Perspectives of Australian general practitioners on shared care for paediatric patients

Australian general practitioners (GPS) are seeing proportionally fewer paediatric patients. GPS may be increasingly relying on secondary or tertiary care physicians to provide care to children with complex, chronic conditions. Shared-care initiatives may provide a solution to the apparent increasing dependence of GPS on paediatric specialists, although, currently, evidence is lacking about both the prevalence and composition of shared care for children in Australia. We invited 377 GPS in Melbourne, Australia, who had referred at least two children to specialist paediatric outpatient clinics within the 2014 calendar year, to participate in a mailed survey study. Items analysed for the present report included those relating to shared-care arrangements between GPS and paediatric specialists. Responses were received from 254 GPS (response rate 67%). The majority (90%) of GPS in our study have been involved in shared-care arrangements with outpatient paediatricians. We found wide variation in the success of these arrangements, measured through the ability of GPS to establish clear roles with paediatricians. For a national discussion around shared care to be productive, clear definitions and classifications will be crucial. Future research could investigate the reasons for variability in shared care in Australia, and examine optimal shared-care arrangements for children.