The Medical journal of Australia
-
To examine policy and implementation issues around multidisciplinary care planning (MDP) as a means of improving outcomes for patients with chronic disease and/or complex care needs. ⋯ While MDP improves many functional outcomes, widespread implementation of MDP in standard practice will require complex and targeted strategies. Devising and testing such strategies is a prerequisite for widespread, routine use of MPD in chronic disease management.
-
Review Meta Analysis
Models of chronic disease management in primary care for patients with mild-to-moderate asthma or COPD: a narrative review.
To review the literature for any promising strategies for the primary care management of mild-to-moderate asthma and chronic obstructive pulmonary disease (COPD) in adults. ⋯ The role of primary health care in management of mild-to-moderate asthma and COPD requires further investigation using randomised controlled trials.
-
To identify sustainable governance arrangements for health care organisations undertaking integrated health service delivery based on best available evidence. ⋯ State governments are increasingly attempting to work with non-government organisations and the private sector to maximise scarce resources in the face of increasing health care demand. Ambitious integration agendas must be underpinned by effective governance mechanisms that are appropriate to the undertaking, the stakeholders involved and the scale of delivery.
-
To review innovative models of primary care in different countries in order to identify potential mechanisms for reforming primary care policy in Australia. ⋯ There are tensions and tradeoffs involved in balancing professional and bureaucratic control and in linking quality and accountability mechanisms. Enhanced linkage between researchers, policymakers and professional groups could assist in exploring options for effective primary care reform.
-
To identify the types of strategy used to coordinate care within primary health care (PHC) and between PHC, health services and health-related services in Australia and other countries that have comparable health systems, and to describe what is known about their effectiveness; to review the implications for health policy and practice in Australia. ⋯ The largely incremental approach to improving coordination of care in Australia has involved a broad range of strategy types but has also perpetuated existing structural problems. Reforms in governance, funding and patient registration in primary health care would provide a stronger base for effective care coordination.