. 
Note: CI—confidence interval; N/A—not applicable (that is, drug was not available at that time).

Table 9.4: Number of repeats for prescribed medications, BEACH, 1999–00 to 2008–09
	Per cent of prescriptions (95% CI)(a)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Number of repeats	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
No repeats	31.9
(30.2–33.7)		33.0
(31.2–34.8)		38.3
(36.7–39.4)		38.0
(36.4–39.6)		37.8
(36.2–39.3)		38.5
(36.8–40.2)		35.9
(34.4–37.5)		35.2
(33.7–36.7)		34.5
(33.1–35.9)		34.0
(32.8–35.2)	§	
One repeat	20.4
(19.5–21.3)		20.3
(19.3–21.4)		17.6
(16.8–18.3)		17.7
(16.8–18.6)		16.6
(15.8–17.3)		17.6
(16.7–18.4)		17.6
(16.8–18.4)		16.4
(15.6–17.1)		16.8
(16.0–17.6)		17.1
(16.1–18.0)		
Two repeats	16.3
(15.2–17.4)		15.2
(14.1–16.3)		13.1
(12.3–14.0)		12.0
(11.0–13.0)		11.4
(10.6–12.1)		10.6
(10.0–11.3)		10.1
(9.4–10.9)		10.5
(9.6–11.4)		10.2
(9.3–11.1)		9.7
(9.0–10.3)		
Three or four repeats	4.3
(3.7–4.8)		4.4
(4.0–4.8)		4.5
(4.1–4.9)		4.8
(4.4–5.1)		5.0
(4.7–5.4)		4.8
(4.4–5.2)		4.5
(3.8–5.2)		4.8
(4.3–5.3)		4.6
(4.0–5.2)		4.4
(4.0–4.8)	—	
Five repeats	26.8
(25.3–28.3)		26.9
(25.6–28.2)		26.4
(25.2–27.7)		27.4
(26.0–28.7)		29.2
(27.9–30.4)		28.3
(27.0–29.6)		31.7
(30.3–33.1)		33.0
(31.7–34.4)		33.8
(32.5–35.1)		34.8
(33.6–36.0)		
Six or more repeats	0.3
(0.0–0.6)		0.1
(0.1–0.2)		0.0
(0.0–0.0)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.3)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)	—	
(a)	Missing data removed.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Note: CI—confidence interval. Results are reported to one decimal place, a result of 0.0 indicates that the prescription accounted for < 0.05%. 

9.2	Medications supplied by GPs 
Rates of GP-supplied medications per 100 encounters and per 100 problems managed increased significantly in the 10-year period. Rates rose from 6.9 per 100 encounters in 
1999–00 to 11.0 in 2008–09 (Table 9.1a). The extrapolated national effect of this change is 
5.3 million more medications supplied directly to the patient by GPs in 2008–09 than in 
1999–00. Per 100 problems managed, the rates increased from 4.7 to 7.1 between the two data periods (Table 9.1b).
Table 9.5 shows rates of generic medications most frequently supplied by GPs between 
1999–00 and 2008–09. The majority of these medications were vaccines and rates for most of them increased significantly over the period. The supply of pneumococcal vaccine rose significantly from 0.1 per 100 encounters in 1999–00 to 0.7 per 100 in 2008–09. The extrapolated national effect of this change is that pneumococcal vaccine was supplied 680,000 more times in 2008–09 than in 1999–00. The peak for papillomavirus vaccine can be seen in 2007–08 with one supplied per 100 encounters. The rate dropped significantly in 2008–09 to 0.6 per 100 encounters on average. For the influenza vaccine, the move away from prescribing towards GP supply was evident in the significant increase in its supply by GPs (Table 9.5) that coincided with the significant decrease in its prescribing rates (Table 9.3). This change follows federal government policy starting in 2001 which made the vaccine available free-of-charge to all Australians aged 65 years and over, to Indigenous people aged 50 years and older and to younger Indigenous persons with health risks. The vaccines can be ordered by the GP directly from the supplier. 
9.3	Medications advised for over-the-counter purchase
The overall rate of advised OTC medications showed no significant change over the period (Table 9.1a). Table 9.6 shows the most commonly advised OTC medications at the generic level. The rate of advised sodium chloride for topical nasal use rose significantly from <0.05 per 100 encounters in 1999–00 to 0.2 in 2008–09. The extrapolated national effect of this change is that this medication was advised by GPs 180,000 more times in 2008–09 than in 1999–00. Rates of advised cetirizine also rose significantly.

Table 9.5: Medications most frequently supplied by GPs, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Generic medication	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Influenza virus vaccine	0.7
(0.5–0.9)		0.6
(0.4–0.7)		0.9
(0.7–1.1)		0.7
(0.5–0.9)		1.2
(0.9–1.4)		1.2
(0.9–1.6)		1.6
(1.3–1.8)		2.0
(1.6–2.3)		1.5
(1.2–1.7)		2.3
(2.0–2.7)		
Pneumococcal vaccine	0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.4
(0.3–0.5)		0.9
(0.8–1.0)		0.6
(0.6–0.7)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		
Papillomavirus vaccine	N/A		N/A		N/A		N/A		N/A		N/A		N/A		0.0Ŧ
(0.0–0.0)		1.0
(0.9–1.1)		0.6
(0.6–0.7)	§	
Vitamin B12 (cobalamin)	0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.4
(0.3–0.4)		0.4
(0.4–0.5)		
Mumps/measles/rubella vaccine	0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		
Diph/pert/tetanus/Hep B/Polio/Hib vaccine	N/A		N/A		N/A		N/A		N/A		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.3–0.4)		
Rotavirus vaccine	N/A		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.1
(0.1–0.2)		0.3
(0.2–0.3)		
Haemophilus B vaccine	0.3
(0.3–0.4)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.3
(0.2–0.4)		0.2
(0.2–0.2)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		
ADT–CDT vaccine (diphtheria–tetanus) 	0.3
(0.2–0.3)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)	—	
Polio vaccine oral sabin/injection	0.4
(0.3–0.5)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
Meningitis vaccine	0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.2
(0.1–0.2)		0.3
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		
Total GP-supplied medications	6.9
(6.0–7.7)		6.9
(5.9–7.9)		7.6
(6.6–8.7)		9.3
(8.0–10.6)		8.6
(7.6–9.6)		8.1
(7.3–8.8)		8.8
(8.2–9.5)		8.9
(8.2–8.6)		10.1
(9.5–10.7)		11.0
(10.3–11.8)		
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant change, and — indicates there was no change. 
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters. 
Note: CI—confidence interval. N/A—not applicable (that is, drug was not available at that time).
Table 9.6: Most frequently advised over-the-counter medications, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Generic medication	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Paracetamol	2.5
(2.2–2.8)		2.4
(2.0–2.7)		2.1
(1.9–2.4)		2.6
(2.3–2.9)		2.5
(2.1–2.8)		2.3
(2.0–2.6)		2.5
(2.2–2.8)		2.4
(2.1–2.7)		2.6
(2.2–2.9)		2.3
(2.0–2.6)	—	
Ibuprofen	0.3
(0.2–0.4)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.7
(0.5–0.8)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		0.6
(0.5–0.7)		0.5
(0.5–0.6)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		
Diclofenac diethyl topical	0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)	—	
Sodium chloride topical nasal	0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		
Aspirin	0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)	—	
Sodium/potassium/citric/
glucose rehydration	0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)	—	
Clotrimazole topical	0.2
(0.0–0.4)		0.2
(0.0–0.4)		0.2
(0.0–0.5)		0.2
(0.0–0.4)		0.2
(0.0–0.4)		0.2
(0.0–0.4)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)	—	
Cetirizine	0.0Ŧ
(0.0–0.0)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		
Paracetamol–codeine	0.3
(0.2–0.4)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		
Loratadine	0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.1
(0.1–0.2)		
Fexofenadine	0.1
(0.0–0.9)		0.1
(0.0–0.5)		0.1
(0.0–0.5)		0.1
(0.0–0.4)		0.1
(0.0–0.5)		0.2
(0.0–0.5)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)	—	
Total advised medications	9.4
(8.7–10.1)		9.0
(8.2–9.7)		8.9
(8.2–9.6)		10.2
(9.3–11.1)		9.8
(9.0–10.5)		10.1
(9.2–10.9)		9.8
(9.0–10.5)		9.4
(8.7–10.1)		10.1
(9.3–10.9)		8.9
(8.3–9.4)	—	
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval. 

10	Other treatments
This chapter includes data about the other treatments provided in general practice from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The survey form allowed GPs to record up to two other treatments for each problem managed at the encounter. Other treatments included all clinical and procedural treatments provided. These groups are defined in Appendix 4. Between 2005–06 and 2008–09 the GPs were asked to indicate whether the treatment was provided by a practice nurse (tick box). In this chapter all ‘other treatments’ are reported, irrespective of whether they were done by the GP or by the practice nurse. That is, the non-pharmacological management provided in general practice patient encounters is described, rather than management provided specifically by the general practitioner. Treatments provided by the practice nurse are reported separately in 
Chapter 13.
Routine clinical measurements or observations, such as measurements of blood pressure and physical examinations, were not included between 1998–99 and 2004–05. With the inclusion of practice nurse activities in BEACH since 2005–06, clinical observations have been recorded, but only when undertaken by the practice nurse.
The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in the other treatments provided between 1999–00 and 2008–09. An example of an extrapolated change is given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8. 
10.1	Clinical treatments
Overall, there was no change in the rate of clinical treatments provided at general practice encounters when comparing 1999–00 and 2008–09 data. However, there was a significant increase in the rate of clinical treatments recorded between 1999–00 and 2004–05, followed by a 25% decrease in 2005–06. The rate of clinical treatments then gradually increased to 34.0 per 100 encounters in 2008–09 (Table 10.1).
There were numerous changes when comparing the individual types of clinical treatments given over the 10-year period. Since 1999–00 there was an overall increase in the rate of general advice and education given to patients, from 4.2 per 100 encounters in 1999–00 to 6.1 per 100 in 2008–09. There were also numerous significant changes within this period (Table 10.1). The rate of other administrative/documentation shows a similar pattern, with peaks of 1.8 per 100 encounters occurring in 2003–04 and 2008–09. 
A significant linear increase was seen in the rate of sickness certificates provided over the 10‑year period, given at a rate of 0.6 per 100 encounters in 1999–00 and increasing to 1.9 per 100 encounters in 2008–09. This represents an estimated 1.5 million more sickness certificates provided nationally in 2008–09 than in 1999–00. 
Table 10.2 shows that some changes have occurred in the rates at which clinical treatments were used in the management of specific problems. The rate at which clinical treatments were used in the management of tobacco abuse increased fivefold from 0.1 per 100 tobacco abuse encounters in 1999–00 to 0.5 per 100 in 2008–09. Clinical treatments were provided in the management of asthma less often in 2008–09 than in 1999–00. A significant linear decrease over the 10-year period is shown, equating to 270,000 fewer occasions at which a clinical treatment was given in the management of asthma in 2008–09 than in 1999–00.
10.2	Procedures
Overall, the rate at which procedures were provided by GPs increased significantly over time, from 12.5 per 100 encounters in 1999–00 to 16.7 per 100 encounters in 2008–09. This equates to an estimated additional 6.1 million occasions at which a procedure was performed in 2008–09 compared with 1999–00 (Table 10.3).
This significant rise in the rate of procedures is reflected in the rates of individual types of procedural treatments. For example, there was an increase in pap smears, from 0.8 per 100 encounters in 1999–00 to 1.2 per 100 encounters in 2008–09. This equates to a national estimated 540,000 additional pap smears undertaken by GPs in 2008–09 compared with 1999–00. Other procedural treatments that demonstrate a significant increase over this time included local injections (Table 10.3). 
A number of changes were apparent in the most common problems managed with a procedure between 1999–00 and 2008–09 (Table 10.4). In parallel with the aforementioned increase in the rate of pap smears there was an associated increase in the rate of female genital check-ups, from 0.5 per 100 encounters in 1999–00 to 1.1 per 100 in 2008–09. This equated to an additional 730,000 female genital check-ups performed in 2008–09 compared with during 1999–00. 
 For solar keratosis (the problem most often managed with a procedure) the rate at which a procedure was performed rose marginally, from 0.8 per 100 contacts in 1999–00 to 0.9 per 100 in 2008–09.
Significantly more procedures were performed in the management of hypertension over time, with an additional 120,000 procedures performed nationally for this problem in 
2008–09 than in 1999–00 (Table 10.4). 

Table 10.1: The most frequent clinical treatments, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Treatment	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Advice/education*	4.2
(3.7–4.7)		5.8
(5.2–6.4)		6.3
(5.6–7.0)		6.9
(6.1–7.7)		6.8
(6.1–7.6)		7.0
(6.2–7.8)		4.8
(4.1–5.4)		5.7 
(5.0–6.5)		7.2
(6.3–8.1)		6.1
(5.4–6.9)	§	
Counselling—problem*	3.4
(3.0–3.9)		3.4
(3.0–3.8)		4.7
(4.0–5.3)		5.5
(4.8–6.1)		4.7
(4.1–5.3)		4.2
(3.3–5.0)		4.8
(4.1–5.4)		4.4
(3.7–5.0)		4.3
(3.8–4.9)		3.8
(3.3–4.4)	—	
Counselling/advice—nutrition/weight*	4.2
(3.8–4.6)		5.6
(5.0–6.1)		5.5
(5.0–5.9)		5.2
(4.7–5.8)		4.6
(4.2–5.1)		5.3
(4.7–5.9)		3.6
(3.2–4.0)		3.4
(3.0–3.7)		4.2
(3.8–4.6)		4.1
(3.6–4.5)	—	
Advice/education—treatment*	6.2
(5.6–6.8)		5.9
(5.3–6.5)		5.1
(4.6–5.6)		4.2
(3.8–4.7)		4.4
(3.8–4.9)		4.6
(4.0–5.1)		3.1
(2.6–3.5)		2.8
(2.5–3.1)		3.5
(3.1–3.8)		3.5
(3.1–4.0)		
Counselling—psychological*	2.6
(2.4–2.8)		2.8
(2.6–3.1)		3.2
(2.8–3.5)		2.9
(2.6–3.1)		2.9
(2.6–3.1)		3.2
(2.9–3.5)		3.1
(2.8–3.3)		2.9
(2.6–3.1)		3.2
(2.9–3.4)		3.2
(3.0–3.5)		
Advice/education—medication*	2.9
(2.6–3.2)		2.6
(2.3–2.9)		2.8
(2.6–3.1)		2.5
(2.2–2.7)		3.4
(3.1–3.7)		3.4
(2.9–3.8)		1.6
(1.4–1.7)		1.8
(1.6–2.0)		2.0
(1.8–2.2)		2.3
(2.1–2.6)	§	
Sickness certificate*	0.6
(0.5–0.7)		1.1
(0.9–1.3)		1.1
(0.9–1.3)		1.3
(1.1–1.5)		1.0
(0.9–1.2)		1.7
(1.3–2.1)		1.6
(1.4–1.9)		1.6
(1.3–1.8)		1.7
(1.4–2.0)		1.9
(1.6–2.2)		
Other admin/document*	1.0
(0.9–1.2)		1.5
(1.3–1.6)		1.5
(1.4–1.7)		1.6
(1.4–1.7)		1.8
(1.6–2.0)		1.3
(1.1–1.5)		1.0
(0.9–1.1)		1.2
(1.1–1.4)		1.5
(1.4–1.7)		1.8
(1.7–2.0)	§	
Reassurance, support	1.6
(1.4–1.8)		1.5
(1.3–1.8)		1.5
(1.3–1.7)		1.4
(1.2–1.5)		1.5
(1.3–1.7)		1.6
(1.2–1.9)		1.0
(0.8–1.2)		1.1
(0.9–1.3)		1.4
(1.2–1.6)		1.5
(1.3–1.8)	—	
Counselling/advice—exercise*	1.6
(1.4–1.8)		2.2
(1.9–2.4)		2.1
(1.8–2.3)		1.6
(1.4–1.8)		1.5
(1.3–1.7)		1.9
(1.4–2.3)		1.1
(0.9–1.2)		1.1
(1.0–1.3)		1.3
(1.1–1.5)		1.4
(1.2–1.6)	—	
Counselling/advice—smoking*	0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.6
(0.6–0.7)		0.8
(0.6–1.0)		0.5
(0.4–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.8
(0.7–0.8)	—	
Counselling/advice—prevention*	0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.3
(0.2–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.5)		0.4
(0.1–0.8)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.5
(0.4–0.6)		0.4
(0.3–0.5)	—	
Counselling/advice—lifestyle*	0.3
(0.2–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.5)		0.5
(0.3–0.7)		0.3
(0.2–0.4)		0.4
(0.0–1.0)		0.5
(0.3–0.6)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.2
(0.1–0.3)	—	
(continued)
Table 10.1 (continued): The most frequent clinical treatments, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Treatment	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Counselling/advice—alcohol*	0.4
(0.3–0.4)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.5
(0.2–0.7)		0.3
(0.3–0.3)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)	—	
Family planning*	0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.2–0.6)		0.3
(0.2–0.3)		0.3
(0.3–04)		0.4
(0.3–0.4)		0.3
(0.3–0.4)	—	
Observe/wait*	0.6
(0.5–0.7)		0.7
(0.4–1.0)		0.3
(0.2–0.4)		0.3
(0.2–0.3)		0.3
(0.2–0.4)		0.4
(0.0–0.7)		0.3
(0.2–0.4)		0.3
(0.2–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.6)	—	
Counselling/advice—health/body*	0.6
(0.4–0.7)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.1–0.6)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.2–0.4)		0.4
(0.3–0.5)	—	
Counselling/advice—pregnancy*	0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.4)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)	—	
Counselling/advice—relaxation*	0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.4)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
Counselling/advice—STDs*	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)	—	
Counselling/advice—drug abuse*	0.4
(0.1–0.6)		0.3
(0.2–0.5)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.3)		0.2
(0.1–0.3)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		
Counselling/advice—relationship*	0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		
Total clinical treatments	33.5
(31.8–35.2)		37.2
(35.1–39.3)		38.1
(36.1–40.1)		37.2
(35.0–39.4)		36.6
(34.5–38.8)		39.2
(37.1–41.4)		29.2
(27.3–31.1)		29.5
(27.6–31.4)		34.5
(32.5–36.5)		34.0
(32.1–35.9)	§	
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; admin—administration; STD—sexually transmitted disease.

Table 10.2: The most common problems managed with a clinical treatment, BEACH, 1999–00 to 2008–09
	Rate at which a clinical treatment was given, per 100 contacts(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Depression*	1.6
(1.5–1.8)		1.8
(1.6–2.0)		1.7
(1.6–1.9)		1.7
(1.6–1.9)		1.7
(1.6–1.9)		1.8
(1.7–2.0)		1.7
(1.5–1.8)		1.5
(1.4–1.6)		1.8
(1.6–1.9)		1.8
(1.7–2.0)	—	
Upper respiratory tract infection	1.4
(1.2–1.6)		1.7
(1.5–1.9)		2.0
(1.7–2.2)		1.8
(1.6–2.0)		1.6
(1.4–1.8)		1.8
(1.5–2.0)		1.6
(1.3–1.8)		1.5
(1.3–1.6)		1.8
(1.6–2.0)		1.7
(1.5–1.9)	—	
Hypertension*	1.1
(0.9–1.2)		1.4
(1.2–1.6)		1.4
(1.2–1.5)		1.5
(1.3–1.7)		1.3
(1.1–1.4)		1.3
(1.2–1.5)		1.0
(0.9–1.2)		0.9
(0.8–1.0)		1.2
(1.1–1.4)		1.1
(1.0–1.2)	—	
Lipid disorders*	0.8
(0.7–0.9)		1.0
(0.9–1.2)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.8
(0.7–0.8)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		
Diabetes—all*	0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.1
(0.9–1.2)		
Anxiety*	0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.7
(0.7–0.8)		0.8
(0.7–0.9)		0.9
(0.8–1.0)	—	
Gastroenteritis*	0.8
(0.7–0.9)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.8
(0.7–0.9)		0.7
(0.6–0.7)		
Test results*	0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.4
(0.3–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.5)		0.5
(0.4–0.6)		0.5
(0.3–0.6)		0.4
(0.3–0.4)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		
Back complaint*	0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.5
(0.5–0.6)		0.6
(0.5–0.6)	—	
Sprain/strain*	0.5
(0.5–0.6)		0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.4
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.4)		
Obesity	0.4
(0.3–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.4
(0.3–0.4)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)	—	
Acute stress reaction	0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.4
(0.4–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.5)	—	
Osteoarthritis*	0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.5
(0.4–0.5)		0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)	—	
 (continued)
Table 10.2 (continued): The most common problems managed with a clinical treatment, BEACH, 1999–00 to 2008–09
	Rate at which a clinical treatment was given, per 100 contacts(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
General check-up*	0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.3)		0.3
(0.2–0.4)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		
Asthma	0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		0.6
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		
Acute bronchitis/
bronchiolitis	0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.5
(0.4–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.4
(0.3–0.4)	—	
Tobacco abuse	0.1
(0.1–0.2)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.2)		0.2
(0.2–0.2)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.5
(0.4–0.5)		
Pregnancy*	0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		
Urinary tract infection*	0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
Menopausal complaint	0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.4
(0.3–0.5)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		
Total problems with clinical treatments	30.4
(28.9–31.9)		32.8
(31.1–34.5)		33.6
(31.9–35.2)		32.8
(31.0–34.7)		32.4
(30.7–34.2)		34.4
(32.6–36.2)		26.7
(25.1–28.3)		26.8
(25.1–28.4)		31.2
(29.5–33.0)		30.9
(29.2–32.5)	—	
(a)	Rate of provision of clinical treatment for selected problem per 100 total selected problems.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant change, and — indicates there was no change.
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval. This table includes individual problems which had clinical treatments given at a rate of >= 0.5 per 100 selected problems in any year, and any other statistically significant differences of interest.

Table 10.3: The most frequent procedural treatments, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Treatment	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Excision/removal tissue/
biopsy/destruction/
debridement/cauterisation*	3.0
(2.8–3.2)		2.6
(2.4–2.9)		2.7
(2.5–3.0)		2.9
(2.6–3.1)		3.1
(2.7–3.6)		3.3
(3.0–3.6)		3.0
(2.7–3.2)		3.4
(3.0–3.7)		3.4
(3.1–3.8)		3.2
(2.9–3.5)	—	
Local injection/
infiltration*(b)	0.2
(0.2–0.3)		0.2
(0.1–0.2)		1.2
(0.9–1.4)		1.5
(1.3–1.7)		1.6
(1.4–1.8)		2.0
(1.7–2.2)		2.0
(1.8–2.2)		1.9
(1.7–2.1)		2.3
(2.1–2.5)		2.3
(2.1–2.4)		
Dressing/pressure/
compression/tamponade*	2.2
(2.0–2.3)		1.8
(1.6–1.9)		1.8
(1.7–1.9)		2.0
(1.8–2.1)		1.8
(1.7–2.0)		2.0
(1.8–2.1)		2.1
(1.9–2.3)		2.3
(2.1–2.4)		2.2
(2.1–2.4)		2.3
(2.1–2.4)	—	
Physical medicine/
rehabilitation*	1.7
(1.5–1.8)		2.0
(1.8–2.3)		2.2
(1.9–2.4)		2.1
(1.8–2.4)		1.7
(1.5–1.9)		2.0
(1.7–2.3)		1.4
(1.1–1.6)		1.1
(0.9–1.3)		1.3
(1.1–1.5)		1.2
(1.1–1.3)		
Incision/drainage/flushing/
aspiration/removal body fluid*	1.1
(1.0–1.2)		1.1
(1.0–1.1)		1.2
(1.0–1.2)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.0
(1.0–1.1)		1.3
(1.2–1.4)		1.3
(1.1–1.4)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		
Pap smear*	0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.1
(0.9–1.2)		1.1
(0.9–1.3)		1.0
(0.8–1.1)		1.0
(0.8–1.1)		0.9
(0.8–1.0)		1.1
(0.9–1.2)		1.2
(1.0–1.3)		
Repair/fixation—suture/
cast/prosthetic device (apply/remove)*	1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		0.8
(0.7–0.9)		
Other therapeutic procedures/surgery NEC*	1.1
(0.8–1.3)		1.1
(0.9–1.4)		1.4
(1.2–1.7)		1.2
(1.0–1.4)		1.1
(0.9–1.3)		1.2
(0.9–1.5)		0.8
(0.6–0.9)		0.7
(0.6–0.9)		0.8
(0.6–0.9)		0.9
(0.7–1.1)	—	
Electrical tracings*	0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.5)		0.5
(0.4–0.5)		0.6
(0.5–0.6)		0.5
(0.4–0.5)	—	
Physical function test*	0.3
(0.3–0.4)		0.5
(0.3–0.6)		0.4
(0.3–0.5)		0.5
(0.4–0.7)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.6
(0.4–0.7)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		
Urine test*	0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.2–0.4)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.4
(0.4–0.5)		0.3
(0.2–0.3)		
Glucose test*	0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)	—	
(continued)
Table 10.3 (continued): The most frequent procedural treatments, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Treatment	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Other diagnostic procedures*	0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.3)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.3)		0.2
(0.1–0.3)		0.3
(0.2–0.3)		
Total procedural treatments	12.5
(11.9–13.0)		12.2
(11.6–12.8)		13.8
(13.1–14.5)		14.6
(13.9–15.3)		14.7
(14.0–15.5)		15.5
(14.6–16.4)		14.4
(13.7–15.1)		15.2
(14.4–16.0)		16.7
(15.9–17.5)		16.7
(16.0–17.5)		
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, § indicates a non-linear significant change, and — indicates there was no change. 
(b)	Excludes all local injection/infiltrations performed for immunisations.
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NEC—not elsewhere classified.
Table 10.4: The most common problems managed with a procedural treatment, BEACH, 1999–00 to 2008–09
	Rate at which a procedural treatment was given, per 100 contacts(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Solar keratosis/sunburn 	0.8
(0.7–0.8)		0.7
(0.6–0.8)		0.8
(0.6–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.1)		0.9
(0.7–1.1)		0.9
(0.8–1.0)		0.9
(0.8–1.0)		0.9
(0.8–1.1)		0.9
(0.8–1.0)		
Female genital check-up* 	0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.7)		0.8
(0.7–0.9)		0.8
(0.7–1.0)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.9
(0.8–1.0)		1.1
(0.9–1.2)		
Laceration/cut 	0.7
(0.6–0.7)		0.5
(0.5–0.6)		0.5
(0.4–0.5)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)	—	
Excessive ear wax 	0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.6
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.6
(0.5–0.6)		0.7
(0.6–0.8)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.6
(0.6–0.7)		
Malignant neoplasm skin 	0.4
(0.3–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.5
(0.4–0.6)		0.6
(0.4–0.7)		0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.5
(0.4–0.6)		0.6
(0.5–0.7)		
Warts 	0.5
(0.5–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.4
(0.4–0.5)		0.6
(0.5–0.6)		0.5
(0.4–0.6)		0.5
(0.4–0.5)	—	
(continued)
Table 10.4 (continued): The most common problems managed with a procedural treatment, BEACH, 1999–00 to 2008–09
	Rate at which a procedural treatment was given, per 100 contacts(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Problem managed	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Chronic ulcer skin (including varicose ulcer)	0.5
(0.4–0.5)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.3
(0.2–0.4)		0.4
(0.4–0.5)		0.4
(0.3–0.5)		0.5
(0.4–0.6)	—	
Sprain/strain* 	0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.4
(0.3–0.4)		0.5
(0.4–0.6)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.3–0.5)		0.3
(0.2–0.3)		
General check-up*	0.1
(0.1–0.1)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.3)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.2–0.3)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		
Back complaint* 	0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.5
(0.4–0.5)		0.4
(0.3–0.6)		0.4
(0.3–0.5)		0.5
(0.4–0.6)		0.4
(0.4–0.5)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.4)	—	
Vitamin/nutritional deficiency	0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		
Hypertension*	0.1
(0.0–0.1)		0.2
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		
Asthma	0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.3
(0.3–0.4)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		
Total problems with procedural treatments	11.8
(11.3–12.3)		11.5
(10.9–12.1)		13.1
(12.4–13.7)		13.6
(13.0–14.2)		13.7
(13.1–14.4)		14.3
(13.5–15.0)		13.6
(12.9–14.2)		14.3
(13.6–15.0)		15.6
(14.9–16.4)		15.6
(15.0–16.3)		
(a)	Rate of provision of clinical treatment for selected problem per 100 total selected problems.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change. 
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval. This table includes individual problems which had procedural treatments done at a rate of >= 0.5 per 100 selected problems in any year, and any other statistically significant differences of interest.

11	Referrals and admissions
A referral is defined as the process by which the responsibility for part or all of the care of a patient is temporarily transferred to another health care provider. Only new referrals arising at the encounter were included (that is, continuations were not recorded). For each encounter, GPs could record up to two referrals, and each referral was linked by the GP to the problem(s) for which the patient was referred. Referrals included those to specialists, allied health professionals, hospitals for admission, emergency departments or other medical services. Referrals to hospital outpatient clinics and other GPs were classified as referrals to other medical services.
This chapter includes data about the referrals and admissions from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant change, and — indicates there was no change.
Significant linear changes can be extrapolated to estimate the national increase or decrease in GP referrals and admissions between 1999–00 and 2008–09. An example of an extrapolated change is given for each table. The method used to extrapolate to national change estimates is described in Chapter 2, Section 2.8. 
Table 11.1 shows that over time there was an increasing likelihood that the patient would be referred at the encounters (at 12.8% of encounters in 2008–09 compared with 10.4% in 
1999–00), suggesting that the patient was referred to at least one other provider at about 3.8 million more GP encounters in 2008–09 than in 1999–00. There was a significant increase in the overall number of referrals per 100 encounters, from 11.1 in 1999–00 to 13.7 in 2008–09, reflecting both the increased likelihood of referral and a slight increase in the likelihood of multiple referrals at the encounter once the decision to refer had been made. The increase was reflected for most medical specialists with the exception of gynaecologists, neurologists and psychiatrists. 
There was an overall significant increase in specialist referrals with a notable rise between 2007–08 and 2008–09. In particular, significant increases occurred in referrals to dermatologists, cardiologists and gastroenterologists. 
The rate of referral to an allied health service changed significantly over the decade. The referral rate decreased from 3.1 per 100 encounters in 1999–00 to a low of 2.3 per 100 in 
2001–02, and then steadily increased to 3.9 per 100 in 2008–09. The rate of referrals to physiotherapists, psychologists, podiatrist or chiropodists, and dietitians or nutritionists all increased between 1999–00 and 2008–09.
In 2008–09 there were significantly fewer referrals/admissions to hospitals compared with 1999–00 but the frequency was very low in all years.

Table 11.1: The most frequent referrals, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Referral	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
At least one referral	10.4
(10.0–10.8)		9.9
(9.6–10.3)		10.0
(9.6–10.4)		10.6
(10.2–11.0)		11.0
(10.5–11.5)		10.9
(10.5–11.3)		11.3
(10.9–11.8)		11.5 
(11.0–11.9)		11.8
(11.3–12.2)		12.8
(12.3–13.2)		
Medical specialist	7.3
(7.0–7.6)		7.4
(7.1–7.7)		7.3
(7.0–7.6)		7.7
(7.3–8.0)		7.9
(7.5–8.2)		7.7
(7.4–8.0)		8.2
(7.8–8.5)		8.0 
(7.7–8.4)		8.0
(7.6–8.3)		9.0 
(8.7–9.3)		
	Surgeon	0.8
(0.7–0.8)		0.7
(0.7–0.8)		0.8
(0.7–0.8)		0.7
(0.7–0.8)		0.8
(0.8–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.8)		0.8 
(0.8–0.9)		0.8
(0.8–0.9)		0.9
(0.8–1.0)		
	Orthopaedic surgeon	0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.7
(0.7–0.8)		0.8
(0.7–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.8
(0.7–0.8)		0.7
(0.6–0.7)		0.8
(0.7–0.9)		
	Dermatologist	0.6
(0.5–0.6)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.6
(0.5–0.6)		0.6
(0.6–0.7)		0.7
(0.6–0.8)		0.7
(0.6–0.8)		0.6
(0.5–0.7)		0.7
(0.6–0.7)		0.7
(0.7–0.8)		
	Ophthalmologist	0.7
(0.6–0.7)		0.7
(0.6–0.7)		0.8
(0.7–0.8)		0.7
(0.7–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		0.8 
(0.7–0.9)		0.7
(0.6–0.7)		0.8
(0.7–0.8)		
	Cardiologist	0.4
(0.3–0.4)		0.4
(0.3–0.4)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.5
(0.5–0.6)		0.6
(0.5–0.7)		
	Ear, nose and throat	0.5
(0.4–0.5)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		0.6
(0.5–0.6)		
	Gastroenterologist	0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.5–0.6)		0.4
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.5–0.6)		
	Gynaecologist	0.5
(0.5–0.6)		0.6
(0.5–0.6)		0.5
(0.5–0.6)		0.6
(0.6–0.7)		0.6
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.5
(0.5–0.6)		0.4
(0.4–0.5)		0.5
(0.5–0.6)	—	
	Urologist	0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.3–0.3)		0.3
(0.3–0.4)		0.3
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.3
(0.3–0.3)		0.4
(0.3–0.4)		
	Neurologist	0.2
(0.2–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.2)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)	—	
	Psychiatrist	0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)	—	
(continued)
Table 11.1 (continued): The most frequent referrals, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Referral	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Allied health service	3.1
(2.9–3.3)		2.3
(2.2–2.5)		2.3
(2.1–2.4)		2.5
(2.3–2.7)		2.6
(2.4–2.8)		2.7
(2.5–2.9)		2.9
(2.7–3.1)		3.1
(2.9–3.3)		3.5
(3.2–3.7)		3.9
(3.6–4.1)		
	Physiotherapy	1.0
(0.9–1.1)		1.0
(0.9–1.1)		0.9
(0.8–1.0)		1.1
(0.9–1.2)		1.0
(0.9–1.1)		1.1
(0.9–1.1)		1.1
(1.0–1.3)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.2
(1.1–1.3)		
	Psychologist	0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.4
(0.4–0.5)		0.7
(0.6–0.7)		0.8
(0.7–0.9)		
	Podiatrist/chiropodist	0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.3–0.4)		0.3
(0.3–0.4)		0.4
(0.3–0.4)		
	Dietitian/nutritionist	0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		
	Dentist	0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)	—	
	Audiologist/acoustic testing	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.0Ŧ
(0.0–0.0)		0.1
(0.1–0.1)		0.1
(0.1–0.1)	—	
	Optometrist	0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		
	Diabetes education	0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)	—	
	Breast clinic	0.0Ŧ
(0.0–0.1)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.1)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.0–0.1)		
	Counsellor	0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)	—	
	Mental health team	0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.0Ŧ 
(0.0–0.1)		0.1
(0.0–0.1)	—	
	Drug and alcohol	0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.0–0.1)		0.1
(0.0–0.1)	—	
(continued)
Table 11.1 (continued): The most frequent referrals, BEACH, 1999–00 to 2008–09 
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Referral	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Hospital	0.7
(0.6–0.8)		0.5
(0.4–0.6)		0.4
(0.4–0.5)		0.6
(0.5–0.6)		0.6
(0.5–0.6)		0.5
(0.4–0.5)		0.4
(0.3–0.4)		0.4
(0.3–0.5)		0.4
(0.3–0.5)		0.3
(0.3–0.4)		
Emergency department	0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		0.2
(0.2–0.2)		
Other referrals/other medical services(c)	0.0Ŧ
(0.0–0.0)		0.2
(0.1–0.2)		0.4
(0.3–0.4)		0.3
(0.2–0.3)		0.4
(0.4–0.5)		0.4
(0.4–0.5)		0.4
(0.3–0.4)		0.5
(0.5–0.6)		0.5
(0.4–0.6)		0.3
(0.2–0.4)		
Total referrals	11.1
(10.7–11.6)		10.4
(10.0–10.8)		10.5
(10.1–10.9)		11.1
(10.7–11.6)		11.6
(11.1–12.1)		11.5
(11.1–12.0)		12.0
(11.5–12.5)		12.2 
(11.7–12.7)		12.5
(12.0–13.0)		13.7
(13.2–14.2)		
(a)	Column will not add to 100, as multiple referrals could be written at each encounter.
(b)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change.
(c)	Other referrals and other medical services have been reported together for comparability. The ‘other medical services’ group was introduced in 2003–04, previously these were grouped with ‘other referrals’.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
Note: CI—confidence interval.

12	Investigations
The GPs participating in the study were asked to record (in free text) any pathology, imaging or other tests ordered or undertaken at the encounter, and to nominate the patient problem(s) associated with each test order placed. This allows the linkage of test orders to a single problem or multiple problems. Up to five orders for pathology and two for imaging and other tests could be recorded at each encounter. A single test may have been ordered for the management of multiple problems, and multiple tests may have been used in the management of a single problem.
A pathology test order may be for a single test (for example Pap smear, HbA1c) or for a battery of tests (for example lipids, full blood count). Where a battery of tests was ordered, the battery name was recorded rather than each individual test. GPs also recorded the body site for any imaging ordered (for example X-ray chest, CT head).
This chapter includes data about the investigations ordered or performed in general practice from each of the 10 years from 1999–00 to 2008–09. The direction and type of change is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change. 
Significant linear changes can be extrapolated to estimate the national increase or decrease in investigations ordered or performed between 1999–00 and 2008–09 or between 2000–01 for pathology and imaging groups. Examples of extrapolated change are given for each table. The method used to extrapolate to national estimates is described in Chapter 2, Section 2.8. 
Comprehensive investigation of GPs’ pathology and imaging ordering has been published in a number of reports. Interested readers may wish to consult the reports listed below.
•	In 2000, a comprehensive report on pathology ordering by GPs in Australia in 1998, written by the then General Practice Statistics and Classification Unit (GPSCU) using BEACH data, was published on the Internet by the Diagnostics and Technology Branch of the then Department of Health and Aged Care.54 
•	A report on imaging orders by GPs in Australia in 1999–00, written by the then GPSCU using BEACH data, and published by the AIHW and the University of Sydney in 2001.55 
•	A report on changes in pathology ordering by GPs from 1998 to 2001 was also produced by the GPSCU as an AIHW–University of Sydney book in the GP series in 2003.56 
•	A review of GP pathology ordering in the National Health Priority Areas and other selected problems between 2000 and 2008 is reported in Chapter 5 of the AGPSCC publication General practice in Australia, health priorities and policies 1998 to 2008.57
12.1	Number of encounters where pathology or imaging was ordered
Table 12.1 shows there was a significant increase in the proportion of encounters at which pathology and/or imaging was ordered, from 18.9% in 1999–00 to 24.2% in 2008–09, equating to an increase of almost 8 million encounters at which tests were ordered in 
2008–09. The likelihood of ordering at least one pathology test increased from 13.8% of encounters in 1999–00 to 18.2% in 2008–09, which is almost 6.5 million additional encounters at which pathology was ordered in 2008–09. The proportion of encounters generating imaging orders increased from 6.7% in 1999–00 to 8.5% in 2008–09, resulting in an estimated 2.7 million more encounters nationally at which imaging was ordered in 2008–09.
12.2	Pathology test orders by MBS groups
Table 12.2 shows the changes in the total number of pathology test orders, and in the distribution of these by MBS pathology groups. These can only be compared from 2000–01 onwards because of the change in coding method introduced in 2000–01 (see Chapter 2). The number of tests ordered increased from 29.7 tests (or battery of tests) per 100 encounters in 2000–01 to 45.6 in 2008–09, which extrapolates to approximately 21.3 million more test orders in 2008–09 than in 2000–01 nationally.
The largest increase was in orders for chemical pathology, which increased from 15.6 per 100 encounters in 2000–01 to 27.0 in 2008–09. This extrapolates to an estimated 14.6 million additional chemistry test orders in 2008–09 than 9 years earlier. Haematology increased at a slower rate, rising from 5.8 tests per 100 encounters in 2000–01 to 8.2 in 2008–09, a national increase of approximately 3.4 million tests. Microbiology test orders increased from 4.6 per 100 encounters in 2000–01 to 5.7 in 2008–09, extrapolating to an increase of about 1.8 million additional test orders in 2008–09. There were far smaller increases in order rates for tissue pathology, immunology and simple tests, and no increases in the other test groups.
As shown in Figure 12.1, both the likelihood of ordering pathology and the total number of tests ordered have significantly increased over the 9 years to 2008–09. However, the growth in the number of tests/batteries ordered has been larger than the growth in likelihood of ordering, because once a decision to order has been made, the number of tests ordered has increased from an average of 2.15 tests/batteries per tested encounter to 2.51.
12.3	Imaging test orders by MBS group
Table 12.3 shows the changes in imaging orders by imaging group from 2000–01 to 2008–09. The first 2 years of imaging data cannot be compared with subsequent years because of coding changes introduced in 2000.
Total test orders increased significantly from 7.7 per 100 encounters in 2000–01 to 9.8 in 
2008–09, suggesting a national increase of just under 3.3 million encounters generating an order for imaging. Ultrasound imaging increased from 2.1 tests per 100 encounters in 
2000–01 to 3.6 per 100 in 2008–09, a national increase of over 1.9 million encounters with ultrasound orders. Computerised tomography increased from 0.7 per 100 encounters in 2000–01 to 1.3 in 2008–09, equating to 760,000 encounters. Magnetic resonance imaging increased from less than 0.05 per 100 encounters in 2000–01 to 0.1 in 2008–09. Diagnostic radiology and nuclear medicine imaging order rates did not change during this period.

Figure 12.1: Encounters where pathology was ordered, and pathology test order rates per 100 encounters, 1999–00 to 2008–09 (95% CI)
Vertical bar chart showing proportions on y-axis and year on x-axis.

Note: Data collection method and coding system changed in 2000–01. Data from 1999–00 are not comparable with data from 2000–01 to 2008–09 in regard to pathology test orders.

Table 12.1: Number of encounters at which pathology or imaging was ordered, BEACH, 1999–00 to 2008–09
	Per cent of encounters (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (a)
 	
Test ordered	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,804)		(n = 95,898)		(n = 96,688)		
At least one test ordered 	18.9
(18.3–19.5)		19.3
(18.7–19.9)		19.2
(18.6–19.8)		20.3
(19.7–21.0)		20.8
(20.1–21.5)		21.2
(20.6–21.8)		22.1
(21.4–22.7)		23.0
(22.3–23.7)		23.4
(22.7–24.1)		24.2
(23.5–24.8)		
At least one pathology test ordered	13.8
(13.3–14.3)		13.8
(13.3–14.3)		14.0
(13.5–14.5)		14.7
(14.2–15.3)		15.5
(14.9–16.1)		15.7
(15.2–16.3)		16.4
(15.8–16.9)		17.4
(16.8–18.0)		17.4
(16.7–18.0)		18.2
(17.6–18.8)		
At least one imaging test ordered	6.7
(6.4–7.0)		6.8
(6.5–7.1)		6.9
(6.6–7.2)		7.5
(7.1–7.8)		7.2
(6.9–7.5)		7.3
(7.0–7.6)		7.8
(7.4–8.1)		7.9
(7.6–8.2)		8.3
(8.0–8.6)		8.5
(8.1–8.8)		
(a)	The direction and type of change from 1999–00 to 2008–09 is indicated for each result: / indicates a statistically significant change.
Note: CI—confidence interval.

Table 12.2: Distribution of pathology orders across pathology groups, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Pathology test ordered	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,804)		(n = 95,898)		(n = 96,688)		
Chemistry*	NAv		15.6
(14.8–16.5)		16.5
(15.6–17.3)		17.7
(16.8–18.6)		19.1
(18.1–20.1)		20.4
(19.5–21.4)		21.8
(20.6–22.9)		24.5
(23.3–25.7)		24.9
(23.6–26.2)		27.0
(25.8–28.2)		
Haematology*	NAv		5.8
(5.5–6.1)		6.2
(5.8–6.5)		6.3
(5.9–6.6)		6.8
(6.4–7.2)		7.0
(6.6–7.3)		7.3
(6.9–7.7)		7.9
(7.5–8.3)		7.9
(7.5–8.3)		8.2
(7.8–8.6)		
Microbiology*	NAv		4.6
(4.3–4.9)		4.9
(4.5–5.2)		5.1
(4.8–5.5)		5.3
(4.9–5.7)		5.2
(4.9–5.6)		5.6
(5.2–5.9)		5.9
(5.4–6.3)		5.7
(5.3–6.0)		5.7
(5.3–6.1)		
Cytology*	NAv		1.5
(1.3–1.7)		1.6
(1.4–1.7)		1.7
(1.5–1.8)		1.8
(1.5–2.0)		1.6
(1.5–1.8)		1.7
(1.6–1.9)		1.7
(1.5–1.9)		1.9
(1.7–2.1)		2.0
(1.7–2.2)		
Other NEC*	NAv		0.8
(0.7–0.9)		0.7
(0.6–0.8)		0.8
(0.6–0.9)		0.8
(0.7–0.9)		0.8
(0.7–1.0)		0.7
(0.6–0.8)		0.8
(0.7–1.0)		1.0
(0.8–1.2)		0.8
(0.7–1.0)	—	
Tissue pathology*	NAv		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.5
(0.4–0.6)		0.7
(0.5–0.8)		0.8
(0.6–0.9)		0.6
(0.5–0.7)		0.7
(0.6–0.8)		0.8
(0.6–0.9)		0.7
(0.6–0.9)		
Immunology*	NAv		0.5
(0.4–0.6)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.5)		0.5
(0.4–0.6)		0.6
(0.5–0.7)		0.6
(0.5–0.7)		0.7
(0.6–0.7)		0.8
(0.7–0.9)		
Infertility/pregnancy*	NAv		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.3
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.2–0.3)		0.2
(0.1–0.2)		0.2
(0.2–0.3)	—	
Simple test; other*	NAv		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.1–0.2)		0.2
(0.2–0.3)		
Total pathology tests	NAv		29.7
(28.4–30.9)		31.0
(29.7–32.4)		32.9
(31.5–34.4)		35.2
(33.7–36.7)		36.7
(35.2–38.2)		38.6
(36.9–40.3)		42.4
(40.7–44.2)		43.2
(41.3–45.0)		45.6
(43.8–47.4)		
(a)	Data collection method and coding system changed in the 1999–00 BEACH year. Data from 1999–00 is not comparable with subsequent years in regard to pathology groups.
(b)	The direction and type of change from 2000–01 to 2008–09 is indicated for each result: / indicates a statistically significant change, / indicates a marginal change, and — indicates there was no change.
*	Includes multiple ICPC-2 and ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NAv—not available; NEC—not elsewhere classified.

Table 12.3: Most frequent imaging tests ordered, BEACH, 1999–00 to 2008–09
	Rate per 100 encounters(a) (95% CI)		
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09	 (b)
 	
Imaging test ordered	(n = 104,856)		(n = 99,307)		(n = 96,973)		(n = 100,987)		(n = 98,877)		(n = 94,386)		(n = 101,993)		(n = 91,805)		(n = 95,898)		(n = 96,688)		
Diagnostic radiology*	NAv		4.7
(4.5–5.0)		4.5
(4.3–4.7)		5.0
(4.8–5.3)		4.6
(4.3–4.8)		4.5
(4.3–4.7)		4.8
(4.5–5.0)		4.6
(4.4–4.8)		4.8
(4.6–5.0)		4.7
(4.5–5.0)	—	
Ultrasound*	NAv		2.1
(2.0–2.3)		2.5
(2.3–2.6)		2.6
(2.5–2.8)		2.7
(2.5–2.8)		2.7
(2.5–2.8)		2.9
(2.7–3.1)		3.2
(3.0–3.3)		3.4
(3.2–3.5)		3.6
(3.4–3.8)		
Computerised tomography*	NAv		0.7
(0.6–0.7)		0.8
(0.7–0.8)		0.8
(0.7–0.9)		0.8
(0.7–0.9)		1.0
(0.9–1.1)		1.0
(0.9–1.1)		1.1
(1.0–1.2)		1.2
(1.1–1.3)		1.3
(1.2–1.4)		
Nuclear medicine imaging*	NAv		0.1
(0.1–0.1)		0.1
(0.1–0.2)		0.1
(0.1–0.2)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)	—	
Magnetic resonance imaging*	NAv		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.0)		0.0Ŧ
(0.0–0.1)		0.0Ŧ
(0.0–0.0)		0.1
(0.0–0.1)		0.0Ŧ
(0.0–0.1)		0.1
(0.1–0.1)		0.1
(0.1–0.1)		
Total imaging tests	NAv		7.7
(7.3–8.0)		7.9
(7.6–8.2)		8.6
(8.2–9.0)		8.2
(7.8–8.6)		8.3
(8.0–8.6)		8.8
(8.4–9.2)		9.0
(8.6–9.3)		9.5
(9.2–9.9)		9.8
(9.4–10.2)		
(a)	Data collection method and coding system changed in the 1999–00 BEACH year. Data from 1999–00 is not comparable with subsequent years in regard to imaging groups.
(b)	The direction and type of change from 2000–01 to 2008–09 for imaging is indicated for each result: / indicates a statistically significant change and — indicates there was no change.
Ŧ	Rates are reported to one decimal place. This indicates that the rate is < 0.05 per 100 encounters.
*	Includes multiple ICPC-2 and ICPC-2 PLUS codes (see Appendix 4).
Note: CI—confidence interval; NAv—not available.

13	Practice nurse activity
This section investigates changes in the activities of practice nurses in association with the GP–patient encounters for the years 2005–06 to 2008–09.
In November 2004, four Medicare item numbers were introduced into the MBS that allowed GPs to claim for specified tasks undertaken by a practice nurse under the direction of the GP. The recording form for the 2005–06 BEACH year was amended to capture this information.
•	GPs were allowed to record multiple (up to three) Medicare item numbers where appropriate, rather than be limited to one item number.
•	In the ‘other treatments’ section, for each problem managed, GPs were asked to tick the ‘practice nurse’ box if the treatment recorded was provided by the practice nurse rather than by the GP. If the box was not ticked it was assumed the GP gave the treatment.
The survey form allowed GPs to record up to two other treatments for each problem managed at the encounter. Other treatments include all clinical and procedural treatments provided at the encounters. These groups are defined in Appendix 4.
Between November 2004 and March 2008 three new practice nurse items were added to the MBS. In November 2008 item 00711 was added, covering health checks done by practice nurses or Aboriginal health workers. This item was therefore only available to BEACH participants for the period November 2008—March 2009 inclusive.
The eight practice nurse Medicare items available during the 2008–09 BEACH data period are listed with a short description in Table 13.1.58 
This section investigates changes in:
•	the distribution of the Medicare items claimed for practice nurses 
•	treatments provided by practice nurses in association with the GP-recorded encounter
•	problems for which the practice nurse provided the treatment in direct association with the GP-recorded encounters.
In Chapter 10, all treatments (other than medications) recorded by the GPs were reported, irrespective of whether they were provided by the GP or by a practice nurse. As in previous years, injections recorded in the provision of immunisations and vaccinations were not included, as these are already counted as pharmacological management. In contrast, this section, being a description of practice nurse activity, reports only the activities indicated as being conducted by a practice nurse and includes the injections for immunisation/
vaccination that were not counted in Chapter 10. GPs are also instructed not to record their taking of routine clinical measurements, such as blood pressure. However, where the practice nurse undertook these activities at the consultation, and it was recorded as a practice nurse activity, they have been included in the analysis in this chapter.
When viewing these results, it must be remembered that these practice nurse data will not include activities undertaken by the practice nurse during the GP’s BEACH recording period that were outside (not associated with) the recorded encounter. Such activities could include Medicare-claimable activities (for example, immunisations/vaccinations) provided under instruction from the GP but not at the time of the encounter, or provision of other services not currently claimable from Medicare (for example, dietary advice to an individual or in a group situation).
13.1	Overview of practice nurse activity
Encounters involving a practice nurse as a proportion of all recorded encounters increased significantly from 4.2% in 2005–06 to 6.4% in 2008–09, an increase of about 50%. The number of problems for which the practice nurse was involved in the care provided at the encounter also increased significantly between 2005–06 (2.8%) and 2008–09 (4.2%). However, of those encounters at which the practice nurse activity was specified, the proportion said to be claimable from Medicare, remained constant over the 4 years, at 36–39% (Table 13.1). 
Extrapolation of these results to national Medicare claims for GP consultations in these years suggests that in 2008–09, practice nurses were actively involved in provision of care at about 7.2 million encounters, about 2.5 million more than in 2005–06.59
Table 13.1: Summary of practice nurse involvement at encounter, and claims made, BEACH,
2005–06 to 2008–09
	2005–06		2006–07		2007–08		2008–09	
Variable	Number		Number		Number		Number	
Total encounters 	101,993		91,805		95,898		96,688	
Encounters involving practice nurse 	4,295		4,769		5,791		6,183	
	Encounters at which practice nurse activity described	4,013		4,710		5,712		6,052	
	Encounters with practice nurse item number but activity 	not described	282		59		79		131	
Encounters at which one or more practice nurse item numbers were recorded as claimable 	1,683		1,823		2,060		2,416	
Total problems managed 	149,088		136,333		145,078		149,462	
Problems managed with practice nurse involvement	4,111		4,922		5,909		6,281	
Proportions	Per cent 
(95% CI)		Per cent 
(95% CI)		Per cent 
(95% CI)		Per cent 
(95% CI)	
Encounters involving the practice nurse as a proportion of total encounters 	4.2
(3.7–4.7)		5.2
(4.6–5.8)		6.0
(5.5–6.6)		6.4
(5.8–7.0)	
Practice nurse claimable encounters as a proportion of total encounters	1.7		2.0		2.1		2.5	
Proportion of practice nurse involved encounters for which one or more practice nurse item numbers were recorded 	39.2
(34.7–43.6)		38.2
(34.0–42.4)		35.6
(32.4–38.8)		39.1
(35.9–42.3)	
Problems involving the practice nurse as a proportion of total problems 	2.8
(2.4–3.1)		3.6
(3.2–4.1)		4.1
(3.7–4.5)		4.2
(3.8–4.6)	
Note: CI—confidence interval; some of these results may differ from those previously published. These data have been re-analysed for all years to include those encounters at which an item number was recorded but no practice nurse activity was described, in the count of total practice nurse activity.
13.2	Distribution of practice nurse item numbers claimed at encounters
The number of practice nurse item numbers claimed per 100 GP–patient encounters significantly increased from 1.7 items per 100 encounters in 2005–06 to 2.5 per 100 in 2008–09. Extrapolation of these results suggests that the BEACH sample represented about 1.7 million claimed practice nurse items in 2005–06 and about 2.8 million in 2008–09. Medicare data show there were 3.21 million such claims in 2005–06 and 5.44 million in 2008–09.59 The 
2005–06 BEACH sample represented about 53% of the practice nurse activity claimed from Medicare during that period and 59.0% in 2008–09. The balance of the Medicare claims for practice nurse items would be for services provided by the nurse independent of the GP–patient encounter.
There was no significant change in the distribution of practice nurse item numbers claimed for work associated with the BEACH encounters: about two-thirds accounted for by immunisation and about one-third by wound treatment, in each of the four data years. The combined uptake of all cervical smear item numbers did increase, from 0.5% in 2005–06 to 1.1% of these claims in 2008–09 (Table 13.2).
Table 13.2: Distribution of practice nurse item numbers recorded at encounter, BEACH, 2005–06 to 2008–09
Medicare item 
number		Per cent of total (95% CI)	
	Short descriptor	2005–06		2006–07		2007–08		2008–09	
		(n = 1,696)		(n = 1,835)		(n = 2,073)		(n = 2,438)	
10993	Immunisation	69.5
(63.8–75.3)		66.8
(61.5–72.2)		64.1
(59.6–68.6)		63.5
(59.0–68.1)	
10994(a)	Cervical smear and preventive checks	N/A		0.2
(0.0–0.5)		0.2
(0.0–0.4)		0.7
(0.1–1.2)	
10995(a)	Cervical smear and preventive checks—women 
20–69 years, no smear in past 4 years	N/A		0.1
(0.0–0.2)		0.1
(0.0–0.2)		0.4
(0.0–0.9)	
10996	Wound treatment (other than normal aftercare)	30.0
(24.3–35.7)		32.6
(27.2–40.0)		34.4
(30.0–38.8)		33.3
(29.1–37.5)	
10997(b)	Service provided to a person with a chronic disease by a practice nurse or registered Aboriginal Health Worker 	N/A		N/A		0.7
(0.2–1.2)		1.9
(0.9–2.9)	
10998(c)	Cervical smear	0		0.1
(0.0–0.3)		0.3
(0.2–0.5)		0.1
(0.0–0.2)	
10999(c)	Cervical smear—women 20–69 years, no smear in past 4 years	0.5
(0.0–0.9)		0.2
(0.0–0.4)		0.3
(0.0–0.8)		0.0	
00711(d)	Health check by a practice nurse or registered Aboriginal Health Worker	N/A		N/A		N/A		0.1
(0.0–0.2)	
Total practice nurse item numbers—rate per 100 total encounters	1.7
(1.4–2.0)		2.0
(1.7–2.3)		2.2 
(1.9–2.4)		2.5
(2.2–2.9)	
(a)	Item number introduced in November 2006.
(b)	Item number introduced in November 2007. 
(c)	Item numbers introduced in November 2004, but broadened in 2006, so they are not limited to services in rural areas.
(d)	Item number introduced in November 2008.
Note: N/A—Not applicable.
13.3	Treatments provided by practice nurses
The number of procedures (including tests undertaken) undertaken by practice nurses at 
GP–patient encounters rose significantly by 55%, from 4.0 per 100 encounters in 2005–06 to 6.4 per 100 in 2008–09. The practice nurses also took on an increasing proportion of the procedural work recorded at the encounters, from 22.7% to 30.4%. However, their provision of clinical treatments (such as advice and health education) at the GP–patient encounters remained infrequent (Table 13.3).
Table 13.3: Summary of treatments provided by practice nurse, BEACH, 2005–06 to 2008–09 
	Per cent of each activity that was performed/
assisted by the practice nurse (95% CI)		Rate per 100 encounters 
(95% CI)	
Treatment	2005–06	2006–07	2007–08	2008–09		2005–06
(n = 101,993)	2006–07
(n = 91,805)	2007–08
(n = 95,898)	2008–09
(n = 96,688)	
Procedural treatments(a)	22.7
(20.2–25.2)	28.1
(25.5–30.8)	29.7
(27.5–32.0)	30.4
(28.0–32.9)		4.0
(3.5–4.5)	5.2
(4.6–5.8)	6.1
(5.5–6.7)	6.4
(5.8–7.1)	
Clinical treatments	0.7
(0.5–0.9)	1.5
(0.9–2.2)	1.3
(1.0–1.6)	1.4
(1.1–1.6)		0.2
(0.1–0.3)	0.5
(0.3–0.6)	0.5
(0.4–0.6)	0.5
(0.4–0.6)	
All other treatments	9.0
(7.9–10.1)	11.8
(10.4–13.2)	11.9
(10.8–13.0)	12.5
(11.3–13.7)		4.2
(3.7–4.8)	5.7
(4.9–6.4)	6.5
(5.9–7.2)	6.9
(6.2–7.6)	
(a)	Procedural treatments here include all injections for immunisations/vaccinations. These are not included in the summary of the content of encounter in Table 5.1, summary of management in Table 8.1 or in the analyses of other treatments in Chapter 10, because the immunisation/vaccination is already counted as a prescription or GP-supplied medication.
Individual treatments 
On average, for every 100 encounters in which the practice nurse activity was described by the GP, the nurses undertook about 107–110 activities across all years. 
In terms of procedural treatments, increases were apparent in two specific areas, INR blood tests and check-ups. In 2005–06, these two actions could not be coded by the data entry staff as specific procedures. For 2006–07 such codes were introduced as possible practice nurse activities in response to the data recorded by the GPs in 2005–06. Between 2006–07 and 
2008–09, practice nurse INR tests increased from 1.8 per 100 encounters in which they were involved to 6.4 per 100, almost a three-fold increase. The extrapolated result suggests that nationally, practice nurses did about 450,000 INR tests at GP–patient encounters in 2008–09, about 350,000 more than in 2006–07. Over the same period practice nurse check-ups increased from 4.0 per 100 practice nurse encounters to 6.3 per 100 suggesting that nationally they did about 250,000 more check-ups in relation to GP–patient encounters in 2008–09 than they did 3 years earlier. 
In the area of clinical treatments only one clear change emerged. Administrative procedures (excluding provision of sickness certificates) done by practice nurses at GP–patient encounters increased from 0.7 to 2.3 per 100 practice nurse encounters, a 3-fold increase (Table 13.4).
13.4	Problems managed with practice nurse involvement 
The problems managed most often with the assistance of a practice nurse in association with the consultation were immunisation/vaccination, followed by laceration/cut, chronic skin ulcer, diabetes, and general check-up. There was little change in the rate of nurse involvement in most problems managed. The exception was their work associated with atrial fibrillation/flutter. Nurses were involved in the management of this problem at almost three times the rate in 2008–09 than in 2005–06. This increase in activity is clearly related to the increase in the number of INR tests (noted above) over the same period, as these tests are used for patients taking warfarin, usually those with atrial fibrillation (Table 13.5).
Table 13.4: Most frequent treatments provided by practice nurses, BEACH, 2005–06 to 2008–09
	Rate per 100 encounters where PN activity described(a) (95% CI)	
Treatment	2005–06		2006–07		2007–08		2008–09	
	(n = 4,013)		(n = 4,710)		(n = 5,712)		(n = 6,052)	
Procedural treatments (including tests)	102.2
(100.1–104.3)		101.3
(99.2–103.5)		102.3
(100.7–104.0)		102.5
(100.5–104.8)	
	Local injection/infiltration*	41.0 
(36.6–45.4)		37.3 
(33.0–41.6)		37.7 
(34.7–40.7)		38.2
(34.9–41.6)	
	Dressing/pressure/compression/tamponade*	23.7 
(21.3–26.2)		22.4 
(19.8–24.9)		20.7 
(18.7–22.8)		21.2
(19.2–23.3)	
	Incision/drainage/flushing/aspiration/removal body fluid*	8.1 
(6.2–10.0)		8.8 
(6.7–11.0)		6.8 
(5.6–7.9)		7.4
(6.0–8.8)	
	INR test	NAv		1.8 
(1.0–2.6)		4.9 
(3.6–6.2)		6.4 
(4.9–7.9)	
	Check-up—practice nurse*	NAv		4.0 
(2.3–5.6)		6.1 
(4.8–7.4)		6.3
(4.0–8.6)	
	Electrical tracings*	5.4 
(4.1–6.7)		4.5 
(3.7–5.2)		5.2 
(4.3–6.1)		4.4
(3.6–5.2)	
	Excision/removal tissue/biopsy/destruction/
debride/cauterise*	7.4 
(5.6–9.2)		5.7 
(4.2–7.2)		4.9 
(3.8–5.9)		4.3
(3.4–5.2)	
	Repair/fixation-suture/cast/prosthetic device (apply/remove)*	6.4 
(5.0–7.8)		6.0 
(5.0–7.0)		5.0 
(4.2–5.7)		4.3
(3.6–5.0)	
	Physical function tests*	3.9 
(2.6–5.3)		4.3 
(2.8–5.7)		3.5 
(2.3–4.7)		2.7
(2.0–3.4)	
	Urine test*	1.4 
(0.8–2.0)		1.4 
(0.8–2.0)		2.1 
(1.3–3.0)		1.7
(1.0–2.4)	
	Other procedures/minor surgery NEC*	0.9 
(0.5–1.3)		1.0 
(0.7–1.4)		1.5 
(1.0–2.0)		1.4
(0.8–2.0)	
	Glucose test	0.7 
(0.3–1.1)		1.0 
(0.4–1.5)		1.0 
(0.7–1.3)		1.0
(0.6–1.3)	
	Pap smear	0.3 
(0.0–0.6)		0.6 
(0.2–0.9)		0.5 
(0.3–0.8)		0.7
(0.1–1.3)	
	Pregnancy test*	0.3 
(0.1–0.6)		0.3 
(0.1–0.5)		0.5 
(0.3–0.8)		0.5 
(0.3–0.7)	
Clinical treatments	5.2 
(3.7–6.7)		8.9 
(5.6–12.1)		7.7 
(6.2–9.2)		7.4
(6.0–8.8)	
	Other administrative procedure*	0.7 
(0.4–1.0)		1.1 
(0.7–1.6)		2.0 
(1.4–2.6)		2.3
(1.6–3.0)	
	Advice/education—treatment * 	0.2 
(0.1–0.4)		0.9 
(0.5–1.3)		0.6 
(0.4–0.8)		0.9
(0.5–1.3)	
	Advice/education*	0.9 
(0.4–1.3)		1.5 
(0.6–2.4)		1.4 
(0.8–2.1)		0.8
(0.5–1.1)	
	Counselling/advice—nutrition/weight*	0.6 
(0.2–0.9)		1.2 
(0.2–2.1		0.5 
(0.1–0.9)		0.7
(0.4–1.1)	
	Counselling—problem*	0.9 
(0.2–1.5)		0.8 
(0.3–1.3)		0.6 
(0.3–0.8)		0.5
(0.2–0.7)	
All practice nurse activities at the encounter	107.4 
(105.0–108.9)		110.2 
(107.7–112.8)		110.0 
(108.4–111.6)		109.9
(108.1–111.6)	
(a)	Figures do not total 100, as more than one treatment can be performed by a practice nurse at each encounter, and only those individual
treatments accounting for >= 0.5% of total treatments by practice nurse are included.
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4).
Note: PN—practice nurse; CI—confidence interval; INR—International Normalised Ratio blood test; NEC—not elsewhere classified; NAv—data not available.
Table 13.5: The most common problems managed with the involvement of practice nurse, BEACH,
2005–06 to 2008–09
	Rate per 100 contacts with PN activity described (95% CI)	
Problem managed	2005–06		2006–07		2007–08		2008–09	
	(n = 4,013)		(n = 4,710)		(n = 5,712)		(n = 6,052)	
Immunisation/vaccination—all*	30.9 
(26.9–34.9)		30.8 
(26.5–35.0)		29.5 
(26.7–32.2)		29.5
(26.2–32.7)	
Laceration/cut	6.4 
(5.0–7.8)		6.2 
(5.2–7.2)		6.0 
(5.0–7.0)		6.4
(5.5–7.3)	
Chronic ulcer skin (including varicose ulcer)	6.8 
(5.6–8.0)		6.0 
(4.9–7.1)		4.7
(3.7–5.6)		5.9
(4.9–6.9)	
General check-up*	2.5 
(1.7–3.3)		3.1 
(2.2–3.9)		4.3 
(3.1–5.4)		3.7
(2.9–4.4)	
Atrial fibrillation/flutter	1.2
(0.6–1.7)		1.4 
(0.8–2.0)		2.8 
(2.0–3.6)		3.4
(2.6–4.3)	
Diabetes—all*	1.7 
(1.0–2.4)		2.5 
(1.8–3.1)		3.0 
(2.4–3.7)		3.1
(2.4–3.7)	
Malignant neoplasm skin	3.2 
(2.3–4.2)		2.9 
(2.1–3.8)		2.6 
(1.8–3.3)		2.6
(1.9–3.3)	
Excessive ear wax	2.2 
(1.6–2.9)		3.0 
(2.4–3.6)		2.8 
(2.2–3.4)		2.5
(2.0–3.0)	
Skin infection, post-traumatic	1.8 
(1.3–2.3)		1.7 
(1.2–2.2)		1.6 
(1.0–2.1)		1.9
(1.5–2.3)	
Hypertension*	1.1 
(0.6–1.5)		1.6 
(1.0–2.2)		1.8 
(1.2–2.3)		1.8
(1.2–2.4)	
Vitamin/nutritional deficiency	0.9
(0.5–1.3)		0.5
(0.3–0.8)		1.0
(0.6–1.4)		1.6
(1.2–2.1)	
Blood test blood/lymph	0.2
(0.1–0.4)		0.6
(0.1–1.1)		0.7
(0.4–1.0)		1.1
(0.5–1.7)	
Asthma	1.5 
(1.0–2.0)		2.3 
(1.6–3.0)		1.2 
(0.9–1.6)		1.1
(0.7–1.5)	
Boil/carbuncle	0.6
(0.4–0.9)		0.8
(0.5–1.1)		0.9
(0.5–1.2)		1.1
(0.7–1.4)	
Abrasion/scratch/blister	1.2 
(0.7–1.6)		0.7 
(0.4–1.0)		1.2 
(0.6–1.7)		0.8
(0.5–1.0)	
Repair/fixate-suture/cast/prosthetic device (apply/remove)	1.2 
(0.7–1.8)		1.2 
(0.7–1.6)		1.1 
(0.8–1.5)		0.8
(0.5–1.1)	
Burns/scalds	0.9 
(0.5–1.3)		1.2 
(0.8–1.7)		1.1 
(0.8–1.4)		0.9
(0.6–1.2)	
Skin complaint	1.2
(0.7–1.7)		1.2 
(0.8–1.7)		1.0 
(0.7–1.3)		0.9
(0.6–1.2)	
Contraception, other than oral	1.1 
(0.6–1.5)		0.5 
(0.3–0.8)		0.9 
(0.6–1.2)		0.8
(0.5–1.0)	
Fracture	1.1 
(0.7–1.5)		1.0 
(0.6–1.5)		0.8 
(0.5–1.0)		0.5
(0.3–0.7)	
Injury skin NEC	1.0 
(0.6–1.4)		0.6 
(0.3–0.9)		0.4 
(0.2–0.6)		0.4
(0.2–0.6)	
Total problems	102.4 
(101.7–103.2)		104.5
(103.3–105.8)		103.4 
(102.7–104.2)		103.8
(103.1–104.5)	
*	Includes multiple ICPC-2 or ICPC-2 PLUS codes (see Appendix 4). 
Note: CI—confidence interval; NEC—not elsewhere classified.
14	Patient risk factors
General practice is a useful intervention point for health promotion because about 88% of Australians visit a GP at least once each year.8 GPs, through ongoing professional education, have substantial knowledge of population health, screening programs and other interventions. They are also in an ideal position to advise patients about the benefits of health screening, and to counsel patients about their lifestyle choices on an individual basis. 
Since April 1998, a section on the bottom of each encounter form has been used to investigate aspects of patient health or health care delivery not covered by general practice encounter-based information. These additional substudies are referred to as Supplementary Analysis of Nominated Data (SAND). The SAND methods are described in Chapter 2. 
The patient risk factors measured include self-reported height and weight (for calculation of BMI), alcohol consumption and smoking status. Patient risk factors are investigated for a subsample of 40 of the 100 patient encounters recorded by each GP. An example of the encounter form with the patient risk factor SAND questions is included in Appendix 1. The methods used for investigating patient risk factors are described in 
Section 2.4.
Abstracts of results and the research tools used in all SAND substudies from April 1998 to March 2009 have been published. Those from:
•	April 1998–99 were published in Measures of health and health care delivery in general practice in Australia11
•	April 1999 to July 2006 were published in Patient-based substudies from BEACH: abstracts and research tools 1999–200612
•	August 2006 to March 2007 were published in General practice activity in Australia
 2006–0713
•	April 2007 to January 2008 were published in General practice activity in Australia 
2007–0810
•	February 2008 to January 2009 are included in Chapter 15 of the companion report General practice activity in Australia 2008–09.1
This chapter includes data about the risk behaviours of general practice patients from each of the 10 years of the BEACH study from 1999–00 to 2008–09. The direction and type of change from 1999–00 to 2008–09 is indicated for each result in the far right column of the tables: / indicates a statistically significant linear change, / indicates a marginally significant linear change, § indicates a non-linear significant or marginal change, and — indicates there was no change.
The results of the patient risk factors, BMI and smoking status are presented in tables 14.1 to 14.3 for each year from 1999–00 to 2008–09. Results for alcohol consumption are presented for each year from 2001–02 to 2008–09, as data from 1999–00 and 2000–01 are not comparable.

Patient BMI and alcohol consumption data collected in the BEACH study have been investigated in further detail and published. Interested readers can consult these publications for further information:
•	prevalence of the three WHO defined levels of obesity was published in Chapter 7 of the AGPSCC publication General practice in Australia, health priorities and policies 1998 to 2008.60
•	overweight and obesity in children attending general practice was publishes in Cretikos et al. (2008).61
•	the relationship between morbidity managed and alcohol consumption is reported in Proude et al. (2006).62
14.1	Body mass index
Adults
Overall the rates of overweight and obesity in adults attending general practice has increased significantly from approximately 50% in 1999–00 (52.5%; 95% CI: 51.7–53.4) to 60% in 2008–09 (61.5%; 95% CI: 61.6–62.3) (results not tabulated).
Taken individually, there was a significant increase in the prevalence of overweight and obesity in adults attending general practice, from 33.1% and 19.4%, respectively, in 1999–00 to 36.1% and 25.4% in 2008–09 (Table 14.1). The significant increases in overweight and obesity are apparent in both male and female patients. The increase is largely due to an increase in prevalence of obesity, the rates of overweight only increasing by a much smaller amount (tables 14.2 and 14.3).
Children
In contrast, the rates of overweight and obesity in children aged 2–17 years have remained static from 1999–00 to 2008–09, with about 11% of children being obese and about 17% overweight (Table 14.1).
14.2	Smoking
There was a significant decrease in the rates of current daily and occasional smoking in adults aged 18 years and over, from 18.9% and 5.2%, respectively, in 1999–00 to 15.3% and 2.6% in 2008–09 (Table 14.1). This decrease was apparent in both male and female patients (tables 14.2 and 14.3).
14.3	Alcohol consumption
The rates of at-risk levels of alcohol consumption among adults at general practice encounters have remained static at around 26% of adult patients from 2001–02 to 2008–09 (Table 14.1).

Table 14.1: Comparative results for all patient risk factors, BEACH, 1999–00 to 2008–09
Risk factor	Per cent (95% CI)	 (a)
 	
	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09		
Adults (aged 18 years and over)																				
BMI class(b) (n)	(33,069)		(31,957)		(31,789)		(32,367)		(31,890)		(30,476)		(33,101)		(32,334)		(31,062)		(33,526)		
	Obese	19.4
(18.8–20.0)		20.2
(19.5–20.8)		21.5
(20.8–22.2)		20.9
(20.2–21.5)		22.1
(21.4–22.7)		22.4
(21.7–23.2)		22.2
(21.5–22.9)		23.5
(22.7–24.2)		23.9
(23.1–24.6)		25.4
(24.7–26.1)		
	Overweight	33.1
(32.5–33.8)		34.1
(33.4–34.7)		33.5
(32.9–34.1)		33.8
(33.2–34.5)		34.5
(33.8–35.1)		34.6
(33.9–35.2)		34.6
(33.9–35.2)		35.0
(34.3–35.6)		35.4
(34.7–36.0)		36.1
(35.5–36.7)		
	Normal	44.3
(43.5–45.1)		42.8
(42.0–43.7)		42.1
(41.3–42.9)		42.4
(41.6–43.3)		40.7
(39.9–41.6)		40.3
(39.5–41.2)		40.5
(39.7–41.4)		39.0
(38.1–39.8)		38.3
(37.4–39.2)		36.1
(35.3–36.8)		
	Underweight	3.2
(3.0–3.5)		2.9
(2.7–3.1)		3.0
(2.8–3.2)		2.9
(2.7–3.1)		2.8
(2.6–3.0)		2.7
(2.5–2.9)		2.8
(2.5–3.0)		2.6
(2.4–2.8)		2.5
(2.3–2.7)		2.5
(2.3–2.7)		
Smoking status (n)	(32,483)		(32,124)		(31,966)		(32,651)		(32,718)		(31,295)		(33,558)		(31,176)		(31,652)		(34,194)		
	Daily	18.9
(18.1–19.6)		19.3
(18.5–20.1)		18.4
(17.7–19.2)		17.2
(16.5–17.9)		17.6
(16.8–18.3)		18.0
(17.2–18.7)		17.1
(16.3–17.8)		16.1
(15.4–16.9)		16.5
(15.8–17.3)		15.3
(14.6–15.9)		
	Occasional	5.2
(4.9–5.6)		4.4
(4.0–4.7)		4.1
(3.8–4.4)		4.1
(3.8–4.4)		4.3
(4.0–4.7)		3.7
(3.4–4.0)		3.6
(3.4–3.9)		3.2
(2.9–3.4)		2.9
(2.7–3.2)		2.6
(2.4–2.9)		
	Previous	27.1
(26.3–27.8)		27.3
(26.5–28.1)		27.8
(27.0–28.6)		27.2
(26.5–28.0)		28.0
(27.3–28.8)		28.0
(27.2–28.8)		27.1
(26.3–27.8)		28.8
(28.0–29.6)		27.9
(27.1–28.6)		28.8
(28.1–29.6)	—	
	Never	48.8
(47.9–49.7)		49.1
(48.1–50.1)		49.7
(48.7–50.7)		51.4
(50.4–52.4)		50.1
(49.1–51.0)		50.3
(49.4–51.3)		52.3
(51.3–53.2)		51.9
(50.9–52.9)		52.7
(51.7–53.6)		53.3
(52.4–54.2)		
Alcohol consumption(c) (n)	..		..		(31,559)		(32,140)		(31,721)		(30,414)		(32,753)		(30,347)		(30,796)		(33,347)		

	At-risk alcohol level	NAv		NAv		26.0
(25.1–26.8)		26.2
(25.3–27.1)		26.7
(25.8–27.6)		26.4
(25.5–27.3)		25.9
(25.0–26.8)		27.0
(26.1–28.0)		26.2
(25.3–27.1)		25.2
(24.3–26.0)	—	

	Responsible drinker	NAv		NAv		44.1
(43.3–45.0)		44.2
(43.4–45.1)		44.9
(44.1–45.8)		44.9
(44.0–45.7)		44.8
(44.0–45.7)		44.6
(43.7–45.5)		44.6
(43.7–45.5)		45.2
(44.3–46.1)	—	
	Non-drinker	NAv		NAv		29.9
(28.9–30.9)		29.5
(28.5–30.6)		28.4
(27.3–29.4)		28.7
(27.7–29.8)		29.3
(28.2–30.4)		28.3
(27.3–29.4)		29.3
(28.2–30.3)		29.6
(28.6–30.7)	—	
(continued)
Table 14.1 (continued): Comparative results for all patient risk factors, BEACH, 1999–00 to 2008–09
	Per cent (95% CI)	 (a)
 	
Risk factor	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09		

Children (aged 2–17 years)(d) (n)	(4,053)		(3,610)		(3,518)		(3,380)		(3,189)		(3,018)		(3,338)		(3,087)		(3,046)		(2,970)		

	Obese	10.4
(9.3–11.5)		11.4
(10.1–12.6)		10.9
(9.7–12.1)		11.9
(10.5–13.2)		11.8
(10.5–13.2)		10.8
(9.5–12.2)		10.9
(9.7–12.1)		10.6
(9.3–11.9)		11.2
(10.0–12.5)		10.5
(9.3–11.7)	—	
	Overweight	17.4
(16.3–18.6)		17.8
(16.5–19.2)		17.9
(16.5–19.3)		18.3
(16.9–19.6)		19.2
(17.7–20.7)		17.7
(16.3–19.1)		17.9
(16.5–19.2)		18.6
(17.2–20.0)		17.1
(15.7–18.5)		16.7
(15.3–18.2)	—	
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, and — indicates there was no change.
(b)	Adult patients aged 18+ with a recorded height outside the ABS height range based on age and sex were excluded.
(c)	From 2001–02 onwards, the wording of the responses to the first and third alcohol questions was amended to exactly reflect the AUDIT instrument from which they are derived. Therefore data from 2000–01 are not directly comparable with data from 2001–02 onwards.
(d)	Children with height outside the ABS height range based on age and sex were excluded. Child BMI has been re-calculated for 1999–00 to 2005–06 and will differ from data previously published to incorporate this exclusion and to apply a more precise method for calculating child BMI.
Note: CI—confidence interval; BMI—body mass index; NAv—not available.

Table 14.2: Comparative results for adult male patient risk factors, BEACH, 1999–00 to 2008–09 
	Per cent (95% CI)	 (a)
 	
Risk factor	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09		
BMI class(b) (n)	(13,062)		(12,800)		(12,512)		(12,450)		(12,434)		(12,288)		(12,882)		(12,715)		(12,126)		(13,595)		
	Obese	18.1
(17.3–19.0)		19.2
(18.4–20.1)		20.0
(19.1–20.9)		19.9
(19.1–20.8)		20.7
(19.8–21.5)		21.3
(20.4–22.3)		21.6
(20.7–22.5)		22.4
(21.6–23.3)		23.1
(22.1–24.1)		25.0
(24.1–26.0)		
	Overweight	40.9
(39.9–41.8)		41.0
(39.9–41.8)		41.0
(40.0–42.0)		41.5
(40.5–42.4)		42.3
(41.3–43.2)		42.0
(41.0–43.0)		42.6
(41.6–43.6)		42.3
(41.4–43.3)		43.0
(42.0–44.0)		43.6
(42.7–44.6)		
	Normal	39.4
(38.3–40.4)		38.2
(37.0–39.3)		37.4
(36.3–38.6)		37.2
(36.2–38.3)		35.6
(34.5–36.7)		35.3
(34.2–36.5)		34.3
(33.3–35.4)		34.0
(32.9–35.1)		32.7
(31.6–33.8)		30.3
(29.3–31.4)		
	Underweight	1.6
(1.4–1.9)		1.6
(1.4–1.9)		1.5
(1.3–1.8)		1.4
(1.1–1.6)		1.5
(1.3–1.7)		1.4
(1.1–1.6)		1.5
(1.3–1.7)		1.2
(1.0–1.4)		1.2
(1.0–1.4)		1.0
(0.8–1.2)	—	
Smoking status (n)	(12,230)		(12,869)		(12,547)		(12,521)		(12,692)		(12,613)		(13,016)		(12,257)		(12,335)		(13,841)		
	Daily	23.4
(22.3–24.5)		22.6
(21.5–23.7)		21.6
(20.5–22.6)		20.4
(19.4–21.4)		21.0
(20.0–22.0)		21.2
(20.2–22.3)		20.7
(19.7–21.8)		19.4
(18.3–20.5)		19.8
(18.8–20.8)		18.1
(17.2–19.0)		
	Occasional	5.4
(4.9–5.9)		4.4
(4.0–4.9)		4.6
(4.1–5.1)		4.5
(4.0–5.0)		4.5
(4.0–4.9)		4.3
(3.9–4.7)		4.1
(3.7–4.6)		3.8
(3.4–4.2)		3.3
(2.9–3.7)		3.0
(2.6–3.4)		
	Previous	36.3
(35.1–37.4)		36.5
(35.2–37.8)		36.6
(35.4–37.9)		36.4
(35.2–37.6)		37.3
(36.2–38.5)		36.5
(35.3–37.6)		35.7
(34.5–36.9)		37.1
(35.8–38.4)		36.5
(35.3–37.7)		37.9
(36.8–39.1)	—	
	Never	35.0
(33.9–36.1)		36.5
(35.3–37.7)		37.2
(36.0–38.4)		38.7
(37.5–40.0)		37.2
(36.0–38.4)		38.0
(36.8–39.2)		39.5
(38.2–40.7)		39.7
(38.5–41.0)		40.4
(39.2–41.6)		41.0
(39.8–42.2)		
Alcohol consumption(c) (n)	..		..		(12,464)		(12,391)		(12,334)		(12,294)		(12,792)		(12,005)		(12,071)		(13,583)		
	At-risk alcohol level	NAv		NAv		32.0
(30.8–33.2)		32.8
(31.6–34.1)		33.1
(31.9–34.3)		32.6
(31.3–33.8)		31.6
(30.3–32.8)		32.5
(31.2–33.8)		31.7
(30.5–32.9)		30.1
(28.9–31.2)	—	
	Responsible drinker	NAv		NAv		46.8
(45.7–48.0)		46.6
(45.5–47.8)		47.3
(46.1–48.5)		47.7
(46.4–48.9)		47.9
(46.7–49.1)		48.0
(46.7–49.2)		47.6
(46.4–48.8)		48.9
(47.8–50.1)	—	
	Non-drinker	NAv		NAv		21.2
(20.1–22.2)		20.5
(19.5–21.5)		19.6
(18.5–20.7)		19.8
(18.7–20.9)		20.5
(19.4–21.6)		19.5
(18.5–20.6)		20.7
(19.6–21.8)		21.0
(20.0–22.0)	—	
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, and — indicates there was no change.
(b)	Adult patients aged 18+ with a recorded height outside the ABS height range based on age and sex were excluded.
(c)	From 2001–02 onwards, the wording of the responses to the first and third alcohol questions was amended to exactly reflect the AUDIT instrument from which they are derived. Therefore data from 2000–01 are not directly comparable with data from 2001–02 onwards.	Note: CI—confidence interval; BMI—body mass index; NAv—not available.
Table 14.3: Comparative results for adult female patient risk factors, BEACH, 1999–00 to 2008–09
	Per cent (95% CI)	 (a)
 	
Risk factor	1999–00		2000–01		2001–02		2002–03		2003–04		2004–05		2005–06		2006–07		2007–08		2008–09		
BMI class(b) (n)	(19,655)		(18,820)		(19,039)		(19,670)		(19,214)		(17,976)		(19,976)		(19,410)		(18,703)		(19,671)		
	Obese	20.2
(19.5–21.0)		20.8
(20.0–21.6)		22.4
(21.6–23.2)		21.5
(20.7–22.3)		23.0
(22.1–23.8)		23.2
(22.4–24.1)		22.6
(21.7–23.4)		24.2
(23.3–25.1)		24.3
(23.5–25.2)		25.6
(24.8–26.4)		
	Overweight	27.9
(27.2–28.7)		29.4
(28.6–30.1)		28.5
(27.8–29.3)		29.0
(28.2–29.8)		29.4
(28.6–30.1)		29.3
(28.6–30.1)		29.3
(28.6–30.0)		30.1
(29.4–30.9)		30.4
(29.7–31.2)		30.9
(30.2–31.6)		
	Normal	47.6
(46.6–48.5)		46.0
(45.0–47.0)		45.2
(44.2–46.1)		45.7
(44.7–46.8)		44.1
(43.1–45.1)		43.8
(42.7–44.8)		44.6
(43.6–45.6)		42.2
(41.2–43.2)		41.9
(40.9–43.0)		40.0
(39.1–41.0)		
	Underweight	4.3
(4.0–4.6)		3.8
(3.5–4.1)		3.9
(3.6–4.2)		3.8
(3.5–4.2)		3.6
(3.3–3.9)		3.6
(3.3–4.0)		3.5
(3.2–3.8)		3.5
(3.2–3.8)		3.3
(3.0–3.6)		3.4
(3.2–3.7)		
Smoking status (n)	(19,930)		(18,920)		(19,182)		(19,875)		(19,780)		(18,468)		(20,288)		(18,718)		(19,081)		(20,079)		
	Daily	16.2
(15.4–16.9)		17.1
(16.3–17.9)		16.4
(15.6–17.2)		15.2
(14.4–15.9)		15.4
(14.6–16.1)		15.7
(15.0–16.5)		14.7
(14.0–15.4)		14.0
(13.3–14.8)		14.4
(13.7–15.2)		13.3
(12.6–14.0)		
	Occasional	5.1
(4.7–5.4)		4.3
(4.0–4.7)		3.8
(3.4–4.1)		3.9
(3.5–4.3)		4.2
(3.9–4.6)		3.3
(3.0–3.7)		3.3
(3.0–3.6)		2.7
(2.5–3.0)		2.6
(2.4–2.9)		2.4
(2.2–2.7)		
	Previous	21.4
(20.7–22.2)		20.9
(20.0–21.7)		22.0
(21.2–22.9)		21.5
(20.7–22.3)		22.0
(21.2–22.8)		22.2
(21.3–23.0)		21.5
(20.7–22.3)		23.3
(22.5–24.2)		22.3
(21.4–23.1)		22.5
(21.7–23.3)	—	
	Never	57.4
(56.3–58.4)		57.7
(56.6–58.8)		57.8
(56.7–58.9)		59.4
(58.3–60.5)		58.4
(57.3–59.5)		58.8
(57.7–59.9)		60.5
(59.5–61.6)		59.9
(58.8–61.0)		60.7
(59.6–61.7)		61.7
(60.7–62.7)		
Alcohol consumption(c) (n)	..		..		(19,095)		(19,749)		(19,387)		(18,120)		(19,961)		(18,342)		(18,715)		(19,764)		
	At-risk alcohol level	NAv		NAv		22.0
(21.1–22.9)		22.1
(21.2–23.0)		22.6
(21.7–23.6)		22.2
(21.3–23.2)		22.2
(21.3–23.2)		23.5
(22.5–24.5)		22.6
(21.6–23.6)		21.8
(20.8–22.7)	—	
	Responsible drinker	NAv		NAv		42.4
(41.3–43.4)		42.7
(41.7–43.8)		43.5
(42.4–44.5)		43.0
(41.9–44.0)		42.8
(41.8–43.9)		42.4
(41.3–43.5)		42.6
(41.6–43.7)		42.6
(41.6–43.7)	—	
	Non-drinker	NAv		NAv		35.6
(34.4–36.9)		35.2
(33.9–36.5)		33.9
(32.7–35.2)		34.8
(33.4–36.2)		35.0
(33.6–36.3)		34.1
(32.8–35.4)		34.8
(33.5–36.1)		35.6
(34.3–36.9)	—	
(a)	The direction and type of change is indicated for each result: / indicates a statistically significant change, / indicates a marginally significant change, and — indicates there was no change.
(b)	Adult patients aged 18+ with a recorded height outside the ABS height range based on age and sex were excluded. 
(c)	From 2001–02 onwards, the wording of the responses to the first and third alcohol questions was amended to exactly reflect the AUDIT instrument from which they are derived. Therefore data from 2000–01 are not directly comparable with data from 2001–02 onwards.	Note: CI—confidence interval; BMI—body mass index; NAv—not available.

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	27. 	Britt H 1997. A new coding tool for computerised clinical systems in primary care–ICPC PLUS. Aust Fam Physician 26(Suppl 2):S79–S82.
	28. 	Bridges-Webb C, Britt H, Miles DA, Neary S, Charles J, Traynor V 1992. Morbidity and treatment in general practice in Australia 1990–1991. Med J Aust 157(19 Oct Spec Sup):S1–S56.
	29. 	O'Halloran J, Miller GC, Britt H 2004. Defining chronic conditions for primary care with ICPC–2. Fam Pract 21(4):381–6.
	30. 	World Health Organization Collaborating Centre for Drug Statistics Methodology 1997. Anatomical Therapeutic Chemical (ATC) classification index with Defined Daily Doses (DDDs). January 1998 edn. Oslo: WHO.
	31. 	Britt H, Miller G, Bayram C 2007. The quality of data on general practice – a discussion of BEACH reliability and validity. Aust Fam Physician 36(1–2):36–40.
	32. 	Driver B, Britt H, O'Toole B, Harris M, Bridges-Webb C, Neary S 1991. How representative are patients in general practice morbidity surveys? Fam Pract 8(3):261–8.
	33. 	Britt H, Harris M, Driver B, Bridges-Webb C, O'Toole B, Neary S 1992. Reasons for encounter and diagnosed health problems: convergence between doctors and patients. Fam Pract 9(2):191–4.
	34. 	Britt H 1998. Reliability of central coding of patient reasons for encounter in general practice, using the International Classification of Primary Care. Journ Informatics in Prim Care May:3–7.
	35. 	Britt H 1997. A measure of the validity of the ICPC in the classification of reasons for encounter. Journ Informatics in Prim Care Nov:8–12.
	36. 	Bentsen BG 1976. The accuracy of recording patient problems in family practice. J Med Educ 51(4):311–6.
	37. 	Barsky AJ, III 1981. Hidden reasons some patients visit doctors. Ann Intern Med 94
(4 pt 1):492–8.
	38. 	Morrell DC, Gage HG, Robinson NA 1971. Symptoms in general practice. J R Coll Gen Pract 21(102):32–43.
	39. 	Anderson JE 1980. Reliability of morbidity data in family practice. J Fam Pract 10(4):677–83.
	40. 	Marsland DW, Wood M, Mayo F 1980. Content of family practice. New York: Appleton-Century-Crofts.
	41. 	Bensing J 1983 The use of the RFE classification system in observation studies – some preliminary results. Presented at the The Tenth WONCA Conference on Family Medicine; 1983.
	42. 	Howie JG 1972. Diagnosis–the Achilles heel? J R Coll Gen Pract 22(118):310–5.
	43. 	Alderson M 1988. Morbidity and health statistics. 1st edn. Southampton: Stickton Press.
	44. 	Crombie DL 1990. The problem of variability in general practitioner activities. In: Yearbook of research and development. London: Her Majesty's Stationary Office, 
21–24.
	45. 	Britt H, Bhasale A, Miles DA, Meza A, Sayer GP, Angelis M 1996. The sex of the general practitioner: a comparison of characteristics, patients, and medical conditions managed. Med Care 34(5):403–15.
	46. 	Knottnerus JA 1991. Medical decision making by general practitioners and specialists. Fam Pract 8(4):305–7.
	47. 	Britt H, Meza RA, Del Mar C 1996. Methodology of morbidity and treatment data collection in general practice in Australia: a comparison of two methods. Fam Pract 13(5):462–7.
	48. 	Gehlbach SH 1979. Comparing methods of data collection in an academic ambulatory practice. J Med Educ 54(9):730–2.
	49. 	Britt H, Angelis M, Harris E 1998. The reliability and validity of doctor-recorded morbidity data in active data collection systems. Scand J Prim Health Care 16(1):50–5.
	50. 	Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C et al. 2008. General practice activity in Australia 1998–99 to 2007–08: 10 year data tables. General practice series no. 23. Cat. no. GEP 23. Canberra: Australian Institute of Health and Welfare.
	51. 	Charles J, Britt H, Valenti L 2004. The evolution of the general practice workforce in Australia, 1991–2003. Med J Aust 181(2):85–90.
	52. 	Britt H & Harrison C 2009. GP clinical activity. In: Britt H, Miller GC (eds). General practice in Australia, health priorities and policies 1998 to 2008. General practice series no. 24. Cat. no. GEP 24. Canberra: Australian Institute of Health and Welfare, 38–56.
	53. 	McWhinney IR 1986. Are we on the brink of a major transformation of clinical method? CMAJ 135(8):873–8.
	54. 	Britt H, Miller GC, McGeechan K, Sayer GP 1999. Pathology ordering by general practitioners in Australia 1998. Cat. no. GEP 4. General practice series no. 4. Canberra: Department of Health and Aged Care. Viewed 4 September 2008, <pandora.nla.gov.au/pan/31109/20021113-0000/www.health.gov.au/
haf/docs/pathorder.htm>.
	55. 	Britt H, Miller GC, Knox S 2001. Imaging orders by general practitioners in Australia 1999–00. General Practice Series No 7. Cat. no. GEP 7. Canberra: Australian Institute of Health and Welfare.
	56. 	Britt H, Knox S, Miller GC 2003. Changes in pathology ordering by general practitioners in Australia 1998–2001. General practice series no. 13. Cat. no. GEP 13. Canberra: Australian Institute of Health and Welfare.
	57. 	Bayram C & Valenti L 2009. GP pathology ordering. In: Britt H, Miller GC (eds). General practice in Australia, health priorities and policies 1998 to 2008. General practice series no. 24. Cat. no. GEP 24. Canberra: Australian Institute of Health and Welfare, 57–86.
	58. 	Australian Government Department of Health and Ageing 2007. Medicare Benefits Schedule Book. Canberra: DoHA.
	59. 	Medicare Australia 2009. Health statistics, Medicare Benefits Schedule. Canberra: Medicare Australia. Viewed 24 August 2009, <www.medicareaustralia.gov.au/statistics/mbs_item.shtml>.
	60. 	Valenti L 2009. Overweight and obesity. In: Britt H, Miller GC (eds). General practice in Australia, health priorities and policies 1998 to 2008. General practice series no. 24. Cat. no. GEP 24. Canberra: Australian Institute of Health and Welfare, 105–120.
	61. 	Cretikos MA, Valenti L, Britt HC, Baur LA 2008. General practice management of overweight and obesity in children and adolescents in Australia. Med Care 46(11):1163–9.
	62. 	Proude EM, Britt H, Valenti L, Conigrave KM 2006. The relationship between self-reported alcohol intake and the morbidities managed by GPs in Australia. BMC Fam Pract 7:17.

Glossary
A1 Medicare items: Medicare item numbers 1, 2, 3, 4, 13, 19, 20, 23, 24, 25, 33, 35, 36, 37, 38, 40, 43, 44, 47, 48, 50, 51, 601, 602.
Aboriginal: The patient identifies himself or herself as an Aboriginal person.
Activity level: The number of general practice A1 Medicare items claimed during the previous 3 months by a participating GP.
Allied and other health professionals: Those who provide clinical and other specialised services in the management of patients, including physiotherapists, occupational therapists, dietitians, dentists and pharmacists.
Chapters (ICPC-2): The main divisions within ICPC-2. There are 17 chapters primarily representing the body systems.
Chronic problem: see Diagnosis/problem, Chronic problem.
Commonwealth concession card: An entitlement card provided by the Australian Government that entitles the holder to reduced cost medicines under the Pharmaceutical Benefits Scheme and a limited number of other concessions from state and local government authorities.
Complaint: A symptom or disorder expressed by the patient when seeking care.
Component (ICPC-2): In ICPC-2 there are seven components which act as a second axis across all chapters.
Consultation: See Encounter.
Diagnosis/problem: A statement of the provider’s understanding of a health problem presented by a patient, family or community. GPs are instructed to record at the most specific level possible from the information available at the time. It may be limited to the level of symptoms.
•	New problem: The first presentation of a problem, including the first presentation of a recurrence of a previously resolved problem, but excluding the presentation of a problem first assessed by another provider.
•	Old problem: A previously assessed problem that requires ongoing care, including follow‑up for a problem or an initial presentation of a problem previously assessed by another provider.
•	Chronic problem: A medical condition characterised by a combination of the following characteristics: duration that has lasted or is expected to last 6 months or more, a pattern of recurrence or deterioration, a poor prognosis, and consequences or sequelae that impact on an individual’s quality of life. (Source: O’Halloran J, Miller GC, Britt H 2004. Defining chronic conditions for primary care with ICPC-2. Fam Pract 21(4):381–6). 
•	Work-related problem: Irrespective of the source of payment for the encounter, it is likely in the GP’s view that the problem has resulted from work-related activity or workplace exposures or that a pre-existing condition has been significantly exacerbated by work activity or workplace exposure.
Encounter (enc): Any professional interchange between a patient and a GP.
•	Indirect: Encounter where there is no face-to-face meeting between the patient and the GP but a service is provided (for example prescription, referral).
•	Direct: Encounter where there is a face-to-face meeting of the patient and the GP.
Direct encounters can be further divided into:
–	Medicare-claimable
▪	Surgery consultations: Encounters identified by any one of MBS item numbers 3, 23, 36, 44, 52, 53, 54, 57, 5000, 5020, 5040, 5060, 5200, 5203, 5207, 5208.
▪	Home visits: Encounters identified by any one of MBS item numbers 4, 24, 37, 47, 58, 59, 60, 65, 5003, 5023, 5043, 5063, 5220, 5223, 5227, 5228.
▪	Hospital encounters: Encounters identified by any one of MBS item numbers 19, 33, 40, 50, 87, 89, 90, 91.
▪	Residential aged care facility: Encounters identified by any one of MBS item numbers 20, 35, 43, 51, 92, 93, 95, 96, 5010, 5028, 5049, 5067, 5260, 5263, 5265, 5267.
▪	Health assessments: Encounters identified by any one of MBS item numbers 700, 702, 704, 706, 708, 710, 712.
▪	Chronic disease management items: Encounters identified by any one of MBS item numbers 720, 721, 722, 723, 724, 725, 726, 727, 728, 729, 730, 731.
▪	Case conferences: Encounters identified by any one of MBS item numbers 734, 736, 738, 740, 742, 744, 746, 749, 757, 759, 762, 765, 768, 771, 773, 775, 778, 779.
▪	Incentive payments: Encounters identified by any one of MBS item numbers 2497, 2501, 2503, 2504, 2506, 2507, 2509, 2517, 2518, 2521, 2522, 2525, 2526, 2546, 2547, 2552, 2553, 2558, 2559, 2574, 2575, 2577, 2578, 2598, 2600, 2603, 2606, 2610, 2613, 2616, 2620, 2622, 2624, 2631, 2633, 2635, 2664, 2666, 2668, 2673, 2675, 2677, 2704, 2705, 2707, 2708.
▪	Other MBS encounters: Encounters identified by an MBS item number that does not identify place of encounter (see A1 Medicare items).
–	Workers compensation: Encounters paid by workers compensation insurance.
–	Other paid: Encounters paid from another source (for example state).
General practitioner (GP): A medical practitioner who provides primary comprehensive and continuing care to patients and their families within the community (Royal Australian College of General Practitioners).
GP Consultation Service Items: Includes GP services provided under the MBS Professional services category including MBS items classed as A1, A2, A5, A6, A7, A14, A17, A18, A19, A20, A22 and selected items provided by GPs classified in A11, A15 and A27.
Medication: Medication that is prescribed, provided by the GP at the encounter or advised for over-the-counter purchase.
Medication rates: The rate of use of all medications, including medications that were prescribed, supplied by the GP and advised for over-the-counter purchase.
Medication status:
•	New: The medication prescribed/provided at the encounter/advised is being used for the management of the problem for the first time.
•	Continuation: The medication prescribed/provided at the encounter/advised is a continuation or repeat of previous therapy for this problem.
•	Old: See Continuation.
Morbidity: Any departure, subjective or objective, from a state of physiological wellbeing. In this sense, sickness, illness and morbid conditions are synonymous.
Patient status: The status of the patient to the practice.
•	New patient: The patient has not been seen before in the practice.
•	Old patient: The patient has attended the practice before.
Practice nurse involvement: Encounters at which a practice nurse MBS item number and/or a treatment (either clinical or procedural) was recorded as done by the practice nurse.
Prescribed rates: The rate of use of prescribed medications (that is, does not include medications that were GP-supplied or advised for over-the-counter purchase).
Problem managed: See Diagnosis/problem.
Provider: A person to whom a patient has access when contacting the health care system.
Reasons for encounter (RFEs): The subjective reasons given by the patient for seeing or contacting the general practitioner. These can be expressed in terms of symptoms, diagnoses or the need for a service.
Recognised GP: A medical practitioner who is:
•	vocationally recognised under Section 3F of the Health Insurance Act, or
•	a holder of the Fellowship of the Royal Australian College of General Practitioners who participates in, and meets the requirements for, quality assurance and continuing medical education as defined in the Royal Australian College of General Practitioners (RACGP) Quality Assurance and Continuing Medical Education Program, or
•	undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the Fellowship of the Royal Australian College of General Practitioners, or undertaking an approved placement in general practice as part of some other training program recognised by the RACGP as being of equivalent standard. (Source: Commonwealth Department of Health and Aged Care 2001. Medicare benefits schedule book. Canberra: DHAC). 
Referral: The process by which the responsibility for part or all of the care of a patient is temporarily transferred to another health care provider. Only new referrals to specialists and allied health professionals, and for hospital and residential aged care facility admissions arising at a recorded encounter are included. Continuation referrals are not included. Multiple referrals can be recorded at any one encounter.
Repatriation health card: An entitlement card provided by the Department of Veterans’ Affairs that entitles the holder to access a range of Repatriation health care benefits, including access to prescription and other medications under the Pharmaceutical Benefits Scheme.
Rubric: The title of an individual code in ICPC-2.
Significant: This term is used to refer to a statistically significant results. Statistical significance is measured at the 95% confidence level in this report. 
Torres Strait Islander: The patient identifies himself or herself as a Torres Strait Islander person.
Work-related problem: See Diagnosis/problem.

Appendices
Appendix 1: Example of a 2008–09 recording form
The recording form and instructions with which the data in this abstract were collected are available in rich text format on request. 

Appendix 2: GP characteristics questionnaire, 2008–09
The recording form and instructions with which the data in this abstract were collected are available in rich text format on request. 

Appendix 3: Dissemination of results from the BEACH program
A full list of BEACH publications is also available from the Family Medicine Research Centre website: <www.fmrc.org.au/publications/>.
BOOKS—GENERAL PRACTICE SERIES (BEACH) ISSN 1442-3022
Britt H & Miller GC (eds) 2009. General practice in Australia, health priorities and policies 1998–2008. General practice series no. 24. Cat. no. GEP 24. Canberra: Australian Institute of Health and Welfare.	
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C et al. 2008. General practice activity in Australia 1998–99 to 2007–08: 10 year data tables. General Practice Series No. 23. Cat. no. GEP 23. Canberra: Australian Institute of Health and Welfare.	
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C et al. 2008. General practice activity in Australia 2007–08. General Practice Series No. 22. Cat. no. GEP 22. Canberra: Australian Institute of Health and Welfare.	
Britt H, Miller GC, Charles J, Bayram C, Pan Y, Henderson J, Valenti L, O’Halloran J, Harrison C, Fahridin S 2008. General practice activity in Australia 2006–07. Cat. no. GEP 21. Canberra: AIHW.	
Britt H, Miller GC, Henderson J, Bayram C 2007. Patient–based substudies from BEACH: abstracts and research tools 1999–2006. Cat. no. GEP 20. Canberra: AIHW.	
Britt H, Miller GC, Charles J, Pan Y, Valenti L, Henderson J, Bayram C, O’Halloran J, Knox S 2007. General practice activity in Australia 2005–06. Cat. no. GEP 19. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Pan Y, Henderson J, Bayram C, Valenti L, Ng A, O’Halloran J 2005. General practice activity in Australia 2004–05. Cat. no. GEP 18. 
Canberra: AIHW.	
Knox S, Britt H, Pan Y, Miller GC, Bayram C, Valenti L, Charles J, Henderson J, Ng A, O’Halloran J 2005. Locality matters: the influence of geography on general practice activity 
in Australia 1998–2004. Cat. no. GEP 17. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Pan Y, Henderson J, Bayram C, O’Halloran J, Ng A 2004. General practice activity in Australia 2003–04. Cat. no. GEP 16. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Bayram C, O’Halloran J, Henderson J, Pan Y, Harrison C 2004. General practice activity in the states and territories of Australia 1998–2003. Cat. no. GEP 15. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Henderson J, Pan Y, Bayram C, Harrison C 2003. General practice activity in Australia 2002–03. Cat. no. GEP 14. Canberra: AIHW.	
Britt H, Knox S, Miller GC 2003. Changes in pathology ordering by GPs in Australia 
1998–2001. Cat. no. GEP 13. Canberra: AIHW.	
O’Halloran J, Britt H, Valenti L, Harrison C, Pan Y, Knox S 2003. Older patients attending general practice in Australia 2000–02. Cat. no. GEP 12. Canberra: AIHW.	
Bayram C, Britt H, Kelly Z, Valenti L 2003. Male consultations in general practice in Australia 1999–00. Cat. no. GEP 11. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Henderson J, Pan Y, Sutton C, Harrison C 2002. General practice activity in Australia 2001–02. Cat. no. GEP 10. Canberra: AIHW.	
Henderson J, Pan Y, Britt H, Charles J, Miller GC, Knox S 2002. Cardiovascular problems and risk behaviours among patients at general practitioner encounters in Australia 1998–00. Cat. no. GEP 9. Canberra: AIHW.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Henderson J, Kelly Z, Pan Y 2001. General practice activity in Australia 2000–01. Cat. no. GEP 8. Canberra: AIHW.	
Britt H, Miller GC, Valenti L 2001. ‘It’s different in the bush’: a comparison of general practice activity in metropolitan and rural areas of Australia 1998–2000. Cat. no. GEP 6. Canberra: AIHW.	
Britt H, Miller GC, Knox S 2001. Imaging orders by general practitioners in Australia 
1999–00. Cat. no. GEP 7. Canberra: AIHW.	
Britt H, Miller GC, Charles J, Knox S, Sayer GP, Valenti L, Henderson J, Kelly Z 2000. General practice activity in Australia 1999–2000. Cat. no. GEP 5. Canberra: AIHW.	
Sayer GP, Britt H, Horn F, Bhasale A, McGeechan K, Charles J, Miller GC, Hull B, Scahill S 2000. Measures of health and health care delivery in general practice in Australia. Cat. no. GEP 3. Canberra: AIHW.	
Britt H, Miller GC, McGeechan K, Sayer GP 1999. Pathology ordering by general practitioners in Australia 1998. Cat. no. GEP 4. Canberra: Department of Health and Aged Care.	
Britt H, Sayer GP, Miller GC, Charles J, Scahill S, Horn F, Bhasale A, McGeechan K 1999. General practice activity in Australia 1998–99. Cat. no. GEP 2. Canberra: AIHW.	
Britt H, Sayer GP, Miller GC, Charles J, Scahill S, Horn F, Bhasale A 1999. BEACH Bettering the Evaluation and Care of Health: a study of general practice activity, six-month interim report. Cat. no. GEP 1. Canberra: AIHW.	
OTHER BOOKS
Bullot M, Dixon T, Henderson J, Tomes G 2008. Review and evaluation of Australian information about primary health care: a focus on general practice. Cat. no. HWI 103. Canberra: Australian Institute of Health and Welfare.	
Senes S, Britt H 2001. A general practice view of cardiovascular disease and diabetes in Australia. Cardiovascular disease series no. 18. Cat. no. CVD 17. Canberra: AIHW.	
CONTRIBUTIONS TO BOOKS
Australian Institute of Health and Welfare 2008 Australia's Health 2008: the eleventh biennial health report of the Australian Institute of Health and Welfare. Britt H, Harrison C, contributors. Canberra: AIHW.	
Australian Institute of Health and Welfare 2006. Australia’s health 2006: the tenth biennial health report of the Australian Institute of Health and Welfare. Britt H, contributor. Canberra: AIHW.	
Australian Government Department of Health and Ageing 2005. General practice in Australia: 2004. Britt H, contributor. Canberra: DoHA. 	
Australian Institute of Health and Welfare 2004. Australia’s health 2004: the ninth biennial health report of the Australian Institute of Health and Welfare. Britt H, contributor. Canberra: AIHW. 	
Australian Institute of Health and Welfare 2002. Australia’s health 2002: the eighth biennial health report of the Australian Institute of Health and Welfare. Britt H, contributor. Canberra: AIHW.	
Australian Institute of Health and Welfare 2000. Australia’s health 2000: the seventh biennial health report of the Australian Institute of Health and Welfare. Britt H, contributor. Canberra: AIHW.	
Commonwealth Department of Health and Aged Care 2000. General practice in Australia: 2000. Britt H, contributor. Canberra: DHAC.	
Australian Institute of Health and Welfare 1998. Australia’s health 1998: the sixth biennial health report of the Australian Institute of Health and Welfare. Britt H, contributor. Canberra: AIHW.	
REFEREED ARTICLES IN RECOGNISED JOURNALS
Webster RJ, Heeley EL, Peiris DP, Bayram C, Cass A, Patel AA 2009. Gaps in cardiovascular disease risk management in Australian general practice. Med J Aust 191(6):324–329.	
Woods RL, Tonkin AM, Nelson MR, Britt HC, Reid CM 2009. Should aspirin be used for the primary prevention of cardiovascular disease in people with diabetes? Med J Aust 190(11):614–615.	
Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, MacIntyre CR 2009. Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older. Vaccine 27(4):520–529.	
Booth ML, Knox S, Kang M 2008. Encounters between adolescents and general practice in Australia. J Paediatr Child Health.	
Cretikos MA, Valenti L, Britt HC, Baur LA 2008. General practice management of overweight and obesity in children and adolescents in Australia. Med Care 46(11):
1163–1169.	
Frewen A, Arcuri A, Harrison C, Copeland J, Britt H 2008. Management of cannabis and psychostimulant use among general practice patients. Aust J Primary Health 14(3):132–140.	
Britt HC, Harrison CM, Miller GC, Knox SA 2008. Prevalence and patterns of multimorbidity in Australia. Med J Aust 189(2):72.	
Knox SA, Harrison CM, Britt HC, Henderson JV 2008. Estimating prevalence of common chronic morbidities in Australia. Med J Aust 189(2):66–70.	
Henderson J, Miller G, Pan Y, Britt H 2008. The effect of advertising in clinical software on general practitioners' prescribing behaviour. Med J Aust 188(1):15–20.	
Bayram C, Knox S, Miller G, Ng A, Britt H 2007. Clinical activity of overseas-trained doctors practising in general practice in Australia. Aust Health Rev 31(3):440–8.	
Stark RJ, Valenti L, Miller GC 2007. Management of migraine in Australian general practice. Med J Aust 187(3):142–6.	
O’Halloran J, Britt H, Valenti L 2007. General practitioner consultations at residential aged-care facilities. Med J Aust 187(2):88–91.	
Bindman AB, Forrest CB, Britt H, Crampton P, Majeed A 2007. Diagnostic scope of and exposure to primary care physicians in Australia, New Zealand, and the United States: cross sectional analysis of results from three national surveys. BMJ 334(7606):1261–6.	
Gunasekera H, Knox S, Morris P, Britt H, McIntyre PB, Craig JC 2007. The spectrum and management of otitis media in Australian Indigenous and non-Indigenous children: a national study. Pediatr Infect Dis J 26:689–92.	
Britt H, Miller G, Bayram C 2007. The quality of data on general practice—A discussion of BEACH reliability and validity. Aust Fam Physician 36(1–2):36–40.	
Charles J, Britt H, Knox S 2006. Patient perception of their weight, attempts to lose weight and their diabetes status. Aust Fam Physician 35(11):925–8.	
Henderson J, Britt H, Miller G 2006. Extent and utilisation of computerisation in Australian general practice. Med J Aust 185(2):84–87.	
Charles J, Britt H, Valenti L 2006. The independent effect of age of general practitioner on clinical practice. Med J Aust 185(2):105–9.	
Miller GC, Britt HC, Valenti L, Knox S 2006. Adverse drug events: counting is not enough, action is needed [letter]. Med J Aust 184(12):646.	
Miller GC, Britt HC, Valenti L 2006. Adverse drug events in general practice patients in Australia. Med J Aust 184(7):321.	
Proude EM, Britt H, Valenti L, Conigrave KM 2006. The relationship between self-reported alcohol intake and the morbidities managed by GPs in Australia. BMC Fam Pract 7(1):17.	
Pan Y, Henderson J, Britt H 2006. Antibiotic prescribing in Australian general practice: How has it changed from 1990–91 to 2002–03? Respir Med 100(11):2004–11.	
Chen MY, Pan Y, Britt H, Donovan B 2006. Trends in clinical encounters for pelvic inflammatory disease and epididymitis in a national sample of Australian general practices. Int J STD AIDS 17(6):384.	
Doran CM, Valenti L, Robinson M, Britt H, Mattick RP 2006. Smoking status of Australian general practice patients and their attempts to quit. Addict Behav 31(5):758.	
Freedman E, Britt H, Harrison CM, Mindel A 2006. Sexual health problems managed in Australian general practice: a national, cross sectional survey. Sex Transm Infect 82(1):61–6.	
Rae K, Britt H, Orchard J, Finch C 2005. Classifying sports medicine diagnoses: a comparison of the International classification of diseases 10—Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8). Br J Sports Med 39(12):907–11.	
Degenhardt L, Knox S, Barker B, Britt H, Shakeshaft A 2005. The management of alcohol, tobacco and illicit drug use problems by general practitioners in Australia. Drug Alcohol Rev 24(6):499–506.	
Britt HC, Valenti L, Miller GC 2005. Determinants of consultation length in Australian general practice. Med J Aust 183(2):68–71.	
Valenti L, Charles J, Britt H 2005. Passive smoke in Australian homes: 1999 to 2004 [letter]. Aust N Z J Public Health 29(4):387–8.	
Harrison CM, Britt HC 2005. Antidepressant use in children: a less depressing story [letter]. Med J Aust 182(2):92.	
Harris MF, Furler J, Valenti L, Harris E, Britt H 2004. Matching care to need in general practice: A secondary analysis of Bettering the Evaluation and Care of Health (BEACH) data. Australian Journal of Primary Health 10(3):151–5.	
Knox SA, Chondros P 2004. Observed intra-cluster correlation coefficients in a cluster survey sample of patient encounters in general practice in Australia. BMC Med Res Methodol 4(1):30.	
O’Halloran J, Britt H, Valenti L, Harrison C, Pan Y, Knox S et al. 2004. Encounters with older patients in Australian general practice. Aust Fam Physician 33(10):776.	
Gruen RL, Knox S, Carson P, O’Rourke IC, Britt H, Bailie RS 2004. The demand for surgery: an analysis of referrals from Australian general practitioners. ANZ J Surg 74(10):863–8.	
Harrison CM, Britt H 2004. The rates and management of psychological problems in Australian general practice. Aust N Z J Psychiatry 38(10):781–8	
Caldwell TM, Jorm AF, Knox S, Braddock D, Dear KB, Britt H 2004. General practice encounters for psychological problems in rural, remote and metropolitan areas in Australia. Aust N Z J Psychiatry 38(10):774–80.	
Miller G, Britt H, Pan Y, Knox S 2004. Relationship between general practitioner certification and characteristics of care. Med Care (Aug)42(8):770–8.	
O’Halloran J, Britt H 2004. General practice encounters with older Australians. Australas J Ageing 23(1):7–12.	
Pegram RW, Valenti L 2004. Factors influencing billing status in general practice (letter). Med J Aust 181(2):115.	
Johnston VJ, Britt H, Pan Y, Mindel A 2004. The management of sexually transmitted infections by Australian general practitioners. Sex Transm Infect (Jun)80(3):212–15.	
Gruen RL, Knox S, Britt H, Bailie RS 2004. The Surgical Nosology In Primary-care Settings (SNIPS): a simple bridging classification for the interface between primary and specialist care. BMC Health Serv Res (May)4(1):8.	
O’Halloran J, Miller GC, Britt H 2004. Defining chronic conditions for primary care with ICPC-2. Fam Pract (Aug)21(4):381–6.	
Britt H, Valenti L, Miller GC, Farmer J 2004. Determinants of GP billing in Australia: content and time. Med J Aust (Jul)181(2):100–4.	
Charles J, Britt H, Valenti L 2004. The evolution of the general practice workforce in Australia, 1991–2003. Med J Aust (Jul)181(2):85–90.	
Charles J, Pan Y, Britt H 2004. Trends in childhood illness and treatment in Australian general practice, 1971–2001. Med J Aust (Mar)180(5):216–19.	
Henderson J, Knox S, Pan Y, Britt H 2004. Changes in asthma management in Australian general practice. Primary Care Respiratory Journal (Sep)13(3):138–43.	
Knox SA, Britt H 2004. The contribution of demographic and morbidity factors to self-reported visit frequency of patients: a cross-sectional study of general practice patients in Australia. BMC Fam Pract (Aug)5(1):17.	
Charles J, Valenti L, Britt H 2003. GP visits by health care card holders. A secondary analysis of data from Bettering the Evaluation and Care of Health (BEACH), a national study of general practice activity in Australia. Aust Fam Physician 32(1–2):85–8, 94.	
Bridges-Webb C, Wolk J, Britt H, Pond D 2003. The management of dementia in general practice. A field test of guidelines. Aust Fam Physician 32(4):283–5.	
Harrison CM, Britt HC 2003. Prescriptions for antipsychotics in general practice (letter). Med J Aust 178(9):468–9.	
McManus P, Mant A, Mitchell P, Britt H, Dudley J 2003. Use of antidepressants by general practitioners and psychiatrists in Australia. Aust N Z J Psychiatry 37(2):184–9.	
Britt H, Valenti L, Miller G 2002. Time for care. Length of general practice consultations in Australia. Aust Fam Physician 31(9):876–80.	
Gruen RL, Knox S, Britt H 2002. Where there is no surgeon: the effect of specialist proximity on general practitioners’ referral rates. Med J Aust 177(2):111–15.	
Knox SA, Britt H 2002. A comparison of general practice encounters with patients from English-speaking and non-English-speaking backgrounds. Med J Aust 177(2):98–101.	
Britt HC, Miller GC 2000. The BEACH study of general practice. Med J Aust 173(2):63–4.	
OTHER PUBLICATIONS IN REFEREED JOURNALS
Charles J, Fahridin S, Britt H 2008. Referrals to A&E. Aust Fam Physician 37(7):505.	
Harrison C, Charles J, Britt H 2008. AD(H)D. Aust Fam Physician 37(6):393.	
Charles J, Fahridin S, Britt H 2008. Vertiginous syndrome. Aust Fam Physician 37(5):299.	
Fahridin S, Britt H 2008. Allergic rhinitis. Aust Fam Physician 37(4):203.	
Charles J, Britt H, Fahridin S 2008. Urinary incontinence in the older patient. Aust Fam Physician 37(3):105.	
Charles J, Britt H, Valenti L 2008. Lifestyle matters. Aust Fam Physician 37(1–2):9.	
Fahridin S, Harrison C, Britt H, Charles J 2007. Skin malignancies in general practice. Aust Fam Physician 36(12):984–5.	
Charles J, Miller G, Fahridin S 2007. Management of stroke in general practice. Aust Fam Physician 36(11):890–1.	
Charles J, Miller G, Harrison C 2007. Management of haemachromatosis in general practice. Aust Fam Physician 36(10):792–3.	
Britt H, Fahridin S 2007. Presentations of nausea and vomiting. Aust Fam Physician 36(9):682–3.	
Bayram C, Britt H, Fahridin S 2007. Adolescent attendances in general practice. Aust Fam Physician 36(8):586–7.	
Fahridin S, Charles J, Miller G 2007. Atrial fibrillation in Australian general practice. Aust Fam Physician 36(7):490–1.	
Charles J, Britt H, Fahridin S 2007. Chronic musculoskeletal problems managed in general practice. Aust Fam Physician 36(6):392–3.	
Bayram C, Pan Y, Miller G 2007. Management of travel related problems in general practice. Aust Fam Physician 36(5):298–9.	
Charles J, Britt H, Fahridin S, Miller G 2007. Mental health in general practice. Aust Fam Physician 36(4):200–1.	
Bayram C, Pan Y, Miller G 2007. Gynaecological cancer in Australian general practice. Aust Fam Physician 36(3):104–5.	
Charles J, Pan Y, Britt H 2006. Work related encounters in general practice. Aust Fam Physician 35(12):938–9.	
Charles J, Harrison C 2006. Irritable bowel syndrome in Australian general practice. Aust Fam Physician 35(11):840–1.	
Charles J, Harrison C, Britt H 2006. Malignant neoplasms–management in Australian general practice. Aust Fam Physician 35(10):760–1.	
Charles J, Knox S, Britt H 2006. Postnatal depression in Australian general practice. Aust Fam Physician 35(9):668–9.	
Valenti L, Charles J, Britt H 2006. BMI of Australian general practice patients. Aust Fam Physician 35(8):570–1.	
Charles J, Knox S, Britt H 2006. Skin excisions in Australian general practice. Aust Fam Physician 35(7):474.	
Charles J, Ng A, Miller G 2006. Management of type 2 diabetes in Australian general practice. Aust Fam Physician 35(6):378.	
Miller G, Valenti L, Charles J 2006. Use of diagnostic imaging in Australian general practice. Aust Fam Physician 35(5):280.	
Charles J, Miller G, Ng A 2006. GI malignancies in Australian general practice. Aust Fam Physician 35(4):186.	
Charles J, Miller G, Ng A 2006. Management of psychosis in Australian general practice. Aust Fam Physician 35(3):88.	
AIHW Australian GP Statistics and Classification Centre BEACH overview 2006. Aust Fam Physician 35(3):153–4.	
O’Halloran J, Ng A, Britt H, Charles J 2006. EPC encounters in Australian general practice. Aust Fam Physician 35(1–2):8–10.	
Charles J, Ng A, Britt H 2005. Management of epilepsy in general practice patients. Aust Fam Physician 34(12):1000.	
Charles J, Miller G, Ng A 2005. Management of renal problems in Australian general practice. Aust Fam Physician 34(11):904.	
Charles J, Britt H, Knox S 2005. Encounters with Indigenous patients in Australian general practice. Aust Fam Physician 34(10):810.	
Charles J, Britt H, Ng A 2005. Management of growth delay in patients aged less than 6 years. Aust Fam Physician 34(9):714–15.	
Charles J, Ng A, Britt H 2005. Presentations of headache in Australian general practice. Aust Fam Physician 34(8):618–19.	
Charles J, Ng A, Britt H 2005. Presentations of shortness of breath in Australian general practice. Aust Fam Physician 34(7):520–1.	
Charles J, Britt H, Ng A 2005. Management of cardiovascular conditions in Australian general practice. Aust Fam Physician 34(6):410–11.	
Charles J, Britt H, Ng A 2005. Management of inflammatory skin conditions in Australian general practice. Aust Fam Physician 34(5):316–17.	
Britt H 2005. Adolescent mental health: Reply [letter]. Aust Fam Physician 34(4):215–16.	
Britt H, Valenti L, Miller G, Charles J 2005. Presentations of diarrhoea in Australian general practice. Aust Fam Physician 34(4):218–19.	
Charles J, Pan Y, Britt H 2005. Management of infertility in Australian general practice. Aust Fam Physician 34(3):104–5.	
Charles J, Ng A, Britt H, Pan Y, Miller GC, Valenti L et al. 2005. The treatment of adolescents in Australian general practice. Aust Fam Physician 34(1/2):8–9.	
Bayram C, Pan Y, Valenti L, Britt H, Charles J, Miller GC et al. 2004. Current status of hormone therapy in general practice in Australia. Aust Fam Physician 33(11):872–3.	
Britt H, Valenti L, Miller G, Bayram C, Charles J, Knox S et al. 2004. Presentations of abdominal pain in Australian general practice. Aust Fam Physician 33(12):968–9.	
Britt H, Pan Y, Miller GC, Valenti L, Charles J, Knox S et al. 2004. Presentations of ‘itch’ in Australian general practice. Aust Fam Physician 33(7):488.	
Charles J, Harrison C, Britt H, Pan Y, Miller GC, Valenti L et al. 2004. General practitioners in teaching practices. Aust Fam Physician 33(9):682.	
Britt H 2003. BEACH—Bettering the Evaluation And Care of Health: a continuous national study of general practice activity. Commun Dis Intell 27(3):391–3.	
Britt H, Miller G 2003. General practice medical records (correspondence in reply). Aust Fam Physician 24:2250.	
Britt H, Miller GC, Knox S, Charles J, Valenti L, Henderson J et al. 2003. Bettering the Evaluation And Care of Health 2001–2002 (summary of results). Aust Fam Physician 32(1/2):59–63.	
Britt H 1998. BEACH Bettering the Evaluation And Care of Health. Fam Pract Wonca News 24(4):vii–viii.	
RELATED PUBLICATIONS IN REFEREED JOURNALS
Wang Y, Patrick J, Miller G, O'Halloran J 2008. A computational linguistics motivated mapping of ICPC-2 PLUS to SNOMED CT. BMC Medical Informatics and Decision Making 8(Suppl 1):S5–S12.	
Wang Y, Patrick J, Miller G, O’Halloran J 2006. Linguistic Mapping of Terminologies to SNOMED CT. Presented at the SMCS 2006—Semantic Mining Conference on SNOMED CT; 10 Sep 2006, Copenhagen.	
Britt H, Angelis M, Harris E 1998. The reliability and validity of doctor-recorded morbidity data in active data collection systems. Scand J Prim Health Care 16:50–5.	
Britt H 1998. Reliability of central coding of patient reasons for encounter in general practice, using the International Classification of Primary Care. Informatics (May)3–7.	
Britt H 1997. A measure of the validity of the ICPC in the classification of reasons for encounter. Informatics (November)8–12.	
Britt H, Meza RA, Del Mar C 1996. Methodology of morbidity and treatment data collection in general practice in Australia: a comparison of two methods. Fam Pract 13(5):462–7.	
Meza RA, Angelis M, Britt H, Miles DA, Seneta E, Bridges-Webb C 1995. Development of sample size models for national general practice surveys. Aust J Pub Health 19(1):34–40.	
Britt H, Harris M, Driver B, Bridges-Webb C, O’Toole B, Neary S 1992. Reasons for 
encounter and diagnosed health problems: convergence between doctors and patients. Fam Pract 9:191–4.	
Bridges-Webb C, Britt H, Miles DA, Neary S, Charles J, Traynor V 1992. Morbidity and treatment in general practice in Australia 1990–1991. Med J Aust 157(19 Oct Spec Sup):S1–S56.	
Driver B, Britt H, O’Toole B, Harris M, Bridges-Webb C, Neary S 1991. How representative are patients in general practice morbidity surveys? Fam Pract 8:261–8.	
PUBLISHED FULL-LENGTH CONFERENCE PAPERS
Britt H, Pan Y, Henderson J, Miller GC 2002. The prevalence of cardiovascular disease in general practice in Australia. Presented at Health Outcomes 2002: Current Challenges and Future Frontiers; 17 Jul 2002, Canberra.	
Henderson J, Pan Y, Britt H 2002. Asthma management in general practice. Presented at Health Outcomes 2002: Current Challenges and Future Frontiers; 17 Jul 2002, Canberra.	
Britt H, Miller GC, Valenti L 2001. ‘It’s different in the bush’: a comparison of general practice activity in metropolitan and rural areas of Australia 1998–2000. Presented at the 6th National Rural Health Conference; 7 Apr 2001, Canberra.	
THESES AND TREATISES
Henderson J 2007. The effect of computerisation on the quality of care in Australian general practice. PhD, University of Sydney.	
O’Halloran J 2002. Aged patient encounters in the general practice setting. Bachelor of Applied Science, Health Information Management (Honours) thesis. Sydney: University of Sydney.	
Sutton C 2001. Male encounters with general practitioners in Australia 1999–00. Bachelor of Applied Science, Health Information Management (Honours) thesis. Sydney: University of Sydney.	
Charles J 1999. Changes in morbidity and its management between 1991 and 1997 in general practice in Victoria. Master of Science in Medicine thesis. Sydney: University of Sydney.	
Henderson J 1999. Influencing prescribing behaviour in general practice: a five year follow-up study. Bachelor of Applied Science, Health Information Management (Honours) thesis. Sydney: University of Sydney.	
Kelly Z 1999. Management of upper gastrointestinal problems for patients presenting to general practice in Australia 1998–99. Bachelor of Applied Science, Health Information Management (Honours) thesis. Sydney: University of Sydney.	
Sedgwick D 1998. The prescribing of antibiotics for upper respiratory infections in general practice and its relationship to socio-economic status. Master of Public Health thesis. Sydney: University of Sydney.	
SAND ABSTRACTS (ISSN 1444–9072), available from <pandora.nla.gov.au/tep/14007>
AIHW Australian GP Statistics and Classification Centre 2008. Gastrointestinal symptoms and management among general practice patients. Charles J (ed). SAND abstracts from the BEACH program no. 121. 	
AIHW Australian GP Statistics and Classification Centre 2008. Management of asthma in general practice patients. O'Halloran J (ed). SAND abstracts from the BEACH program no. 120. 	
AIHW Australian GP Statistics and Classification Centre 2008. Management of diabetes in general practice patients. Bayram C (ed). SAND abstracts from the BEACH program no. 119. 	
AIHW Australian GP Statistics and Classification Centre 2008. Risk factors for osteoporosis among general practice patients. Charles J (ed). SAND abstracts from the BEACH program no. 118. 	
AIHW Australian GP Statistics and Classification Centre 2008. Lipid management in patients with high risk conditions. Valenti L (ed). SAND abstracts from the BEACH program no. 117. 	
AIHW Australian GP Statistics and Classification Centre 2008. Schizophrenia and bipolar disorder among general practice patients. Harrison C (ed). SAND abstracts from the BEACH program no. 116.	
AIHW Australian GP Statistics and Classification Centre 2008. Type 2 diabetes among general practice patients. Fahridin S (ed). SAND abstracts from the BEACH program no. 115. 	
AIHW Australian GP Statistics and Classification Centre 2008. Chronic kidney disease among Australian general practice patients. Henderson J (ed). SAND abstracts from the BEACH program no. 114. 	
AIHW Australian GP Statistics and Classification Centre 2008. Hypertension and hypercholesterolaemia among general practice patients. Fahridin S (ed). SAND abstracts from the BEACH program no. 113.	
AIHW Australian GP Statistics and Classification Centre 2008. Prevalence and management of chronic pain. Britt H (ed). SAND abstracts from the BEACH program no. 112. 	
AIHW Australian GP Statistics and Classification Centre 2008. Adverse drug events in general practice patients. Miller G (ed). SAND abstracts from the BEACH program no. 111. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Erectile dysfunction. 
Fahridin S (ed). SAND abstracts from the BEACH program no. 110. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Secondary prevention of heart attach and stroke. Charles J (ed). SAND abstracts from the BEACH program no. 109. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Type 2 diabetes among patients attending general practice. Harrison C (ed). SAND abstracts from the BEACH program no. 108. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Type 2 diabetes and dyslipidaemia. Charles J (ed). SAND abstracts from the BEACH program no. 107. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Weight loss attempts and methods. Charles J (ed). SAND abstracts from the BEACH program no. 106. 	
AIHW Australian GP Statistics and Classification Centre. 2007. Measurement of severity of illness in general practice. Miller G (ed). SAND abstracts from the BEACH program no. 105. 	
AIHW Australian GP Statistics and Classification Centre 2007. Asthma management and medication use among patients attending general practice. Henderson J (ed). SAND abstracts from the BEACH program no. 104.	
AIHW Australian GP Statistics and Classification Centre 2007. Cardiovascular risk in patients attending general practice. Fahridin S (ed). SAND abstracts from the BEACH program no. 103.	
AIHW Australian GP Statistics and Classification Centre 2007. Alzheimer’s disease or dementia in patients attending general practice. O’Halloran J (ed). SAND abstracts from the BEACH program no. 102.	
AIHW Australian GP Statistics and Classification Centre 2007. Types of medicine use and patient use of medicines list. Britt H (ed). SAND abstracts from the BEACH program no. 101.	
AIHW Australian GP Statistics and Classification Centre 2007. Gastrointestinal symptoms in patients attending general practice. Miller G (ed). SAND abstracts from the BEACH program no. 100.	
AIHW Australian GP Statistics and Classification Centre 2007. Lipid management in patients with high risk conditions. Bayram C (ed). SAND abstracts from the BEACH program no. 99.	
AIHW Australian GP Statistics and Classification Centre 2007. Management of hypertension and angina in general practice patients. Fahridin S (ed). SAND abstracts from the BEACH program no. 98.	
AIHW Australian GP Statistics and Classification Centre 2007. Statin medication use among high CHD risk patients attending general practice. Charles J (ed). SAND abstracts from the BEACH program no. 97.	
AIHW Australian GP Statistics and Classification Centre 2007. Inhaled corticosteroid use for asthma management. Britt H (ed). SAND abstracts from the BEACH program no. 96.	
AIHW Australian GP Statistics and Classification Centre 2007. Cultural background of patients attending general practice. Britt H (ed). SAND abstracts from the BEACH program no. 95.	
AIHW Australian GP Statistics and Classification Centre 2006. Type 2 diabetes—investigations and related conditions. O’Halloran J (ed). SAND abstracts from the BEACH program no. 94.	
AIHW Australian GP Statistics and Classification Centre 2006. Sexual dysfunction—premature ejaculation. Henderson J (ed). SAND abstracts from the BEACH program no. 93.	
AIHW Australian GP Statistics and Classification Centre 2006. Prevalence of metabolic syndrome. Bayram C (ed). SAND abstracts from the BEACH program no. 92.	
AIHW Australian GP Statistics and Classification Centre 2006. Prevalence and management of gastrointestinal symptoms. Bayram C (ed). SAND abstracts from the BEACH program no. 91.	
AIHW Australian GP Statistics and Classification Centre 2006. Prevalence, management and investigations for chronic heart failure in general practice patients. Miller G (ed). SAND abstracts from the BEACH program no. 90.	
AIHW Australian GP Statistics and Classification Centre 2006. Estimates of the prevalence of chronic illnesses identified as Health Priority Areas among patients attending general practice. Britt H (ed). SAND abstracts from the BEACH program no. 89.	
AIHW Australian GP Statistics and Classification Centre 2006. Arthritis rates and NSAID use in general practice patients. Miller G (ed). SAND abstracts from the BEACH program no. 88.	
AIHW Australian GP Statistics and Classification Centre 2006. Management of cardiovascular or diabetes related conditions. O’Halloran J (ed). SAND abstracts from the BEACH program no. 87.	
AIHW Australian GP Statistics and Classification Centre 2006. Diabetes Types 1 and 2 and coronary heart disease. Henderson J (ed). SAND abstracts from the BEACH program no. 86.	
AIHW Australian GP Statistics and Classification Centre 2006. Management of osteoporotic fractures in general practice patients. Charles J (ed). SAND abstracts from the BEACH program no. 85.	
AIHW Australian GP Statistics and Classification Centre 2006. Menopausal status, symptoms and treatment of women aged 18 and over. Charles J (ed). SAND abstracts from the BEACH program no. 84.	
AIHW Australian GP Statistics and Classification Centre 2006. Prevalence and management of migraine. Valenti L (ed). SAND abstracts from the BEACH program no. 83.	
AIHW Australian GP Statistics and Classification Centre 2006. Prevalence and management of chronic pain. Henderson J (ed). SAND abstracts from the BEACH program no. 82.	
AIHW Australian GP Statistics and Classification Centre 2005. Prevalence and indications for gabapentin use by patients attending general practice. Valenti L (ed). SAND abstracts from the BEACH program no. 81.	
AIHW Australian GP Statistics and Classification Centre 2005. Employment status and workers compensation claims in general practice patients. Charles J (ed). SAND abstracts from the BEACH program no. 80.	
AIHW Australian GP Statistics and Classification Centre 2005. Hypertension and dyslipidaemia—comorbidity and management in general practice patients. O’Halloran J (ed). SAND abstracts from the BEACH program no. 79.	
AIHW Australian GP Statistics and Classification Centre 2005. NSAID & acid suppressant use in general practice patients. Miller G (ed). SAND abstracts from the BEACH program no. 78.	
AIHW Australian GP Statistics and Classification Centre 2005. Heart failure—underlying causes and medication management. Bayram C (ed). SAND abstracts from the BEACH program no. 77.	
AIHW Australian GP Statistics and Classification Centre 2005. Patients with risk factors for metabolic syndrome. Britt H (ed). SAND abstracts from the BEACH program no. 76 .	
AIHW Australian GP Statistics and Classification Centre 2005. Prevalence, management and investigations for chronic heart failure. Pan Y (ed). SAND abstracts from the BEACH program no. 75.	
AIHW Australian GP Statistics and Classification Centre 2005. Smoking and passive smoking in the home. Valenti L (ed). SAND abstracts from the BEACH program no. 74.	
AIHW Australian GP Statistics and Classification Centre 2005. Warfarin use in patients with qualifying morbidity. Pan Y (ed). SAND abstracts from the BEACH program no. 73.	
AIHW Australian GP Statistics and Classification Centre 2005. Contraceptive use among female general practice patients aged 16–44 years. Bayram C (ed). SAND abstracts from the BEACH program no. 72.	
AIHW Australian GP Statistics and Classification Centre 2005. Patient BMI, morbidity and medication use in adults. Ng A (ed). SAND abstracts from the BEACH program no. 71.	
AIHW Australian GP Statistics and Classification Centre 2005. Inhaled corticosteroid use for asthma management. Miller G (ed). SAND abstracts from the BEACH program no. 70.	
AIHW Australian GP Statistics and Classification Centre 2005. Patient weight, methods and medications tried for weight loss in adults. Henderson J (ed). SAND abstracts from the BEACH program no. 69.	
AIHW Australian GP Statistics and Classification Centre 2005. Patient weight, perception of weight and weight loss in adults. Charles J (ed). SAND abstracts from the BEACH program no. 68.	
AIHW Australian GP Statistics and Classification Centre 2005. Risk factors of patients on lipid-lowering medications. Knox S (ed). SAND abstracts from the BEACH program no. 67.	
AIHW GP Statistics and Classification Unit 2004. Anti-psychotic medication use by general practice patients. Britt H (ed). SAND abstracts from the BEACH program no. 66.	
AIHW GP Statistics and Classification Unit 2004. Language and cultural background of general practice patients. Knox S (ed). SAND abstracts from the BEACH program no. 65.	
AIHW GP Statistics and Classification Unit 2004. Current use of statins by general practice patients. Pan Y (ed). SAND abstracts from the BEACH program no. 64.	
AIHW GP Statistics and Classification Unit 2004. Asthma–prevalence, management and medication side-effects. Henderson J (ed). SAND abstracts from the BEACH program no. 63.	
AIHW GP Statistics and Classification Unit 2004. Use of proton pump inhibitors by general practice patients. Ng A (ed). SAND abstracts from the BEACH program no. 62.	
AIHW GP Statistics and Classification Unit 2004. Prevalence of chronic illnesses identified as National Health Priority Areas among general practice patients. Knox S (ed). SAND abstracts from the BEACH program no. 61.	
AIHW GP Statistics and Classification Unit 2004. Prevalence of GORD and associated proton pump inhibitor use. O’Halloran J (ed). SAND abstracts from the BEACH program no. 60.	
AIHW GP Statistics and Classification Unit 2004. Hypertension management and control in general practice patients. Pan Y (ed). SAND abstracts from the BEACH program no. 59.	
AIHW GP Statistics and Classification Unit 2004. Lipid lowering medications: patient eligibility under PBS. Miller G (ed). SAND abstracts from the BEACH program no. 58.	
AIHW GP Statistics and Classification Unit 2004. Prevalence and management of chronic heart failure in general practice patients. Bayram C (ed). SAND abstracts from the BEACH program no. 57.	
AIHW GP Statistics and Classification Unit 2004. Prevalence, cause and severity of adverse pharmacological events. Valenti L (ed). SAND abstracts from the BEACH program no. 56.	
AIHW GP Statistics and Classification Unit 2004. Patient weight, perception of weight and weight loss. Charles J (ed). SAND abstracts from the BEACH program no. 55.	
AIHW GP Statistics and Classification Unit 2003. Secondary prevention of heart attack or stroke. Harrison C (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 54.	
AIHW GP Statistics and Classification Unit 2003. Smoking status of adults and their attempts to quit. Valenti L (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 53.	
AIHW GP Statistics and Classification Unit 2003. Language and cultural background of patients. Knox S (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 52.	
AIHW GP Statistics and Classification Unit 2003. Use of proton pump inhibitors for gastrointestinal problems. Miller G (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 51.	
AIHW GP Statistics and Classification Unit 2003. Risk factors of patients on lipid lowering medications. Britt H (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 50.	
AIHW GP Statistics and Classification Unit 2003. Health status and management of patients on non-steroidal anti-inflammatory drugs. Knox S (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 49.	
AIHW GP Statistics and Classification Unit 2003. Asthma prevalence and management. Bayram C (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 48.	
AIHW GP Statistics and Classification Unit 2003. Management of depression and anxiety. Harrison C (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 47.	
AIHW GP Statistics and Classification Unit 2003. Coronary heart disease, risk factors and lipid lowering medication. Charles J (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 46.	
AIHW GP Statistics and Classification Unit 2003. Diabetes mellitus prevalence, management and risk factors. Charles J (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 45.	
AIHW GP Statistics and Classification Unit 2003. Severity of illness. Miller G (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 44.	
AIHW GP Statistics and Classification Unit 2003. Initiation and purpose of pathology orders. Pan Y (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 43.	
AIHW GP Statistics and Classification Unit 2003. Prevalence and management of chronic pain. Henderson J (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 42.	
AIHW GP Statistics and Classification Unit 2003. Time of visit and billing status. Valenti L (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 41.	
AIHW GP Statistics and Classification Unit 2003. Type 2 diabetes mellitus, prevalence and management. Henderson J (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 40.	
AIHW GP Statistics and Classification Unit 2003. Severity of asthma, medications and management. Bayram C (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 39.	
AIHW GP Statistics and Classification Unit 2003. Prevalence of chronic heart failure, its management and control. Pan Y (ed). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 38.	
AIHW GP Statistics and Classification Unit 2002. Prevalence of common morbidities in patients encountered in general practice. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 37.	
AIHW GP Statistics and Classification Unit 2002. Patient use of complimentary therapies. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 36.	
AIHW GP Statistics and Classification Unit 2002. Smoking status of adults and their attempts to quit. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 35.	
AIHW GP Statistics and Classification Unit 2002. Gastro-oesophageal reflux disease (GORD). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 34.	
AIHW GP Statistics and Classification Unit 2002. Prevalence and management of cardiovascular risk factors. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 33.	
AIHW GP Statistics and Classification Unit 2002. Patient use of after-hours medical services. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 32.	
AIHW GP Statistics and Classification Unit 2002. Prevalence and severity of chronic heart failure. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 31.	
AIHW GP Statistics and Classification Unit 2002. Lipid lowering medications and coronary heart disease. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 30.	
AIHW GP Statistics and Classification Unit 2002. Non-steroidal anti-inflammatory drugs (NSAIDS) and acid suppressant use. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 29.	
AIHW GP Statistics and Classification Unit 2002. Prevalence of Alzheimer’s disease and dementia. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 28.	
AIHW GP Statistics and Classification Unit 2002. Prevalence and management of influenza. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 27.	
AIHW GP Statistics and Classification Unit 2002. Prevalence of diagnosed hypertension and difficulties in treatment. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 26.	
AIHW GP Statistics and Classification Unit 2002. Prevalence of diabetes, medications and control. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 25.	
AIHW GP Statistics and Classification Unit 2001. Gastro-oesophageal reflux disease (GORD) in general practice patients. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 24.	
AIHW GP Statistics and Classification Unit 2001. Depression. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 23.	
AIHW GP Statistics and Classification Unit 2001. Asthma—prevalence, severity and management. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 22.	
AIHW GP Statistics and Classification Unit 2001. Diabetes—prevalence, management and screening. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 21.	
AIHW GP Statistics and Classification Unit 2001. Screening and management of blood cholesterol. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 20.	
AIHW GP Statistics and Classification Unit 2001. Osteoporosis. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 19.	
AIHW GP Statistics and Classification Unit 2001. Drugs for the treatment of peptic ulcer and reflux. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 18.	
AIHW GP Statistics and Classification Unit 2001. Private prescription products. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 17.	
AIHW GP Statistics and Classification Unit 2001. Effect of day and time of GP visit on billing method. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 16.	
AIHW GP Statistics and Classification Unit 2001. Lipid lowering medication. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 15.	
AIHW GP Statistics and Classification Unit 2001. Co-medications. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 14.	
AIHW GP Statistics and Classification Unit 2000. Perceived stress. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 13.	
AIHW GP Statistics and Classification Unit 2000. Smoking and passive smoking in general practice patients. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 12.	
AIHW GP Statistics and Classification Unit 2000. Patient employment status and occupation. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 11.	
AIHW GP Statistics and Classification Unit 2000. Length of consultation; after-hours arrangements; co-morbidity. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 10.	
AIHW GP Statistics and Classification Unit 2000. Influenza and absenteeism. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 9.	
AIHW GP Statistics and Classification Unit 2000. Hormone replacement therapy (HRT). Sydney: University of Sydney, SAND abstracts from the BEACH program no. 8.	
AIHW GP Statistics and Classification Unit 2000. Health services utilisation, lifestyle status and chronicity. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 7.	
AIHW GP Statistics and Classification Unit 2000. Employment status and workers’ compensation claims. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 6.	
AIHW GP Statistics and Classification Unit 2000. Depression. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 5.	
AIHW GP Statistics and Classification Unit 2000. Cardiovascular disease. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 4.	
AIHW GP Statistics and Classification Unit 2000. Asthma. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 3.	
AIHW GP Statistics and Classification Unit 2000. Anxiety/stress, consultation time, level of education. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 2.	
AIHW GP Statistics and Classification Unit 2000. Allergic rhinitis. Sydney: University of Sydney, SAND abstracts from the BEACH program no. 1.	
ARTICLES IN NON-REFEREED JOURNALS AND OTHER PUBLICATIONS
Charles J, Valenti L, Britt H 2009. Children's BMI and GP management of weight problems in childhood. GP Review 13(1):11.	
Charles J & Britt H 2008. BEACH turns ten. GP Review 12(5):23.	
Charles J & Britt H 2008. Generation Y visits to the GP. GP Review 12(4):16.	
Charles J, Harrison C, Britt H 2008. Diabetes policy and general practice activity. GP Review 12(3):18.	
Charles J, Britt H 2008. Practice Nurses working with GPs. GP Review 12(2):15.	
Charles J, Harrison C, Britt H 2008. Osteoporosis: not just a problem for women. GP Review 12(1):15.	
O'Halloran J, Miller GC, Britt H 2007. SNOMED CT: is it valid for use by Australian GPs? GP Review 11(5):22.	
Charles J, Britt H 2007. 50 years of national general practice surveys. GP Review 11(4):17.	
Harrison C, Charles J, Britt H 2007. Posttraumatic stress disorder among Australian veterans. GP Review 11(3):17.	
Britt H 2007. Preventive activities in general practice. GP Review 11(2):16.	
Charles J, Britt H 2007. Different from the rest. GP Review 11(1):15.	
AIHW Australian GP Statistics and Classification Centre 2006. Generation X visits to the GP. GP Review 10(5):17.	
AIHW Australian GP Statistics and Classification Centre 2006. Lipid disorders in Australian general practice. GP Review 10(4):11.	
AIHW Australian GP Statistics and Classification Centre 2006. Over the counter medications advised by GPs. Charles J (ed). GP Review 10(3):10.	
Miller G, Britt H, Knox S, Charles J 2006. Inhaled corticosteroids and management of asthma. GP Review 10(2):10.	
AIHW Australian GP Statistics and Classification Centre 2006. Injury management in general practice. Charles J (ed). GP Review 10(1):13.	
AIHW Australian GP Statistics and Classification Centre 2005. Locality matters: the influence of geography on general practice in Australia 1998–2004. GP Review 9(5):8.	
AIHW Australian GP Statistics and Classification Centre 2005. Alcohol consumption among general practice patients. Charles J (ed). GP Review 9(4).	
AIHW Australian GP Statistics and Classification Centre 2005. Changing face of the general practice workforce. Charles J (ed). GP Review 9(3).	
AIHW Australian GP Statistics and Classification Centre 2005. Non-pharmacological treatments provided by GPs. GP Review 9(2).	
AIHW GP Statistics and Classification Unit 2005. General practice activity in Australia’s states and territories. Charles J (ed). GP Review 9(1).	
AIHW GP Statistics and Classification Unit 2004. Childhood illness and treatment over three decades. Charles J (ed). GP Review 8(Sept).	
AIHW GP Statistics and Classification Unit 2004. Indigenous Australians at general practice encounters. Charles J (ed). GP Review 8(July).	
AIHW GP Statistics and Classification Unit 2004. Decrease in prescribing rates—5 years of BEACH. Charles J (ed). GP Review 8(May).	
AIHW GP Statistics and Classification Unit 2004. Changes over time: management of depression in general practice. Charles J (ed). GP Review 8(Mar).	
AIHW GP Statistics and Classification Unit 2003. Changes over time—patient health risk factors. Charles J (ed). GP Review 7(Nov).	
AIHW GP Statistics and Classification Unit 2003. Changes over time—NSAID use in general practice. Charles J (ed). GP Review 7(Aug).	
AIHW GP Statistics and Classification Unit 2002. Gender of the general practitioner. Charles J (ed). GP Review 6(Nov).	
Britt H 2002. The BEACH Program. Gpinfonet 6(6):8.	
Britt H 2002. BEACH—Bettering the Evaluation And Care of Health. National Networks (32).	
Britt H 2002. The International Classification of Primary Care (ICPC-2 and ICPC-2 Plus). Coding Matters 9(June):3.	
AIHW GP Statistics and Classification Unit 2002. Measurement of body mass in children attending general practice. Charles J (ed). GP Review 6(June).	
AIHW GP Statistics and Classification Unit 2002. Counselling general practice patients. Charles J (ed). GP Review 6(May).	
AIHW GP Statistics and Classification Unit 2002. Referrals. Charles J (ed). GP Review 6(April).	
AIHW GP Statistics and Classification Unit 2001. Smoking and passive smoking in general practice patients. Charles J (ed). GP Review 5(Dec).	
AIHW GP Statistics and Classification Unit 2001. Severity of illness in general practice patients. Charles J (ed). GP Review 5(Oct).	
AIHW GP Statistics and Classification Unit 2001. Weighty matters: body mass in general practice patients. Henderson J (ed). GP Review 5(Sept).	
AIHW GP Statistics and Classification Unit 2001. Influenza vaccination in general practice patients. Charles J (ed). GP Review 5(Aug).	
GP Statistics and Classification Unit 2001. Measures of health and health care delivery in Australia. AIHW Access (July).	
AIHW GP Statistics and Classification Unit 2001. Employment status and occupation of general practice patients. Charles J (ed). GP Review 5(July).	
AIHW GP Statistics and Classification Unit 2001. Weakness and tiredness as a reason for encounter in general practice. Miller GC (ed). GP Review 5(May).	
AIHW GP Statistics and Classification Unit 2001. Anxiety and stress in patients presenting to GPs in Australia. Britt H (ed). GP Review 5(April).	
Britt H 1999. General practice activity in Australia 1998–1999. NSW Public Health Bulletin 10(12):167–9.	

Appendix 4: Code groups from ICPC-2 and 
ICPC-2 PLUS
Table A4.1: Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Reasons for encounter and problems managed	
Abdominal pain	D01		Pain/cramps; abdominal general	
	D06		Pain; abdominal localised; other	
Abnormal test results	A91		Abnormal result investigations NOS	
	B84		Unexplained abnormal white cells	
	U98		Abnormal urine test NOS	
	X86		Abnormal cervix smear	
Anaemia		B78002	Anaemia; sickle cell	
		B78003	Anaemia; hereditary haemolytic	
		B79001	Anaemia; congenital	
		B79004	Anaemia; hereditary	
	B80		Iron deficiency anaemia	
	B81		Anaemia; vitamin B12/folate deficiency	
	B82		Anaemia; other/unspecified	
Anxiety	P01		Feeling anxious/nervous/tense	
	P74		Anxiety disorder/anxiety state	
Arthritis—all	L88		Rheumatoid/seropositive arthritis	
	L89 		Osteoarthrosis of hip	
	L90 		Osteoarthrosis of knee	
	L91 		Osteoarthrosis, other	
		L70009	Arthritis; pyogenic	
		L70010	Arthritis; viral	
		L70021	Arthritis; septic	
		L81003	Arthritis; traumatic	
		L81015	Haemarthrosis	
		L83010	Arthritis; spine cervical	
		L83011	Osteoarthritis; spine; cervical	
		L84003	Arthritis; spine	
		L84004	Osteoarthritis; spine	
		L84009	Osteoarthritis; spine; thoracic	
		L84010	Osteoarthritis; spine; lumbar	
		L84011	Osteoarthritis; lumbosacral	
		L84012	Osteoarthritis; sacroiliac	
		L84023	Arthritis; spine; thoracic	
(continued)
Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Reasons for encounter and problems managed (continued)	
Arthritis—all (continued)		L84024	Arthritis; spine; lumbar	
		L84025	Arthritis; lumbosacral	
		L84026	Arthritis; sacroiliac	
		L89004	Arthritis; hip	
		L92006	Arthritis; shoulder	
		L92007	Osteoarthritis; shoulder	
		L92011	Humeroscapular periarthritis	
		S91002	Arthritis; psoriatic	
		T99063	Arthritis; crystal (excluding gout)	
Back complaint	L02		Back symptom/complaint	
	L03		Low back symptom/complaint	
	L86		Back syndrome with radiating pain	
Cardiac check-up			See Check-up—ICPC chapter, Cardiovascular	
Check-up—all	–30		Medical examination/health evaluation, complete	
	–31		Medical examination/health evaluation, partial	
	X37		Pap smear	
Check-up—ICPC chapter	A30; A31		General	
	B30; B31		Blood	
	D30; D31		Digestive	
	F30; F31		Eye	
	H30; H31		Ear	
	K30; K31		Cardiovascular	
	L30; L31		Musculoskeletal	
	N30; N31		Neurological	
	P30; P31		Psychological	
	R30; R31		Respiratory	
	S30; S31		Skin	
	T30; T31		Endocrine	
	U30; U31		Urology	
	W30; W31		Prenatal/postnatal	
	X30; X31; X37		Female genital	
	Y30; Y31		Male genital	
	Z30; Z31		Social	
Depression	P03		Feeling depressed	
	P76		Depressive disorder	
Diabetes—non-gestational	T89		Diabetes; insulin-dependent	
	T90		Diabetes; non-insulin-dependent	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Reasons for encounter and problems managed (continued)	
Diabetes—all	T89		Diabetes; insulin-dependent	
	T90		Diabetes; non-insulin-dependent	
	W85		Gestational diabetes	
Female genital check-up			See Check-up—ICPC chapter, Female genital	
Fracture	L72		Fracture; radius/ulna	
	L73		Fracture; tibia/fibula	
	L74		Fracture; hand/foot bone	
	L75		Fracture; femur	
	L76		Fracture; other	
		L84019	Fracture; compression; spine	
		L99017	Fracture; non-union	
		L99018	Fracture; pathological	
		L99019	Fracture; malunion	
		L99095	Fracture; stress	
		N54005	Decompression; fracture; skull	
		N80012	Fracture; skull (base)	
		N80013	Fracture; skull	
		N80014	Injury; head; fracture	
Gastroenteritis	D70		Gastrointestinal infection	
	D73		Gastroenteritis, presumed infectious	
General check-up			See Check-up—ICPC chapter, General	
Hypertension/high BP (RFEs)	K85		Elevated blood pressure (without hypertension)	
	K86		Hypertension; uncomplicated	
	K87		Hypertension; complicated 	
		W81002	Hypertension; pre-eclamptic	
		W81003	Hypertension in pregnancy	
Hypertension (problems)	K86		Hypertension; uncomplicated	
	K87		Hypertension; complicated 	
		W81002	Hypertension; pre-eclamptic	
		W81003	Hypertension in pregnancy	
Immunisation/vaccination—all	A44		Preventive immunisation/medication; general/unspecified	
	D44		Preventive immunisation/medication; digestive	
	N44		Preventive immunisation/medication; neurological	
	R44		Preventive immunisation/medication; respiratory	
Ischaemic heart disease	K74		Ischaemic heart disease with angina	
	K76		Ischaemic heart disease without angina	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Reasons for encounter and problems managed (continued)	
Menstrual problems	X02		Pain; menstrual	
	X03		Pain; intermenstrual	
	X05		Menstruation; absent/scanty	
	X06		Menstruation; excessive	
	X07		Menstruation; irregular/frequent	

 	X08		Intermenstrual bleeding	
	X09		Premenstrual symptom/complaint	
	X10		Postponement of menstruation	
Oral contraception	W10		Contraception; postcoital	
	W11		Contraception; oral	
	W50		Medication; reproductive system	
Osteoarthritis		L83011	Osteoarthritis; spine; cervical	
		L84004	Osteoarthritis; spine	
		L84009	Osteoarthritis; spine; thoracic	
		L84010	Osteoarthritis; spine; lumbar	
Osteoarthritis		L84011	Osteoarthritis; lumbosacral	
		L84012	Osteoarthritis; sacroiliac	
		L89001	Osteoarthritis; hip	
		L90001	Osteoarthritis; knee	
		L91001	Osteoarthritis; degenerative	
		L91003	Osteoarthritis	
		L91008	Heberdens nodes	
		L91015	Osteoarthritis; wrist	
		L92007	Osteoarthritis; shoulder	
Pregnancy	W01		Question of pregnancy	
	W78		Pregnancy	
	W79		Unwanted pregnancy	
Pre/postnatal check-up			See Check-up—ICPC chapter, Prenatal/postnatal	
Prescription—all	–50		Medication prescription/request/renewal/injection	
Rash	S06		Rash; localised	
	S07		Rash generalised	
Rheumatoid arthritis	L88		Rheumatoid/seropositive arthritis	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Reasons for encounter and problems managed (continued)	
Sprain/strain		L19014	Strain; muscle(s)	
	L77		Sprain/strain; ankle	
	L78		Sprain/strain; knee	
	L79		Sprain/strain; joint NOS	
		L83023	Sprain; neck	
		L83024	Strain; neck	
Sprain/strain (continued)		L84020	Sprain; back	
		L84021	Strain; back	

 Swelling (skin)	S04		Lump/swelling; localised	
	S05		Lump/swelling; generalised	
Test results	–60		Results tests/procedures	
	–61		Results examination/test/record/letter other provider	
Tonsillitis	R76		Tonsillitis; acute	
	R90		Hypertrophy; tonsils/adenoids	
Urinary tract infection	U70		Pyelonephritis/pyelitis	
	U71		Cystitis/urinary infection other	
Clinical treatments			
Advice/education	A45002	Advice/education	
	B45002	Advice/education; blood	
	D45002	Advice/education; digestive	
	F45002	Advice/education; eye	
	H45002	Advice/education; ear	
	K45002	Advice/education; cardiovascular	
	L45002	Advice/education; musculoskeletal	
	N45002	Advice/education; neurological	
	P45001	Advice/education; psychological	
	R45002	Advice/education; respiratory	
	S45002	Advice/education; skin	
	T45002	Advice/education; endocrine/metabolic	
	U45002	Advice/education; urology	
	W45004	Advice/education; reproductive	
	X45002	Advice/education; genital; female	
	Y45002	Advice/education; genital; male	
	Z45002	Advice/education; social	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Clinical treatments (continued)		
Advice/education—medication	A45015	Advice/education; medication	
	A45032	Advice/education; Dosette box	
	A45033	Advice/education; Webster pack	
	A48003	Review; medication	
	A48005	Increased; drug dosage	
	A48006	Decreased; drug dosage	
	A48007	Change (in); drug dosage	
	A48008	Stop medication	
	A48009	Recommend medication (not new)	
	A48010	Change (in); medication	
Advice/education—medication (continued)	A48011	Medication; request; refusal	
	A48012	Review; immunisation	
	A40010	Medication; given	
Advice/education—treatment	A45016	Advice/education; treatment	
	A45019	Advice; time off work	
	A45020	Advice; rest/fluids	
	A45021	Advice; naturopathic treatment	
	A45030	Advice/education; first aid	
	A48004	Review; treatment	
	L45004	Advice/education; RICE	
	R45004	Advice/education; asthma	
	T45004	Advice/education; diabetes	
	T45009	Advice; home glucose monitoring	
Counselling/advice—alcohol	P45005	Advice/education; alcohol	
	P58009	Counselling; alcohol	
Counselling/advice—drug abuse	P45006	Advice/education; illicit drugs	
	P58010	Counselling; drug abuse	
	P58020	Rehabilitation; drug	
	P58021	Rehabilitation; alcohol	
Counselling/advice—exercise	A45004	Advice/education; exercise	
	A48005	Counselling; exercise	
Counselling/advice—health/body	A45005	Advice/education; health	
	A45009	Health promotion	
	A45010	Information; health	
	A45011	Health promotion; injury	
	A45018	Advice/education; body	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Clinical treatments (continued)		
Counselling/advice—health/body (continued)	A45026	Advice/education; hygiene	
	A48006	Counselling; health	
	A98001	Health maintenance	
Counselling/advice—lifestyle	P45008	Advice/education; lifestyle	
	P58012	Counselling; lifestyle	
Counselling/advice—nutrition/weight	A45006	Advice/education; diet	
	T45005	Advice/education; nutritional	
	T45007	Advice/education; weight management	
	T58002	Counselling; weight management	
Counselling/advice—pregnancy	W45009	Advice/education; pregnancy	
	W58004	Counselling; prenatal	
	W58006	Counselling; pregnancy	
Counselling/advice—prevention 	A45025	Advice/education; immunisation	
	A48007	Counselling; prevention	
	X45004	Advice/education; breast self-exam	
	X45007	Advice/education; Pap smear	
	X45008	Advice/education; mammography	
	Z45005	Advice/education; environment	
Counselling/advice—relationship	Z45006	Advice/education; parenting	
	Z45007	Advice/education; mothering	
	Z45008	Advice/education; fathering 	
	Z58001	Counselling; conjugal (partner)	
	Z58003	Counselling; marriage/relationship	
	Z58006	Counselling; parenting	
	Z58007	Counselling; mothering	
	Z58008	Counselling; fathering	
	Z58009	Counselling; family	
	Z58011	Counselling; conflict resolution	
Counselling/advice—relaxation	P45007	Advice/education; relaxation	
	P58011	Counselling; relaxation	
	P58017	Counselling; stress management	
Counselling/advice—smoking	P45004	Advice/education; smoking	
	P58008	Counselling; smoking	
Counselling/advice—STDs	A45012	Advice/education; STD	
	A48008	Counselling; STDs	
	X58004	Counselling; STDs; female	
	Y58004	Counselling; STDs; male	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Clinical treatments (continued)		
Counselling—problem	A48002	Counselling; problem	
	A48003	Counselling; individual	
	B58001	Counselling; problem; blood	
	D58001	Counselling; problem; digestive	
	F58001	Counselling; problem; eye	
	H58001	Counselling; problem; ear	
	K58001	Counselling; problem; cardiovascular	
	L58001	Counselling; problem; musculoskeletal	
	N58001	Counselling; problem; neurological	

 Counselling—problem (continued)	R58001	Counselling; problem; respiratory	
	S58001	Counselling; problem; skin	
	T58001	Counselling; problem; endocrine/metabolic	
	U58001	Counselling; problem; urology	
	W58003	Counselling; problem; reproductive	
	X58001	Counselling; problem; genital; female	
	X58003	Counselling; sexual; physical; female	

	Y58001	Counselling; problem; genital; male	
	Y58003	Counselling; sexual; physical; male	
	Z58002	Counselling; problem; social	
Counselling—psychological	P45013	Anger management	
	P58001	Counselling; psychiatric	
	P58002	Psychotherapy	
	P58004	Counselling; psychological	
	P58005	Counselling; sexual; psychological	
	P58006	Counselling; individual; psychological	
	P58007	Counselling; bereavement	
	P58013	Counselling; anger	
	P58014	Counselling; self-esteem	
	P58015	Counselling; assertiveness	
	P58018	Therapy; group	
	P58019	Cognitive behavioural therapy	
	P58022	Counselling; body image	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2/ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Clinical treatments (continued)	
Family planning	A98002	Counselling; genetic female	
	A98003	Counselling; genetic male	
	W14002	Family planning; female	
	W45006	Advice/education; preconceptual	
	W45007	Advice/education; contraception; female	
	W45008	Advice/education; family planning; female	
	W58001	Counselling; abortion	
	W58005	Counselling; terminate pregnancy	
	W58007	Counselling; preconceptual	
	W58012	Counselling; sterilisation; female	
	W58013	Counselling; family planning; female	
	Y14001	Family planning; male	
	Y45006	Advice/education; family planning; male	
	Y45007	Advice/education; contraception; female	
	Y58005	Counselling; sterilisation; male	
	Y58006	Counselling; family planning; male	
Observe/wait	A45001	Observe/wait	
	B45001	Observe/wait; blood	
	D45001	Observe/wait; digestive	
	F45001	Observe/wait; eye	
	H45001	Observe/wait; ear	
	K45001	Observe/wait; cardiovascular	
	L45001	Observe/wait; musculoskeletal	
	N45001	Observe/wait; neurological	
	P45002	Observe/wait; psychological	
	R45001	Observe/wait; respiratory	
	S45001	Observe/wait; skin	
	T45001	Observe/wait; endocrine/metabolic	
	U45001	Observe/wait; urology	
	W45003	Observe/wait; reproductive	
	X45001	Observe/wait; genital; female	
	Y45001	Observe/wait; genital; male	
	Z45001	Observe/wait; social	
Other admin/document	–62 (excluding A62008 and A62014)		
Reassurance, support	A48010	Reassurance/support	
Sickness certificate	A62008	Admin; certificate; sickness	
	A62014	Admin; certificate; workers’ compensation	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2/ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Procedures			
Incision/drainage/flushing/aspiration/
removal body fluid	–51		
Excision/removal tissue/biopsy/ destruction/debridement/cauterisation	–52		
Repair/fixation–suture/cast/prosthetic device (apply/remove)	–54		
Local injection/infiltration	–55		
	A40007	Injection; allergy	
	A40008	Injection; desensitisation	
	B50001	Injection; iron	
	B50007	Injection; blood	
	B50008	Injection; immunoglobulins	
	D50006	Injection; digestive	
	F50006	Injection; eye	
	H50006	Injection; ear	
	K50006	Injection; cardiovascular	
	L50007	Injection; musculoskeletal	
Local injection/infiltration (continued)	N50005	Injection; neurological	
	P50006	Injection; psychological	
	R50005	Injection; respiratory	
	S50006	Injection; skin	
	T50006	Injection; endocrine/metabolic	
	T50007	Injection; vitamin; B12	
	T50008	Injection; hormone	
	T50009	Injection; vitamin	
	U50006	Injection; urological	
	X50006	Injection; genital; F	
	Y50005	Injection; genital; M	
Dressing/pressure/compression/tamponade	–56		
Physical medicine/rehabilitation	–57		
Other procedures/minor surgery NEC	–59		
	A40009	Chemotherapy	
	A40011	Refill; Dosette box	
	A40012	Refill; Webster pack	
Check-up—practice nurse	A30031	School screening	
	–31 (excluding A31015)	Medical examination/health evaluation, partial	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2/ICPC-2 PLUS code	ICPC-2/ICPC-2 PLUS label	
Procedures (continued)			
Diagnostic endoscopy	–40		
Electrical tracings	–42		
Glucose test	T34005	Test; glucose	
INR test	B34025	Test; INR	
Other diagnostic procedures	–43		
	A31015	Assessment; ADL	
Other preventive procedures/high-risk medication	–49 		
	A31027	Assessment; physical fitness	
	X31001	Exam; breast	
	X31005	Check-up; breast	
	Y31003	Check-up; prostate	
Pap smear	X37001	Pap smear	
	X37003	Test; cytology; genital; female	
	X37004	Vault smear	
	X37005	Pap smear; thin prep	
Physical function test	–39		
Urine test	A35001	Test; urine	
	A35002	Urinalysis	
	B35001	Test; urine; blood	
	D35001	Test; urine; digestive	
	P35001	Test; urine; psychological	
	T35001	Test; urine; endocrine/metabolic	
	U35002	Test; urine; urology	
	W35001	Test; urine; reproductive	
	X35001	Test; urine; genital; female	
	Y35001	Test; urine; genital; male	
Referrals 			
Allied health services	–66	Referral to other provider/nurse/therapist/ social worker	
	–68 (excluding A68011; Z68003;Z68004; Z68007 and Z68008)	Other referrals NEC	
	Z67002	Referral; respite care	
Specialist	–67 (excluding A67010; A67011; A67022; A67015; P67005 and Z67002)	Referral to physician/specialist/clinic/hospital	
	A68009	Referral; oncologist	
Emergency department	A67011	Referral; accident and emergency	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Referrals (continued)			
Hospital	A67010	Referral; hospital	
	A67015	Referral; hospice	
	A67022	Admission; hospital	
	P67005	Referral; hospital; psychiatrist	
Other referrals	A68011	Referral	
	Z68003	Referral; financial/legal services	
	Z68004	Referral; police	
	Z68007	Referral; women’s shelter	
	Z68008	Referral; Centrelink	
Pathology test orders (MBS groups)			
Chemistry			
	Amylase	D34004	Test; amylase	
	B12	B34015	Test; B12	
	D34009	Test; Schillings	
	C reactive protein	A34005	Test; C reactive protein	
	Calcium/phosphate	A34006	Test; calcium	
	A34013	Test; phosphate	
	A34024	Test; calcium phosphate	
	Cardiac enzymes	D34005	Test; aspartate aminotransferase	
	K34003	Test; cardiac enzymes	
	K34004	Test; creatine kinase	
	Chemistry; other	A33023	Test; alpha fetoprotein	
	A33026	Test; cancer antigen 125	
	A33027	Test; cancer antigen 15.3	
	A33028	Test; cancer antigen 19.9	
	A33029	Test; carcinoembryonic antigen	
	A33041	Test; cancer antigen	
	A34015	Test; protein	
	A34018	Vitamin assay	
	A34019	Test; lead	
	A34020	Test; blood gas analysis	
	A34022	Test; mineral	
	A34023	Test; zinc	
	A34025	Test; DHEAS	
	A34030	Test; biochemistry	
	A34031	Test; blood alcohol	
	A34032	Test; prolactin	
	A34033	Test; testosterone	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
Chemistry (continued)			
	Chemistry; other (continued)	A34037	Test; Glutathione S-transferase	
	A34038	Test; magnesium	
	A34040	Test; renin	
	A35004	Test; urine sodium	
	A35007	Test; urine; albumin	
	A35008	Test; albumin creatine ratio	
	B34023	Test; transferrin	
	D34002	Test; alanine aminotransferase	
	D35002	Test; 5-HIAA	
	K34001	Test; blood; digitalis	
	K34006	Test; amino acids	
	K34007	Test; troponin	
	N34001	Test; blood; phenylhydantoin	
	P34003	Test; methadone	
	T34018	Test; androgens	
	T34019	Test; insulin	
	T34021	Test; C peptide	
	T34029	Test; aldosterone	
	T34030	Test; parathyroid hormone	
	T34035	Test; lipase	
	T35002	Test; catecholamines	
	W34008	Test; PAPPA	
	W38002	Amniocentesis	
	Y34010	Test; HCG; M	
	Drug screen	A34002	Drug assay	
	A34026	Blood drug screen	
	A34027	Blood screen	
	A35003	Drug screen	
	A35005	Urine drug screen	
	K34005	Test; digoxin	
	N34003	Test; phenytoin	
	N34004	Test; valproate	
	N34005	Test; carbamazepine	
	P34002	Test; lithium	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
Chemistry (continued)			
	EUC	A34007	Test; chloride	
	A34008	Test; electrolytes	
	A34010	Test; EUC	
	A34014	Test; potassium	
	A34017	Test; sodium	
	A34029	Test; U&E	
	A34034	Test; E&C	
	U34002	Test; creatinine	
	U34003	Test; urea	
	U34037	Glomerular filtration rate	
	U38006	Test; renal function	
	HbA1c	T34010	Test; HbA1c	
	T34017	Test; fructosamine	
	T34022	Test; HBA1	
	Ferritin	B34016	Test; ferritin	
	B34019	Test; iron studies	
	Folic acid	B34017	Test; folic acid	
	B34024	Test; folate	
	Glucose/tolerance	T34005	Test; glucose	
	T34009	Test; glucose tolerance	
	T34023	Test; glucose (fasting/random)	
	T34025	Test; glucose; fasting	
	T34026	Test; glucose; random	
	Hormone assay	A34003	Hormone assay	
	D33015	Test; anti gliadin antibody	
	T34007	Test; cortisol	
	T34034	Test; ACTH	
	W34005	Test; HCG	
	W34006	Test; B HCG level (titre/quant)	
	X34002	Test; LH	
	X34003	Test; progesterone	
	X34004	Test; oestradiol	
	X34005	Test; FSH	
	X34006	Test; SHBG; female	
	X34007	Test; free androgen index; female	
	Y34004	Test; SHBG; male	
	Y34005	Test; free androgen index; male	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
Chemistry (continued)			
	Lactose intolerance	D38002	Test; lactose intolerance	
	Lipids	T34001	Check-up; cholesterol	
	T34004	Test; lipids profile	
	T34006	Test; cholesterol	
	T34011	Test; cholesterol HDL	
	T34013	Test; cholesterol LDL	
	T34016	Test; triglycerides	
	T34020	Test; free fatty acids	
	T34024	Test; cholesterol/triglycerides	
	Liver function	A34004	Test; albumin	
	D34003	Test; alkaline phosphatase	
	D34006	Test; bilirubin	
	D34007	Test; gGT	
	D34008	Test; liver function	
		T34012	Test; LDH	
	Multi-biochemical analysis	A34012	Test; multi-biochemical analysis	
	A34021	Test; E & LFT	
	Prostate specific antigen	Y34002	Test; acid phosphatase	
	Y34003	Test; prostate specific antigen	
	Thyroid function	T34015	Test; thyroid function	
	T34027	Test; thyroxine	
	T34028	Test; TSH	
	T34037	Test; thyroid peroxidase	
	Urate/uric acid	U34004	Test; urate/uric acid	
Cytopathology			
	Cytology	A37002	Test; cytology	
	B37003	Test; cytology; blood	
	D37002	Test; cytology; digestive	
	F37002	Test; cytology; eye	
	H37002	Test; cytology; ear	
	K37002	Test; cytology; cardiovascular	
	L37002	Test; cytology; musculoskeletal	
	N37002	Test; cytology; neurological	
	R37002	Test; cytology; respiratory	
	R37003	Test; sputum cytology	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Cytology (continued)	S37002	Test; cytology; skin	
	T37002	Test; cytology; endocrine/metabolic	
	U37002	Test; cytology; urology	
	W37002	Test; cytology; reproduction	
	Y37002	Test; cytology; genital; male	
	Pap smear	X37001	Pap smear	
	X37003	Test; cytology; genital; female	
	X37004	Vault smear	
	X37005	Pap smear; thin prep	
Haematology			
	Blood grouping & typing	B33001	Test; Coombs	
	B33002	Test; blood grouping & typing	
	B33009	Test; blood group	
	B33013	Test; blood; cross match	
	Blood; other	A33042	Test; lymphocyte type & count	
	A34035	Test; blood film	
	A34036	Test; blood thick film	
	B33003	RH; antibody titre	
	B34005	Test; blood; platelets	
	B34007	Test; blood; sickle cell	
	B34021	Test; reticulocyte count	
	B34031	Test; haemoglobin epg	
	B34032	Test; packed cell volume	
	B34033	Test; blood; blood	
	B37001	Exam; bone marrow	
	Coagulation	B34003	Test; coagulation time	
	B34006	Test; part thromboplastin time	
	B34009	Test; prothrombin time	
	B34014	Test; APTT	
	B34022	Test; thrombin time	
	B34025	Test; INR	
	B34026	Test; fibrinogen	
	B34028	Test; bleeding time	
	B34029	Test; coagulation screen	
	K34008	Test; D-Dimer	
	ESR	A34009	Test; ESR	
	Full blood count	A34011	Test; full blood count	
	Haemoglobin	B34018	Test; haemoglobin	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
Tissue pathology (Histopathology)			
	Histology; skin	S37001	Test; histopathology; skin	
	Histology; other	A37001	Test; histopathology	
	B37002	Test; histopathology; blood	
	D37001	Test; histopathology; digestive	
	F37001	Test; histopathology; eye	
	H37001	Test; histopathology; ear	
	K37001	Test; histopathology; cardiovascular	
	L37001	Test; histopathology; musculoskeletal	
	N37001	Test; histopathology; neurological	
	R37001	Test; histopathology; respiratory	
	T37001	Test; histopathology; endocrine/metabolic	
	U37001	Test; histopathology; urology	
	W37001	Test; histopathology; reproductive	
	X37002	Test; histopathology; genital; female	
	Y37001	Test; histopathology; genital; male	
Immunology			
	Anti-nuclear antibodies	L33004	Test; anti-nuclear antibodies	
	Immunology; other	A32001	Test; sensitivity	
	A33005	Test; immunology	
	A33011	Test; HLA	
	A33024	Test; bone marrow surface mark	
	A33025	Test; serum electrophoresis	
	A33051	Test; immune status	
	A33052	Test; skin patch	
	A38004	Test; DNA	
	B33005	Test; immunology; blood	
	B33007	Test; immunoglobulins	
	B33011	Test; IgE	
	B34027	Test; FBC for surface markers	
	B34030	Test; intrinsic factor	
	D32001	Test; sensitivity; digestive	
	D33004	Test; immunology; digestive	
	D33014	Test; endomysial antibody	
	D33028	Test; mitochondrial antibodies	
	D33031	Test; anti-tissue transglutaminase	
	D34010	Test; transglutamase	
	F33002	Test; immunology; eye	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Immunology; other (continued)	H33002	Test; immunology; ear	
	K33002	Test; immunology; cardiovascular	
	 K33003	 Test; ANCA	
	L33003	Test; immunology; musculoskeletal	
	L34001	Test; lupus erythematosus; cell prep	
	N33002	Test; immunology; neurological	
	R32004	Test; sensitivity; respiratory	
	R33004	Test; immunology; respiratory	
	S32001	Test; sensitivity; skin	
	S33002	Test; immunology; skin	
	T33002	Test; immunology; endocrine/metabolic	
	U33003	Test; immunology; urology	
	W33007	Test; immunology; reproductive	
	X33002	Test; immunology; genital; female	
	Y33002	Test; immunology; genital; male	
	RAST	A34016	Test; RAST	
	Rheumatoid factor	L33001	Test; rheumatoid factor	
Infertility/pregnancy	W33002	Test; pregnancy	
	W34002	Test; blood; pregnancy	
	W34003	Test; antenatal	
	W34007	Test; pregnancy screen	
	Y38002	Test; sperm count	
	Y38003	Test; semen examination	
Microbiology			
	Antibody	A33003	Test; antibody	
	Cervical swab	X33004	Test; cervical swab M,C&S	
	Chlamydia	A33006	Test; chlamydia	
	A33034	Test; chlamydia direct immunofl	
	X33006	Test; viral culture; genital; female	
	Ear swab and C&S	H33003	Test; ear swab M,C&S	
	Faeces M,C&S	D33002	Stool(s); culture	
	D33008	Test; faeces M,C&S	
	D36001	Test; faeces; cyst/ova/parasite	
	Fungal ID/sensitivity	A33008	Test; fungal ID/sensitivity	
	A33030	Test; skin scraping fungal M,C&S	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
Microbiology (continued)			
	Hepatitis serology	D33005	Test; hepatitis A serology	
	D33006	Test; hepatitis B serology	
	D33007	Test; hepatitis C serology	
	D33013	Test; hepatitis serology	
	D33018	Test; hepatitis A antibody	
	D33019	Test; hepatitis B antibody	
	D33020	Test; hepatitis D antibody	
	D33021	Test; hepatitis E antibody	
	D33022	Test; hepatitis A antigen	
	D33023	Test; hepatitis C antigen	
	D33024	Test; hepatitis D antigen	
	D33025	Test; hepatitis E antigen	
	D33026	Test; hepatitis antibody	
	D33027	Test; hepatitis antigen	
	HIV	A33021	Test; cytomegalovirus serology	
	B33006	Test; HIV	
	B33008	Test; AIDS screen	
	B33012	Test; HIV viral load	
	H pylori	D33009	Test; H Pylori	
	Microbiology; other	A33004	Test; microbiology	
	A33007	Test; culture and sensitivity	
	A33012	Test; mycoplasma serology	
	A33013	Test; parvovirus serology	
	A33015	Test; Barmah forest virus	
	A33016	Test; Antistreptolysin O Titre	
	A33017	Test; herpes simplex culture	
	A33019	Test; herpes simplex serology	
	A33020	Test; toxoplasmosis serology	
	A33033	Test; swab M,C&S	
	A33035	Test; serology	
	A33036	Antibodies screen	
	A33038	Test; rapid plasma regain	
	A33039	Test; viral swab M,C&S	
	A33040	Test; viral serology	
	A33043	Test; HPV	
	A33044	Test; Brucella	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Microbiology; other (continued)	A33045	Test; fungal M,C&S	
	A33046	Test; measles virus antibodies	
	A33047	Test; Rickettsial serology	
	A33053	Test; Bartonella	
	A33054	Test; MC&S	
	A34028	Test; blood culture	
	A34039	Test; Q fever	
	B33004	Test; microbiology; blood	
	B33010	Test; serum immunoglobulins	
	D33003	Test; microbiology; digestive	
	D33010	Test; hepatitis D serology	
	D33011	Test; hepatitis E serology	
	D33012	Test; rotavirus	
	D33016	Test; hepatitis C antibody	
	D33017	Test; hepatitis B antigen	
	F33001	Test; microbiology; eye	
	F33003	Test; eye swab M,C&S	
	H33001	Test; microbiology; ear	
	K33001	Test; microbiology; cardiovascular	
	L33002	Test; microbiology; musculoskeletal	
	N33001	Test; microbiology; neurological	
	R32005	Test; quantiferon	
	R33001	Culture; tuberculosis	
	R33002	Culture; throat	
	R33003	Test; microbiology; respiratory	
	R33009	Test; influenza serology	
	R33010	Test; Legionnaires antibodies	
	R33011	Test; RSV	
	S33001	Test; microbiology; skin	
	S33005	Test; varicella zoster serology	
	S33006	Test; varicella zoster culture	
	S33007	Test; nail M,C&S	
	T33001	Test; microbiology; endocrine/metabolic	
	U33002	Test; microbiology; urology	
	W34004	Test; antenatal serology	
	W33006	Test; microbiology; reproductive	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Microbiology; other (continued)	X33001	Test; microbiology; genital; female	
	X33003	Culture; gonococcal; female	
	Y33001	Test; microbiology; genital; male	
	Y33003	Culture; gonococcal; male	
	Y33004	Test; viral culture; genital; male	
	Y33005	Test; urethral/penile swab	
	Monospot	A33002	Test; monospot	
	A33014	Test; Paul Bunnell	
	A33031	Test; Epstein Barr virus serology	
	A33032	Test; Epstein Barr virus	
	Nose swab C&S	R33008	Test; nose swab M,C&S	
	Pertussis	R33007	Test; pertussis	
	Ross River fever	A33009	Test; Ross River Fever	
	Rubella	A33001	Test; rubella	
	Skin swab C&S	S33003	Test; skin swab M,C&S	
	Sputum C&S	R33005	Test; sputum M,C&S	
	Throat swab C&S	R33006	Test; throat swab M,C&S	
	Urine M,C&S	U33001	Test; culture; urine	
	U33004	Test; urine M,C&S	
	Vaginal swab and M,C&S	X33005	Test; vaginal swab M,C&S	
	Venereal disease	A33010	Test; venereal disease	
	A33022	Test; syphilis serology	
	A33057	STI screen	
Simple basic tests	B35001	Test; urine; blood	
	D36003	Test; occult blood	
	R32001	Test; Mantoux	
	R32002	Test; tuberculin	
	W33001	Test; urine; pregnancy	
	W35003	Test; urine; HCG	
Other NEC			
	Blood test	A34001	Test; blood	
	Urine test	A35001	Test; urine	
	Urinalysis	A35002	Urinalysis	
	Faeces test	A36001	Test; faeces	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Other pathology test NEC	A35006	Test; urine; FWT	
	A38001	Test; other lab	
	A38002	Pathology	
	A38003	Test; genetic	
	A38005	Test; disease screen	
	B38001	Test; other lab; blood	
	D34001	Test; blood; digestive	
	D35001	Test; urine; digestive	
	D36002	Test; faeces; digestive	
	D38001	Test; other lab; digestive	
	F34001	Test; blood; eye	
	F38001	Test; other lab; eye	
	H34001	Test; blood; ear	
	H38001	Test; other lab; ear	
	K34002	Test; blood; cardiovascular	
	K38001	Test; other lab; cardiovascular	
	L34003	Test; blood; musculoskeletal	
	L38001	Test; other lab; musculoskeletal	
	N34002	Test; blood; neurological	
	N38001	Test; other lab; neurological	
	P34001	Test; blood; psychological	
	P35001	Test; urine; psychological	
	P38001	Test; other lab; psychological	
	R34001	Test; blood; respiratory	
	R38001	Test; other lab; respiratory	
	S34001	Test; blood; skin	
	S38001	Test; other lab; skin	
	T34002	Test; blood; endocrine/metabolic	
	T35001	Test; urine; endocrine/metabolic	
	T38001	Test; other lab; endocrine/metabolic	
	U34001	Test; blood; urology	
	U35002	Test; urine; urology	
	U38001	Test; other lab; urology	
	W34001	Test; blood; reproductive	
	W35001	Test; urine; reproductive	
	W38001	Test; other lab; reproductive	
	X34001	Test; blood; genital; female	
	X35001	Test; urine; genital; female	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Pathology test orders (continued)			
	Other pathology test NEC (continued)	X38001	Test; other lab; genital; female	
	Y34001	Test; blood; genital; male	
	Y35001	Test; urine; genital; male	
	Y38001	Test; other lab; genital; male	
	Z38001	Test; other lab; social	
Imaging test orders (MBS groups)			
Diagnostic radiology	A41001	Radiology; diagnostic	
	A41002	X-ray; chest	
	A41006	X-ray; abdomen	
	A41007	Imaging other	
	A41010	Radiology	
	A41014	Test; imaging; contrast/special	
	B41001	Radiology; diagnostic; blood	
	D41001	GI series	
	D41003	Radiology; diagnostic; digestive	
	D41006	X-ray; oesophagus	
	D41007	X-ray; biliary ducts	
	D41008	X-ray; digestive tract	
	D41009	X-ray; mouth	
	D41012	X-ray; dental	
	D41015	Barium enema	
	D41016	Barium meal	
	D41017	Barium swallow	
	D41020	X-ray; gallbladder	
	F41001	Radiology; diagnostic; eye	
	F41002	X-ray; eye	
	H41001	Radiology; diagnostic; ear	
	H41002	X-ray; ear	
	K41002	Radiology; diagnostic; cardiovascular	
	K41003	Cardiogram	
	K41005	Angiography; coronary	
	K41006	Angiography; femoral	
	K41007	Angiography; cerebral	
	K41011	Angiogram	
	K41012	Angiogram; coronary	
	K41013	Angiogram; cerebral	
	K41014	Angiogram; femoral	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Imaging test orders (MBS groups) (continued)			
Diagnostic radiology (continued)	L41001	Arthrogram	
	L41003	X-ray; bone(s)	
	L41004	Plain x-ray; bone(s)	
	L41005	Radiology; diagnostic; musculoskeletal	
	L41013	X-ray; elbow	
	L41014	X-ray; hand	
	L41015	X-ray; wrist	
	L41016	X-ray; knee	
	L41017	X-ray; hip	
	L41018	X-ray; neck	
	L41019	X-ray; pelvis	
	L41020	X-ray; shoulder	
	L41021	X-ray; lumbosacral	
	L41022	X-ray; cervical	
	L41023	X-ray; thoracic	
	L41024	X-ray; spinal	
	L41025	X-ray; joint(s)	
	L41026	X-ray; foot/feet	
	L41027	X-ray; ankle	
	L41028	X-ray; leg	
	L41029	X-ray; ribs	
	L41030	X-ray; face	
	L41032	X-ray; arm	
	L41033	X-ray; spine; lumbar	
	L41034	X-ray; spine; sacrum	
	L41035	X-ray; spine; coccyx	
	L41036	X-ray; finger(s)/thumb	
	L41037	X-ray; toe(s)	
	L41038	X-ray; heel	
	L41039	X-ray; tibia/fibula	
	L41040	X-ray; femur	
	L41041	X-ray; radius/ulna	
	L41042	X-ray; clavicle	
	L41043	X-ray; humerus	
	L41044	X-ray; jaw	
	L41045	X-ray; temporomandibular joint	
	L41060	X-ray; spine; cervicothoracic	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Imaging test orders (MBS groups) (continued)			
Diagnostic radiology (continued)	L41061	X-ray; spine; sacrococcygeal	
	L41062	X-ray; spine; thoracolumbar	
	L41063	X-ray; back	
	L41064	X-ray; back lower	
	L41065	X-ray; forearm	
	L41066	X-ray; leg lower	
	L41067	X-ray; metacarpal	
	L41068	X-ray; metatarsal	
	L43003	Test; densitometry	
	N41001	Radiology; diagnostic neurological	
	N41004	X-ray; skull	
	P41001	Radiology; diagnostic; psychological	
	R41001	Radiology; diagnostic; respiratory	
	R41002	X-ray; sinus	
	R41003	X-ray; nose	
	S41001	Radiology; diagnostic; skin	
	T41001	Radiology; diagnostic; endocrine/metabolic	
	T41003	X-ray; endocrine/metabolic	
	U41001	Pyelogram; intravenous	
	U41002	Pyelogram; retrograde 	
	U41005	Radiology; diagnostic; urology	
	U41007	X-ray; urinary tract	
	U41008	X-ray; kidney/ureter/bladder	
	W41002	Radiology; diagnostic; reproductive	
	W41003	X-ray; uterus	
	X41001	Mammography; female	
	X41002	Mammography; request; female	
	X41003	Thermography; breast	
	X41005	Radiology; diagnostic; genital; female	
	X41007	X-ray; breast; female	
	Y41001	Radiology; diagnostic; genital; male	
Ultrasound	A41012	Ultrasound	
	A41015	Ultrasound; abdomen	
	A41017	Ultrasound; chest	
	A41021	Ultrasound; inguinal	
	A41022	Ultrasound; abdomen; upper	
	A41023	Ultrasound; abdomen; lower	
(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Treatment group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Imaging test orders (MBS groups) (continued)			
Ultrasound (continued)	B41002	Ultrasound; spleen	
	D41013	Ultrasound; gallbladder	
	D41014	Ultrasound; liver	
	K41001	Echocardiography	
	K41016	Ultrasound; cardiac	
	K43003	Test; Doppler	
	K43004	Test; Doppler carotid	
	K43005	Scan; duplex	
	L41046	Ultrasound; neck	
	L41047	Ultrasound; pelvis	
	L41048	Ultrasound; shoulder	
	L41049	Ultrasound; spine	
	L41050	Ultrasound; knee	
	L41051	Ultrasound; elbow	
	L41070	Ultrasound; wrist	
	L41071	Ultrasound; ankle	
	L41072	Ultrasound; groin	
	L41073	Ultrasound; back	
	L41074	Ultrasound; back lower	
	L41075	Ultrasound; hand/finger(s)	
	L41076	Ultrasound; foot/toe(s)	
	L41078	Ultrasound; arm	
	L41079	Ultrasound; leg	
	N41005	Ultrasound; brain	
	N41007	Ultrasound; head	
	T41004	Ultrasound; thyroid	
	U41009	Ultrasound; renal tract	
	U41010	Ultrasound; kidney	
	W41004	Ultrasound; obstetric	
	W41005	Ultrasound; nuchal translucency	
	X41009	Ultrasound; breast; female	
	X41011	Ultrasound; uterus (not pregnant)	
	Y41005	Ultrasound; prostate	
	Y41006	Ultrasound; scrotum	
	Y41008	Ultrasound; breast; male	
	(continued)

Table A4.1 (continued): Code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 PLUS code	ICPC-2 PLUS label	
Imaging test orders (continued)			
Computerised tomography	A41013	CT scan	
	A41016	CT scan; abdomen	
	A41018	CT scan; chest	
	A41019	CT scan; abdomen; upper	
	A41020	CT scan; abdomen; lower	
	D41018	CT scan; liver	
	K41017	CT scan; cardiac	
	L41052	CT scan; neck	
	L41053	CT scan; pelvis	
	L41054	CT scan; spine	
	L41055	CT scan; spine; cervical	
	L41056	CT scan; spine; thoracic	
	L41057	CT scan; spine; lumbar	
	L41058	CT scan; spine; lumbosacral	
	L41059	CT scan; spine; sacrum	
	L41069	CT scan; spine; thoracolumbar	
	L41077	CT scan; spine; cervicothoracic	
	L41080	CT scan; leg	
	N41006	CT scan; brain	
	N41008	CT scan; head	
	R41004	CT scan; sinus	
	X41010	CT scan; breast; female	
	Y41007	CT scan; breast; male	
Nuclear medicine	A41009	Nuclear medicine	
	A41011	Isotope scan	
	K41015	Scan; thallium heart	
	L41002	Scan; bone(s)	
	R41005	Scan; VQ (lung)	
Magnetic resonance imaging	A41008	MRI	
Notes 
1.	NOS—not otherwise specified; STD—sexually-transmitted disease; NEC—not elsewhere classified; MBS—Medicare Benefits Schedule; EUC—electrolytes, urea and creatinine; LDL—low-density lipoprotein; HDL—high-density lipoprotein; ESR—erythrocyte sedimentation rate; M,C&S—microscopy, culture and sensitivity; HIV—human immunodeficiency virus.
2.	‘–code’—signifies that the concept includes all of the specified code across all chapters of ICPC-2 (excluding the Z social chapter). Codes listed in this appendix are only those currently active within ICPC-2 PLUS.

Appendix 5: Chronic code groups from ICPC-2 and ICPC-2 PLUS
Table A5.1: Chronic code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC/ICPC-2 PLUS label	
Chronic problems managed	
Anxiety disorder	P74		Anxiety disorder	
Autism		P99005	Autism	
		P99006	Autism; child	
Back syndrome with radiating pain	L86		Back syndrome with radiating pain	
Back syndrome without radiating pain (excluding arthritis and sprains/strains)		L84001	Spondylosis	
		L84017	Spondylosis; lumbar	
		L84018	Degeneration; facet joint	
		L84019	Fracture; compression; spine	
		L84022	Spondylolisthesis	
		L84027	Degeneration; spine	
Chronic acne		S96002	Acne; vulgaris	
		S96003	Acne; conglobulate (cystic)	
		S96007	Acne	
Chronic arthritis	L88		Rheumatoid/seropositive arthritis	
	L89		Osteoarthrosis of hip	
	L90		Osteoarthrosis of knee	
	L91		Osteoarthrosis, other	
		L83010	Arthritis; spine; cervical	
		L83011	Osteoarthritis; spine; cervical	
		L84003	Arthritis; spine	
		L84004	Osteoarthritis; spine	
		L84009	Osteoarthritis; spine; thoracic	
		L84010	Osteoarthritis; spine; lumbar	
		L84011	Osteoarthritis; lumbosacral	
		L84012	Osteoarthritis; sacroiliac	
		L84023	Arthritis; spine; thoracic	
		L84024	Arthritis; spine; lumbar	
		L84025	Arthritis; lumbosacral	
		L84026	Arthritis; sacroiliac	
		LL89004	Arthritis; hip	
		L92006	Arthritis; shoulder	
(continued)

Table A5.1 (continued): Chronic code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC/ICPC-2 PLUS label	
Chronic problems managed (continued)	
Chronic arthritis (continued)		L92007	Osteoarthritis; shoulder	
		L92011	Humeroscapular periarthritis	
		S91002	Arthritis; psoriatic	
Chronic fatigue syndrome		A04028	Post viral syndrome	
		A04029	Chronic fatigue syndrome	
		A04030	Post viral fatigue syndrome	
		A04031	Myalgic encephalomyelitis	
Chronic rheumatic heart disease		K71002	Disease; rheumatic; heart	
		K71005	Stenosis; mitral; rheumatic	
		K71008	Stenosis; aortic; rheumatic	
		K71010	Carditis; rheumatic; chronic	
		K71012	Myocarditis; rheumatic; chronic	
		K71013	Pericarditis; rheumatic; chronic	
		K71015	Stenosis; arterial; rheumatic	
Chronic viral hepatitis		D72003	Hepatitis B	
		D72008	Hepatitis C	
		D72009	Hepatitis D	
		D72011	Hepatitis E	
Congenital anomaly, musculoskeletal		L82001	Achondroplastic dwarf	
		L82003	Clubfoot	
		L82007	Lordosis; congenital	
		L82012	Scoliosis; congenital	
		L82013	Ehlers Danlos syndrome	
		L82014	Talipes	
		L82015	Curvature of spine; congenital	
		L82018	Osteogenesis imperfecta	
		L82019	Kyphosis; congenital	
		L82021	Kyphoscoliosis; congenital	
		L82024	Dislocation;hip; congenital	
		L82025	Deformity;foot; congenital	
		L82027	Plagiocephaly	
		L82028	Cleidocranial dyostosis	
		L82029	Hemimelia	
Depressive disorder	P76		Depressive disorder	
Diabetes (non-gestational)	T89		Diabetes, insulin dependent	
	T90		Diabetes, non-insulin dependent	
(continued)

Table A5.1 (continued): Chronic code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC/ICPC-2 PLUS label	
Chronic problems managed (continued)	
Hereditary haemolytic anaemia	B78		Hereditary haemolytic anaemia	
Hypertension (non-gestational)	K86		Hypertension, uncomplicated	
	K87		Hypertension, complicated	
Hypertrophy tonsils/adenoids	R90		Hypertrophy tonsils/adenoids	
Ischaemic heart disease	K74		Ischaemic heart disease with angina	
	K76		Ischaemic heart disease without angina	
Lipid disorders	T93		Lipid disorders	
		T99075	Lipodystrophy	
Metabolic syndrome		T99084	Metabolic syndrome	
		T99085	Syndrome X	
Neck syndrome (excluding arthritis and sprains/strains)		L83001	Cervical spine syndrome	
		L83002	Slipped; disc; cervical	
		L83003	Disc syndrome; cervical	
		L83004	Cervicobrachial syndrome	
		L83005	Cervicocranial syndrome	
		L83006	Disc degeneration; cervical	
		L83007	Irritation; nerve root; cervical	
		L83008	Spondylosis; cervical	
		L83009	Torticollis	
		L83012	Nerve root compression; cervical	
		L83016	Spondylosis; myelopath; cervical	
		L83017	Irritation; cervical	
		L83018	Disc prolapse; cervical	
		L83021	Neuritis; cervical	
		L83022	Lesion; spinal disc; cervical	
		L83025	Injury; whiplash; old	
		L83027	Ruptured disc; cervical	
		L83028	Nucleus pulp hernia; cervical	
		L83029	Stenosis; spinal; cervical	
Psoriasis (excluding arthritis)		S91003	Arthropathy; psoriatic	
		S91004	Guttate psoriasis	
		S91001	Psoriasis	
		S91005	Psoriatic finger/toe nail(s)	
(continued)

Table A5.1 (continued): Chronic code groups from ICPC-2 and ICPC-2 PLUS
Group	ICPC-2 rubric	ICPC-2 PLUS code	ICPC/ICPC-2 PLUS label	
Chronic problems managed (continued)	
Shoulder syndrome (excluding arthritis)		L92001	Bursitis; shoulder	
		L92008	Capsulitis; adhesive	
		L92009	Capsulitis; shoulder	
		L92015	Epicondylitis; shoulder	
		L92002	Fibrositis; shoulder	
		L92010	Frozen shoulder	
		L92017	Painful arc syndrome	
		L92012	Rheumatism; shoulder	
		L92003	Rotator cuff syndrome	
		L92004	Shoulder syndrome	
		L92005	Synovitis; shoulder	
		L92013	Tendonitis; shoulder	
		L92016	Tendonitis; supraspinatus	
		L92014	Tenosynovitis; shoulder	
Note: The code groups listed in Appendix 5 are those which differ from other code groups used in the report (see Appendix 4), limiting analysis to only chronic conditions (see Glossary).

List of tables
Table 2.1:	Number of general practice professional services claimed from Medicare Australia each financial year, 1999–00 to 2008–09 (‘000)	11
Table 3.1:	Annual summary of data sets, 1999–00 to 2008–09 (final weighted data)	20
Table 4.1:	GP characteristics, BEACH, 1999–00 to 2008–09	23
Table 5.1:	Summary of morbidity and management, BEACH, 1999–00 to 2008–09	29
Table 5.2:	Type of encounter, summary of annual results (most frequent events), BEACH, 
1999–00 to 2008–09	31
Table 5.3:	Consultation length (minutes), BEACH, 2000–01 to 2008–09	32
Table 6.1:	Characteristics of patients at encounters, BEACH, 1999–00 to 2008–09	36
Table 6.2:	Number of patient reasons for encounter, BEACH, 1999–00 to 2008–09	38
Table 6.3:	Rate of patient reasons for encounter by ICPC-2 chapter, BEACH, 1999–00 to 
2008–09	38
Table 6.4:	Rate of patient reasons for encounter by ICPC-2 component, BEACH, 
1999–00 to 2008–09	40
Table 6.5:	Most frequent patient reasons for encounter, BEACH, 1999–00 to 2008–09	41
Table 7.1:	Number of problems managed at an encounter, BEACH, 1999–00 to 2008–09	47
Table 7.2:	Distribution of problems managed, by ICPC-2 component, BEACH, 
1999–00 to 2008–09	48
Table 7.3:	Distribution of problems managed, by ICPC-2 chapter, BEACH, 1999–00 to 
2008–09	49
Table 7.4:	Most frequently managed problems, BEACH, 1999–00 to 2008–09	51
Table 7.5:	Most frequently managed new problems, BEACH, 1999–00 to 2008–09	54
Table 7.6:	Most frequently managed chronic problems, BEACH, 1999–00 to 2008–09	56
Table 8.1:	Summary of management, BEACH, 1999–00 to 2008–09	60
Table 8.2:	Encounters for which at least one management was recorded, BEACH, 1999–00 to 2008–09	62
Table 9.1a:	Rates of medications prescribed, advised for over-the-counter purchase, supplied, per 100 encounters, BEACH, 1999–00 to 2008–09	65
Table 9.1b:	Rates of medications prescribed, advised for over-the-counter purchase, supplied 
per 100 problems, BEACH, 1999–00 to 2008–09	65
Table 9.2:	Distribution of prescribed medications (by ATC Level 2), BEACH, 1999–00 to 
2008–09	66
Table 9.3:	Most frequently prescribed medications (by CAPS generic), BEACH, 1999–00 to 2008–09	68
Table 9.4:	Number of repeats for prescribed medications, BEACH, 1999–00 to 2008–09	72
Table 9.5:	Medications most frequently supplied by GPs, BEACH, 1999–00 to 2008–09	74
Table 9.6:	Most frequently advised over-the-counter medications, BEACH, 1999–00 to 
2008–09	75
Table 10.1:	The most frequent clinical treatments, BEACH, 1999–00 to 2008–09	78
Table 10.2:	The most common problems managed with a clinical treatment, BEACH, 
1999–00 to 2008–09	80
Table 10.3:	The most frequent procedural treatments, BEACH, 1999–00 to 2008–09	82
Table 10.4:	The most common problems managed with a procedural treatment, BEACH, 
1999–00 to 2008–09	83
Table 11.1:	The most frequent referrals, BEACH, 1999–00 to 2008–09	86
Table 12.1:	Number of encounters at which pathology or imaging was ordered, BEACH, 
1999–00 to 2008–09	92
Table 12.2:	Distribution of pathology orders across pathology groups, BEACH, 
1999–00 to 2008–09	93
Table 12.3:	Most frequent imaging tests ordered, BEACH, 1999–00 to 2008–09	94
Table 13.1:	Summary of practice nurse involvement at encounter, and claims made, BEACH, 
2005–06 to 2008–09	96
Table 13.2:	Distribution of practice nurse item numbers recorded at encounter, BEACH, 
2005–06 to 2008–09	97
Table 13.3:	Summary of treatments provided by practice nurse, BEACH, 2005–06 to 2008–09	98
Table 13.4:	Most frequent treatments provided by practice nurses, BEACH, 2005–06 to 
2008–09	99
Table 13.5:	The most common problems managed with the involvement of practice nurse, BEACH, 2005–06 to 2008–09	100
Table 14.1:	Comparative results for all patient risk factors, BEACH, 1999–00 to 2008–09	103
Table 14.2:	Comparative results for adult male patient risk factors, BEACH, 1999–00 to 
2008–09	105
Table 14.3:	Comparative results for adult female patient risk factors, BEACH, 1999–00 to 
2008–09	106

List of figures
Figure 2.1: The BEACH relational database
Figure 2.2: The structure of the International Classification of Primary Care—Version 2 (ICPC–2)
Figure 4.1: Summary of changes in GP characteristics, 1999–00 to 2008–09
Figure 12.1: Encounters where pathology was ordered, and pathology test order rates per 100 encounters, 1999–00 to 2008–09 (95% CI)