When appropriately resourced, medical homes can deliver the system-wide benefits of truly integrated primary care
For patients with chronic and complex conditions, optimal care involves a range of clinical skills other than those provided by doctors (eg, a social worker, a clinical nurse specialist or a home care team), some of which are generally not available through Medicare. Patients experience fracturing of their care — such as the need to obtain referrals to consult other health practitioners — and significant out-of-pocket expenses, on which Australians spent around $27.5 billion dollars in 2013–14.1
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- 1. Australian Institute of Health and Welfare. Health expenditure Australia 2013–14 (AIHW Cat. No. HWE 63; Health and Welfare Expenditure Series No. 54). Canberra: AIHW; 2015. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129552833 (accessed May 2016).
- 2. Royal Australian College of General Practitioners. The RACGP’s vision for general practice and a sustainable healthcare system. Melbourne: RACGP; 2015. http://www.racgp.org.au/download/Documents/advocacy/racgp-vision-for-general-practice-and-a-sustainable-health-system.pdf (accessed June 2016).
- 3. Reid RJ, Coleman K, Johnson EA, et al. The Group Medical Home: cost savings, higher patient satisfaction and less burn out for providers. Health Affairs 2010; 29: 835-843.
- 4. Rosenthal TC. The medical home: growing evidence to support a new approach to primary care. J Am Board Fam Med 2008; 21: 427-440.
- 5. Nielsen M, Langner B, Zema C, et al. Benefits of implementing the primary care patient-centered medical home: a review of cost and quality results, 2012. Washington, DC: Patient-Centered Primary Care Collaborative; 2012. https://www.pcpcc.org/sites/default/files/media/benefits_of_implementing_the_primary_care_pcmh.pdf (accessed June 2016).
- 6. Nutting PA, Miller WL, Crabtree BF, et al. Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. Ann Fam Med 2009; 7: 254-260.
- 7. Saultz JW, Albedaiwi W. Interpersonal continuity of care and patient satisfaction: a critical review. Ann Fam Med 2004; 2: 445-451.
- 8. Mead N, Power P. Patient centeredness: a conceptual framework and review of the empirical literature. Sci Med 2000; 51: 1087-1110.
- 9. American College of Physicians. The advanced medical home: a patient-centered, physician-guided model of health care. A policy monograph. Washington, DC: ACP; 2006. http://www.acponline.org/system/files/documents/advocacy/current_policy_papers/assets/adv_med.pdf (accessed June 2016).
- 10. Zhou YY, Kanter MH, Wang JJ, Garrido T. Improved quality at Kaiser Permanente through e-mail between physicians and patients. Health Affairs 2010; 29: 1370-1375.
- 11. Australian Institute of Health and Welfare. Admitted patient care 014-2015: Australian Hospital statistics (AIHW Cat. No. HSE 172; Health Services Series No. 68). 2016. Canberra: AIHW.
- 12. Ernst and Young. A model for Australian General Practice: the Australian person centered medical home. November 2015 http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/new_zealand_ipas_260912-update.pdf (Accessed June 2016).
- 13. Huang X, Rosenthal MB. Transforming specialty practice — the patient-centered medical neighborhood. N Engl J Med 2014; 370: 1376-1379.
- 14. Primary Health Care Advisory Group. Better outcomes for people with chronic and complex health conditions. Canberra: Department of Health, Commonwealth of Australia; 2015. http://www.health.gov.au/internet/main/publishing.nsf/Content/76B2BDC12AE54540CA257F72001102B9/$File/Primary-Health-Care-Advisory-Group_Final-Report.pdf (accessed June 2016).
- 15. Thorlby R. Primary care for the 21st century - The Nuffield Trust. http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/new_zealand_ipas_260912-update.pdf (accessed Oct 2016).
- 16. Royal Australasian College of Physicians. Integrated care and physicians. Discussion paper, March 2016. Sydney: RACP; 2016. http://www.hcasa.asn.au/documents/264-integrated-care-and-physicians-discussion-paper/file (accessed June 2016).
- 17. Australian Medical Association [website]. AMA position statement on the medical home — 2015. Canberra: AMA; 2015. https://ama.com.au/position-statement/ama-position-statement-medical-home (accessed June 2016).
- 18. MacKee N. Medical home potential. MJA InSight 2015; 8 Jun. http://www.doctorportal.com.au/mjainsight/2015/21/medical-home-potential
- 19. Rollins A. GP capitation payments: the New Zealand experience [online]. Aust Med 2014; 26(7): 8. http://search.informit.com.au/documentSummary;dn=482622405164504;res=IELAPA (accessed June 2016).
- 20. Schroder SA, Frist W. Phasing out of fee-for-service payment. N Engl J Med 2013; 368: 2029-2032.
- 21. Swerissen H, Duckett S. Chronic failure in primary care. Melbourne: Grattan Institute; 2016. http://grattan.edu.au/wp-content/uploads/2016/03/936-chronic-failure-in-primary-care.pdf (accessed July 2016).
- 22. Vanhaecht K, Bollmann M, Bower K. Prevalence and use of clinical pathways in 23 countries – an international survey by the European Pathway Association. Int J Care Pathw 2006; 10: 28-34.
- 23. Meyer H. A new care paradigm slashes hospital use and nursing home stay for the elderly and the physically and mentally disabled. Health Affairs 2011; 30: 412-415.
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