Abstract
To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.
Highlights
To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services
In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities
This paper describes how Australian primary health care is currently integrated, assesses the likely impact of current and proposed reforms and suggests what else may be required for effective and sustainable integration
Summary
Gawaine Powell Davies, Associate Professor, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Julie McDonald, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Anna Williams, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Correspondence to: Gawaine Powell Davies, Associate Professor, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia, Phone: +61 2 93851506, Fax: +61 2 93851513, E-mail: g.powell-davies@ unsw.edu.au
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have