RESEARCH ROUNDup

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After-hours primary care
(Primary Health Care Research & Information Service, 2012-07) Anikeeva, Olga
After-hours primary care has the potential to improve consumer access to services and reduce the burden on hospital emergency departments. This RESEARCH ROUNDup outlines the function of five models of after-hours service provision, discusses Australian examples of after-hours services and presents information regarding each model’s effectiveness and shortcomings.
Allied health practitioners in Australian primary health care
(Primary Health Care Research & Information Service, 2014) Raven, Melissa
Allied health practitioners (AHPs) are a large and diverse group of health professionals who are integral to the healthcare system. Many work in primary health care, mainly in private practice. Utilisation of AHP services is higher among people with chronic diseases. AHPs are under-researched, and they often lack recognition for their contribution to health care. This RESEARCH ROUNDup provides an overview of AHPs in primary health care, particularly in Australia. There is a need for more research by and about AHPs, better integration into the health system, and more interprofessional education.
Australia’s primary health care research workforce
(Primary Health Care Research & Information Service, 2009-12) Kalucy, Elizabeth Carment; Katterl, Rachel; McIntyre, Ellen
Australian healthcare is on the brink of a significant reform process. While much is yet to be decided, two clear themes can be identified from the reform reports. The first is the importance of multidisciplinary team work in the primary health care (PHC) setting. The second is the importance of further developing and strengthening Australia’s PHC research sector, which is critical to inform its health policy and practice. These themes of a stronger multidisciplinary focus and a stronger PHC research sector reinforce each other, as clinical, health system and health services research increasingly needs to be undertaken by researchers from multiple disciplines and backgrounds.
Avoiding hospitalisation: ambulatory care sensitive conditions
(Primary Health Care Research & Information Service, 2010-07) Muecke, Sandy
This RESEARCH ROUNDup examines the scope of ambulatory care sensitive conditions (ACSC) in Australia, and their reliability as a measure of primary health care (PHC) performance. Avoidable hospitalisation statistics for Australia, Victoria and New South Wales are presented. Complications of diabetes are the most common ACSCs encountered in Australia. Rurality and socio-economic disadvantage are linked to avoidable hospitalisation.
Avoiding hospitalisation: effective primary care interventions
(Primary Health Care Research & Information Service, 2010-10) Muecke, Sandy
Ambulatory care sensitive conditions (ACSCs) “represent a range of conditions for which hospitalisation should be able to be avoided because the disease or condition has been prevented from occurring, or because individuals have had access to timely and effective primary care”. This RESEARCH ROUNDup investigates the factors that may predict avoidable hospital admissions. It also provides an overview of interventions that may be effective in reducing avoidable hospitalisations, and follows from a previous issue that examined the scope of ACSCs in Australia, and their reliability as a measure of primary health care (PHC) performance.
Blended funding models in primary health care
(Primary Health Care Research & Information Service, 2015) Oliver-Baxter, Jodie
This RESEARCH ROUNDup explores the application of blended funding models in primary health care. It presents a snapshot of examples and evaluations of effects and consequences of implementing blended funding models in Australia, New Zealand and Canada and the impact of these approaches on organisations, care delivery for chronic conditions and patient experience.
Chronic disease self-management
(Primary Health Care Research & Information Service, 2009-07) Katterl, Rachel; Kalucy, Elizabeth Carment
Chronic conditions cannot be ‘cured’. Therefore effective strategies are required to manage the illnesses and minimise their consequences for patients, their families and the health system. Self-management programs represent a way in which this care may be realised. Self-management programs focus on teaching patients to control their chronic illness more effectively. These programs can be generic (for those with multiple chronic diseases) or disease-specific, and are considered to be a component of the overall management of chronic disease. The Australian Government has focused on a dedicated push towards self-management practice. The Department of Health and Ageing currently administers the Sharing Health Care initiative as part of a package that is targeting older Australians with complex and chronic conditions.
Co-morbidity of mental and physical illness: meeting unmet care needs
(Primary Health Care Research & Information Service, 2011-08) Lunnay, Belinda Kate; Bywood, Petra Teresia
People with chronic physical conditions experience poorer mental health compared to the general population. Co-morbid depression and chronic disease are associated with high healthcare use and high costs to the health system. Despite improvements in mental health care service delivery, people experiencing mental illness have high mortality from physical health issues, suggesting that the health care needs of this group are not being met. This RESEARCH ROUNDup explores the reasons for primary health care disadvantage among people with physical and mental illness co-morbidity, and strategies to improve health care provision for this group.
Communication between health professionals across sectors
(Primary Health Care Research & Information Service, 2013-01) Oliver-Baxter, Jodie
Bringing disparate activities and services into a coherent system requires well-resourced communication. The World Health Organization defines health services integration as: bringing together common functions within and between organisations to solve common problems, developing commitment to a shared vision and goals and using common technologies and resources to achieve these goals. This RESEARCH ROUNDup explores strategies that enable interactive, timely, two-way exchange of pertinent clinical information between care providers across primary, acute and specialist settings.
Complementary medicine use in chronic disease: What is the evidence?
(Primary Health Care Research & Information Service, 2013) Oliver-Baxter, Jodie; Brown, Lynsey
The use of complementary and alternative medicine (CAM) is commonplace in people managing chronic disease. This RESEARCH ROUNDup highlights evidence for the medication-based CAM used to address chronic conditions considered national priority areas in Australia. Nevertheless, more high quality evidence on prevalence of use, concurrent use of other medications and profiles of CAM users particularly for specific conditions is required for consumers, clinicians (both CAM and non-CAM), regulators, educators, researchers, policy-makers and funders.
Continuity and safety in care transitions: communication at the hospital/community care interface
(Primary Health Care Research & Information Service, 2010-05) Muecke, Sandy; Kalucy, Elizabeth Carment; McIntyre, Ellen
In the health care setting, risks to patient safety may arise when there is poor written or verbal communication between personnel during times of care transition. Care transition refers to the “set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location”. Transitions occur at staff shift changes within health care institutions, transfer between institutions, or, at the interface between acute and community care. This RESEARCH ROUNDup outlines communication mishaps that may occur in the latter instance, during discharge from hospital to community based care.
Dementia and primary health care
(Primary Health Care Research & Information Service, 2009-04) Katterl, Rachel; Kalucy, Elizabeth Carment
Dementia care is becoming increasingly relevant in Australia as our population ages, presenting challenges for an already stretched health system. General practitioners are the first port of call in dementia identification and care, and are the coordinators of dementia identification and management. There is increasing involvement of practice nurses in these processes. Carers and many health professionals believe early diagnosis is critical, though GPs report diagnosing only for functional necessity such as to prescribe medication. Referrals for carers to information and support services are often delayed until carers reach ‘breaking point’, highlighting the need for anticipatory referral processes. Carers are often called the ‘hidden patients’ as they suffer from higher physical and mental illness resulting from caregiver burden.
eHealth technologies in primary health care: current strengths and limitations
(Primary Health Care Research & Information Service, 2011-11) Anikeeva, Olga; Bywood, Petra Teresia
eHealth aims to improve the quality and safety of Australia’s health system by introducing a more efficient way to collect and share information such as prescriptions and test results. The primary health care sector could benefit substantially from the widespread use of eHealth technologies. The National E-Health Transition Authority is currently working with numerous stakeholders, including general practitioners and allied health professionals to develop an eHealth uptake plan. This RESEARCH ROUNDup focuses on the use of eHealth technologies in primary health care, by exploring the benefits and current limitations of a number of eHealth tools.
Evaluation of chronic disease management in primary health care
(Primary Health Care Research & Information Service, 2009-11) Isherwood, Linda; Kalucy, Elizabeth Carment
Rigorous evaluation of health care interventions can provide the evidence needed to improve patient outcomes and to inform decisions regarding future initiatives. A Healthier Future for all Australians emphasises “knowledge-led continuous improvement, innovation and research” and a “greater investment in public health, health policy and health services research including ongoing evaluation of health reforms”. This RESEARCH ROUNDup follows on from a previous issue: Chronic disease self-management. It covers evaluation research which is being undertaken within Australian primary health care in the field of chronic disease management (CDM).
Generating a report card for type 2 diabetes in Australia
(Primary Health Care Research & Information Service, 2014) Erny-Albrecht, Katrina; Bywood, Petra Teresia
The National Diabetes Strategy and Action Plan proposed by Diabetes Australia, is the latest Australian initiative aimed at turning around the increasing burden of diabetes.1 Approximately 10% of all patients attending a General Practitioner (GP) in Australia have diabetes.2 An integral component of the Action plan is to establish a Commission whose responsibilities would include producing an annual report card to inform Australians of what we are doing well and where we need to do better. The aim of this RESEARCH ROUNDup is to generate a report card for diabetes type 2 based on nationally representative data.
The growing burden of multimorbidity
(Primary Health Care Research & Information Service, 2013) Erny-Albrecht, Katrina; McIntyre, Ellen
Over the past decade the Australian government has initiated a number of health care reforms to address the needs of those with chronic conditions such as diabetes, and heart disease. However, the success of chronic care management models has not been universal. Failure to achieve care goals in some patients might be because many patients have multimorbidity. The recently established Medicare Locals may be well placed to play a central role in providing improved care for those with chronic conditions, and in particular development of management plans that take account of multimorbidity. In this RESEARCH ROUNDup we define some of the key findings central to future discussions of this issue in the Australian setting.
Health information: where do patients obtain it and why does it matter?
(Primary Health Care Research & Information Service, 2014) Erny-Albrecht, Katrina
While most agree that it is important for patients to have information about their health, and population based surveys of the Australian public show that General Practitioners (GPs) remain the most frequent health information source, people are increasingly exposed to health information from mainstream media sources such as the Internet and television.1,2 The quality and accuracy of that information can have a major impact on patient awareness and compliance, and in broader terms affect delivery and access to effective health care, as well as the development of health care policy.3,4 This RESEARCH ROUNDup explores recent reports about the ways in which Australians obtain health information, the quality of that information, and reviews the responsibility of GPs in responding and contributing to that information.
Health literacy and primary health care
(Primary Health Care Research & Information Service, 2011-10) Jackson-Bowers, Eleanor; Howard, Sara Louise; Bywood, Petra Teresia
People with low levels of health literacy report poorer health status and experience poorer health outcomes compared to those with good health literacy. Poor health literacy is most prevalent in socio-economically disadvantaged populations, which are often in greater need of health care to manage complex conditions. In recognition of its potential positive impact on health outcomes, improving the health literacy of populations is being incorporated into policy. This RESEARCH ROUNDup reports on some recent developments in health literacy research and the role of primary health care in enhancing health literacy to improve health outcomes.
Health promotion of physical activity
(Primary Health Care Research & Information Service, 2009-10) Isherwood, Linda; Kalucy, Elizabeth Carment; Katterl, Rachel; Reinfeld-Kirkman, Nova
Health promotion, or “the process of enabling people to increase control over their health and its determinants, and thereby improve their health” is expected to be an integral part of future Australian health policy. It has been suggested that a National Health Promotion and Prevention Agency be established to build the evidence base of effective health promotion and prevention strategies. The Preventative Health Taskforce report recently outlined specific strategies to reduce rates of obesity and tobacco and alcohol consumption. This issue of RESEARCH ROUNDup looks at promotion of physical activity (PA), exploring the effectiveness of interventions and the contributions of recent Australian research to the evidence about promoting physical activity in the primary care setting.
Home Medicine Reviews: Recent changes and potential implications
(Primary Health Care Research & Information Service, 2014) Huynh, Kym; Erny-Albrecht, Katrina; McIntyre, Ellen
Earlier this year, the Pharmacy Guild of Australia announced the restructure of the Home Medicine Review (HMR) program. The new funding provision of this program requires a minimum two-year interval between each review conducted for a specific patient. Significant debate has arisen about the potential implications this will have on all stakeholders, particularly consumers, and on the incidence of medication errors and use of health care resources. The Pharmacy guild has announced that the changes will "ensure the ongoing viability" of the program and as part of this they will also work to identify patients who will most benefit from HMR services.1 This RESEARCH ROUNDup provides a brief overview of the current evidence of the benefits and limitations of HMRs and discusses cohorts of patients who might be targeted to maximise HMR benefits.

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