General practice consultations in residential aged care facilities during the COVID-19 pandemic period

Introduction
Medical Benefits Schedule (MBS) telehealth items have been made available in Australia since March 2020
to facilitate timely healthcare delivery. This study describes the patterns of general practitioner (GP)
consultations in residential aged care facilities (RACFs) during the COVID-19 pandemic.
Methods
Using GP electronic data covering 454 practices in Victoria and 346 practices in NSW, we identified RACF
residents based on GP face-to-face MBS items specifically used in RACFs among those ≥65 years with ≥2 GP
face-to-face consultations over the past two years. We calculated monthly GPs’ in-person visits to RACFs
(MBS item 90001) and proportions of face-to-face, telephone, and video consultations against total claims
of standard GP consultations.
Results
Among 15,851 residents (63.5% aged 85+y, 66.7% female) in Victoria and 6,946 residents (60.4% aged 85+y,
62.3% female) in NSW, monthly GP visits sightly increased in NSW [median (IQR): 1,279 (1,094-1,315) in
2019 and 1,417 (1,337-1,467) in 2020] but decreased in Victoria in 2020 [(4,000 (3,757-4,557) in 2019 and
3,561 (3,434-3,753)] in 2020). Face-to-face consultations declined since April 2020, with 86% and 90% in
NSW and 83% and 71% in Victoria in April and August, respectively, while telephone consults increased to
13% and 10% in NSW and 14% and 26% in Victoria, respectively. Video consultations remained low (<4%) in
both states.
Implication
Telehealth filled the gap of GP services delivery in RACFs during the COVID-19 pandemic. Future studies
should examine how telehealth affects quality of care in aged care residents, including disease
management, medication prescriptions, and routine laboratory testing.