Carmen Zhang
Ying Pan
Helena Britt
General practitioner participants in the BEACH (Bettering the Evaluation and Care of Health) program were asked to indicate which problems managed at the encounter were considered to be work related. From April 2007 to March 2012, at least one work related problem was managed at 2.7% of all encounters (11 429 encounters). A total of 16 045 problems were managed at these encounters, of which 11 911 (74.2%) were work related. Three-quarters (75.7%) of recorded work related encounters were claimable through workers’ compensation.
When compared with the BEACH average, patients seen at work related encounters were more likely to be male (54.8% vs 39.1%) than female (44.3% vs 60.9%). The age distribution of patients at work related encounters reflected workforce age with 8.1% aged 15–24 years, 38.8% aged 25–44 years, 49.5% aged 45–64 years and 3.6% aged 65 years and more.
Musculoskeletal problems accounted for almost 60% of work related problems managed. Psychological problems and skin problems were also frequently recorded, accounting for 12.4% and 9.9% respectively. Table 1 shows the 10 most common specific work related problems managed. Medications were prescribed, supplied at the encounter or advised for over-the-counter purchase at a rate of 52.6 per 100 work related problems. This was a significantly lower rate than the BEACH average (65.4 per 100 problems). Opioids were the most common medication group, recorded at a rate of 17 per 100 work related problems, the most common being paracetamol/codeine 30 mg (6.6 per 100 work related problems).
Table 1. Most common work related problems managed April 2007 to March 2012
| | Rate per 100 work related encounters |
|---|
| Back complaint |
16.0 |
| Sprain/strain |
10.6 |
| Musculoskeletal injury NOS |
9.0 |
| Depression |
5.2 |
| Fracture |
3.5 |
| Skin injury NOS |
3.5 |
| Acute stress reaction |
3.1 |
| Shoulder syndrome (excluding arthritis and osteoarthritis) |
3.0 |
| Bursitis/tendonitis/synovitis |
2.8 |
| Laceration/cut |
2.7 |
| NOS = not otherwise specified |
Other treatments were frequently provided in the management of work related problems (52.6 per 100 work related problems). The most common other treatment was the provision of a sickness certificate (15.1 per 100 work related problems), followed by psychological counselling (5.2 per 100).
Referrals were given at a rate of 16 per 100 work related problems: 43% to a physiotherapist, 15.3% to an orthopaedic surgeon and 8% to a psychologist. This referral rate was much higher than the BEACH average of 9.4 per 100 problems managed.
The imaging order rate of 8.6 per 100 work related problems was significantly higher than the BEACH average of 6.8 per 100 problems, while the rate of pathology test ordering (5.8 per 100 work related problems) was far lower than the BEACH average (33.4 per 100 problems). A wide range of imaging and pathology test orders were recorded. The most common imaging order was for ultrasound of the shoulder (1.1 per 100 work related problems) and the most common pathology test was full blood count (0.8 per 100).
Competing interests: None.
Provenance and peer review: Commissioned; not peer reviewed.
Acknowledgements
The authors thank the GP participants in BEACH and all members of the BEACH team. Funding contributors to BEACH between April 2007–2008 and April 2011– March 2012: Abbott Australasia Pty Ltd; Australian Government Department of Health and Ageing; AstraZeneca Pty Ltd (Australia); Bayer Australia Ltd; CSL Biotherapies Pty Ltd; GlaxoSmithKline Australia Pty Ltd; Janssen-Cilag Pty Ltd; Merck, Sharp and Dohme (Australia) Pty Ltd; National Prescribing Service Ltd; Novartis Pharmaceuticals Australia Pty Ltd; Pfizer Australia; Sanofi-Aventis Australia Pty Ltd; Wyeth Australia Pty Ltd.
Correspondence afp@racgp.org.au
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