What is needed for integration of health services? Medicare Locals - A model for integrating primary health care

Abstract

Primary health care (PHC) is often the first level of contact individuals, families and communities have with the health system. National health reform in Australia has seen the introduction of Medicare Locals (MLs), PHC organisations charged with a number of objectives, one of which is improving the patient journey through developing integrated and coordinated services. Integration in this context refers to the health system’s ability to provide effective care as a person moves between different providers, with appropriate transfer of information and utilisation of resources. This qualitative study explored the perceptions of ML chief executive officers from around Australia regarding the operationalisation of integration in their local area. Analyses provided definitions of integration as connections across service providers and organisations, with emphasis on continuity of care. Many of the participants described the importance of partnerships between general practice and allied health with examples around psychological services and chronic disease management. The requisites (e.g., accessibility, infrastructure, incentives), building blocks (e.g., relationships, communication) and challenges (e.g., geography, culture, funding) of integration will be presented. Further, opportunities for the future will be discussed with emphasis on the value of multidisciplinary teams and applying population health approaches to support patients at a local level.