Abstract
BackgroundRates of chronic disease are escalating around the world. To date health service evaluations have focused on interventions for single chronic diseases. However, evaluations of the effectiveness of new intervention strategies that target single chronic diseases as well as multimorbidity are required, particularly in areas outside major metropolitan centres where access to services, such as specialist care, is difficult and where the retention and recruitment of health professionals affects service provision.MethodsThis study is a longitudinal investigation with a baseline and three follow-up assessments comparing the health and health costs of people with chronic disease before and after intervention at a chronic disease clinic, in regional Australia. The clinic is led by students under the supervision of health professionals. The study will provide preliminary evidence regarding the effectiveness of the intervention, and evaluate the influence of a range of factors on the health outcomes and costs of the patients attending the clinic. Patients will be evaluated at baseline (intake to the service), and at 3-, 6-, and 12-months after intake to the service. Health will be measured using the SF-36 and health costs will be measured using government and medical record sources. The intervention involves students and health professionals from multiple professions working together to treat patients with programs that include education and exercise therapy programs for back pain, and Healthy Lifestyle programs; as well as individual consultations involving single professions.DiscussionUnderstanding the effect of a range of factors on the health state and health costs of people attending an interdisciplinary clinic will inform health service provision for this clinical group and will determine which factors need to be controlled for in future observational studies. Preliminary evidence regarding changes in health and health costs associated with the intervention will be a platform for future clinical trials of intervention effectiveness. The results will be of interest to teams investigating new chronic disease programs particularly for people with multimorbidity, and in areas outside major metropolitan centres.Trial registrationAustralia and New Zealand Clinical Trials Registry: ACTRN12611000724976
Highlights
Rates of chronic disease are escalating around the world
A unique student-led interdisciplinary chronic disease health service was established in regional Australia in 2010 to address workforce shortages and spiralling rates of chronic disease in rural and regional Queensland
Interdisciplinary care has been promoted as a solution to maintain or improve the quality of healthcare, in regional and rural areas [4,5,6] where health service disparity, healthcare access, and a worse burden of chronic diseases may place people living in these areas at a disadvantage in comparison to metropolitan areas [7]
Summary
Setting and services The regional interdisciplinary chronic disease health service is located in a regional city (Rockhampton) approximately 700 kilometres from the state’s capital. TUG Self-reported health perception question for the 12-months prior and 12-months following intake (baseline), which will permit estimation of within-patient change in healthcare costs This data will allow costing of Hospital, Medicare and Pharmaceutical Benefits Scheme related items that will include inpatient admission costs, out-of-pocket expenses for general practitioners and specialist medical appointments, and out-of -pocket medication related expenses. The predictors to be examined in all of the models will be: BMI and waist measurement, disease burden, number and type of comorbidities, self-reported health perception, age, gender, indigenous status, country of birth, language (other than English), marital status, home ownership, highest level of education, occupation and employment status, length and type of intervention; and baseline psychological distress or wellbeing, functional and structural social support, and physical function. Ethics approval has been granted by the Central Queensland Human Research Ethics Committee [HREC 11/QCQ/14]
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