RESEARCH ROUNDup

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    Patient-centred care and self-management support in primary health care
    (Primary Health Care Research & Information Service, 2015) Raven, Melissa
    Patient-centred care (PCC) is prominent in current healthcare, particularly in relation to the care of people with chronic diseases/conditions. Self-management by patients, in tandem with self-management support (SMS) provided by medical/health professionals, is a key strategy in chronic disease management. Patient-centredness is viewed as central to SMS. This RESEARCH ROUNDup discusses PCC and SMS in primary health care (PHC) settings, including a brief outline of the history, policy context, and evidence base.
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    Pay for performance: Australian landscape, international efforts, and impact on practice
    (Primary Health Care Research & Information Service, 2016) Masters, Stacey Cynthia; Brown, Lynsey
    Fee-for-service (FFS) funding continues to dominate primary health care in Australia despite calls for reform. FFS, where providers bill for each service they provide, rewards increased activity. This may lead to over-servicing, increased costs (with no controls on prices charged), and negative impacts on quality of care. In contrast, pay-for-performance (P4P) approaches refer to payments to general practitioners (GPs) or practices, according to the number of times a certain standard of performance is met, and have been shown to improve quality.1; 2 Blended funding models have been trialled in Australia, with the 2011-14 Diabetes Care Project (DCP) incorporating P4P and flexible funding, while retaining FFS components. This RESEARCH ROUNDup will examine P4P in the Australian primary health care context and provide lessons from both systematic reviews and international experiences of P4P in primary health care.
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    Transitions from hospital to primary care
    (Primary Health Care Research & Information Service, 2016) Masters, Stacey Cynthia; Brown, Lynsey
    For older Australians, transitions from hospital to primary care (i.e. general practice, community and/or aged care) are frequently accompanied by discontinuities in medication management, delays in follow‐up care, duplication of tests, adverse events and readmissions to hospital. This RESEARCH ROUNDup describes factors affecting smooth transitions and provides examples of best practice.
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    Understanding the policy cycle and knowledge translation for researchers (A researcher’s guide)
    (Primary Health Care Research & Information Service, 2015) Brown, Lynsey; Hagger, Christina; Bywood, Petra Teresia
    This RESEARCH ROUNDup introduces knowledge translation, suggests avenues where research evidence can inform different stages of the policy cycle, and provides some practical tips for researchers.
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    Use of chronic disease management software in Australia
    (Primary Health Care Research & Information Service, 2015) Erny-Albrecht, Katrina
    Computer based chronic disease management or clinical decision software packages are being developed partly in response to the barriers to optimal care identified by general practitioners: complexity of care regimens, administrative burden, and need for communication within multidisciplinary teams.1 The premise is that the cost of implementation may be offset by improved patient outcomes resulting in reduced complications and/or hospitalisation events. Achieving this is likely to require ongoing management and monitoring to ensure individuals receive optimal care over the long term, as well as practice support to manage the increasing numbers of patients and improve adherence to best‐practice. This RESEARCH ROUNDup summarises the latest evidence and current status of computer software use for chronic disease management in Australia.
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    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.
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    PHC and integration with aged care services: Challenges and approaches in Australia
    (Primary Health Care Research & Information Service, 2015) Brown, Lynsey; Davis, Jenny
    Recent Australian health reforms highlight the role of effective primary health care (PHC) in providing coordinated, person-centred care and keeping individuals out of hospital.1 In the context of an ageing population and rising rates of chronic and complex conditions, there is growing demand for health services. Collaboration is needed across all service providers who support older people, including integrating PHC with aged care services. This RESEARCH ROUNDup highlights current challenges and approaches to such integration in Australia.
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    Primary health care and preventive care
    (Primary Health Care Research & Information Service, 2014) Oliver-Baxter, Jodie; Brown, Lynsey
    Preventive care refers to interventions which aim to prevent progression of a condition. They may be applied at individual or population levels and at various stages of disease development. For the primary health care (PHC) sector, preventive care is a priority and a challenge. This RESEARCH ROUNDup reviews preventive care in the PHC setting including consideration of time, resources and strategies in an Australian context.
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    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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    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.
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    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.
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    Patient enrolment in Australian primary health care
    (Primary Health Care Research & Information Service, 2014) Oliver-Baxter, Jodie
    Patient enrolment in general practice is an important consideration for health systems, administrators, service providers and consumers across the world. This RESEARCH ROUNDup reviews patient enrolment in the Australian context, including both strengths and weaknesses of the approach, the policy context and examples of programs currently being implemented nationally.
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    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.
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    Patient experience of primary health care
    (Primary Health Care Research & Information Service, 2013) Raven, Melissa
    There has been considerable research on patient satisfaction and other aspects of patient experience, but much of it is dated, and the generally positive findings are complicated by significant conceptual and methodological issues. This RESEARCH ROUNDup focuses on patients' experiences of primary health care in Australia in the context of the broader international research base. It briefly discusses relevant findings from the Australian Bureau of Statistics, the National Health Performance Authority's 'Healthy Communities' reports, the Productivity Commission's Report on Government Services, and the Council of Australian Governments Reform Council's report on the National Healthcare Agreement.
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    Primary health care funding models
    (Primary Health Care Research & Information Service, 2013) Oliver-Baxter, Jodie; Brown, Lynsey
    The way primary health care (PHC) services are funded ultimately impacts on the quality, access and coordination of health service delivery. Financial mechanisms have long been used to influence provider behaviour, for example to increase productivity, control costs and improve efficiency.1 Health system administrators are charged with the task of meeting growing demand for services with finite resources, emphasising quality and placing a financial value on it. This RESEARCH ROUNDup examines the funding models that impact on PHC service delivery.
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    International trends and initiatives in primary health care
    (Primary Health Care Research & Information Service, 2013) Brown, Lynsey; Oliver-Baxter, Jodie; Bywood, Petra Teresia
    Recent trends in international health system reform have drawn attention to patient-centred approaches, multimorbidity, integration, workforce models of care and eHealth. A range of primary health care (PHC) initiatives have been implemented to support the operationalisation of these trends in countries’ local contexts. This RESEARCH ROUNDup introduces these trends and identifies initiatives designed to target them, describing evaluation findings where possible. Evidence is presented from countries perceived as comparable to Australia in terms of the organisation, funding and delivery of PHC. Future directions for PHC reform are discussed.
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    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.
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    Social determinants of health: Closing the gap in primary health care
    (Primary Health Care Research & Information Service, 2013) Raven, Melissa
    Australian primary health care has a major role to play in addressing social determinants of health (SDOH). This RESEARCH ROUNDup examines the relevance of the Closing the gap in a generation report of the World Health Organization's Commission on Social Determinants of Health, the Senate inquiry into Australia's response to that report, and more broadly the significance of SDOH.
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    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.
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    Oral health, dental care, and primary health care
    (Primary Health Care Research & Information Service, 2013) Raven, Melissa
    Australia's oral health is suboptimal, particularly among disadvantaged people. One quarter of Australian adults have untreated decay and 23% have moderate or severe gum disease. Poor oral health is not only a source of pain, embarrassment, discrimination, and financial pressure for individuals, but also contributes to significant medical problems that impose a substantial burden on the community, the health system, and the economy. Expenditure on dental health accounts for more than 6% of total health funding. This RESEARCH ROUNDup discusses the problems and the potential solutions at a population and primary health care level, including the establishment of a universal dental care scheme.