Primary Hlth Care

Key to care: report of the Burstow Commission on the future of the home care workforce – LGiU – Local Government Democracy Think Tank – 2 December 2015

Posted on January 22, 2015. Filed under: Aged Care / Geriatrics, Primary Hlth Care, Workforce |

Key to care: report of the Burstow Commission on the future of the home care workforce – LGiU – Local Government Democracy Think Tank – 2 December 2015

Full report

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Recommendations for a National CQI Framework for Aboriginal and Torres Strait Islander Health – 18 December 2014

Posted on January 20, 2015. Filed under: Aboriginal TI Health, Clin Governance / Risk Mgmt / Quality, Primary Hlth Care |

Recommendations for a National CQI Framework for Aboriginal and Torres Strait Islander Health – 18 December 2014

“This report provides advice to the Commonwealth Department of Health about the relevance and potential shape of a national framework for Continuous Quality Improvement (CQI) in Aboriginal and Torres Strait Islander primary health care (PHC).”

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Center for Evidence and Practice Improvement (CEPI) – AHRQ – [AHRQ = US Agency for Healthcare Research and Quality]

Posted on July 23, 2014. Filed under: Evidence Based Practice, Health Informatics, Preventive Healthcare, Primary Hlth Care | Tags: |

Center for Evidence and Practice Improvement (CEPI) – AHRQ – [AHRQ = US Agency for Healthcare Research and Quality]

CEPI consists of five divisions:

Evidence-Based Practice Center Program
U.S. Preventive Services Task Force Program
Division of Decision Science and Patient Engagement
Division of Health Information Technology
Division of Practice Improvement

CEPI is also home to AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR)

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Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems – European Commission EXpert Panel on Effective Ways of Investing in Health (EXPH) – 10 July 2014

Posted on July 22, 2014. Filed under: Health Economics, Primary Hlth Care | Tags: |

Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems – European Commission EXpert Panel on Effective Ways of Investing in Health (EXPH) – 10 July 2014

“Abstract

In this opinion the Expert Panel on effective ways of investing in Health (EXPH), considers primary care to be the provision of universally accessible, integrated, person-centred, comprehensive health and community services, provided by a team of professionals accountable for addressing a large majority of personal health needs. These services are delivered in a sustained partnership with patients and informal care givers, in the context of family and community and play a central role in the overall coordination and continuity of people’s care.

The professionals active in primary care teams include, among others, dentists, dieticians, general practitioners/family physicians, nurses, occupational therapists, optometrists, pharmacists, physiotherapists, psychologists and social workers.

The Expert Panel notes that strong primary care systems contribute to equity and improved health outcomes but emphasises that primary care needs to continuously evolve if it is to respond to changing challenges in society.

A strong primary care system can be the starting point for effective referral and discharge systems, ensuring integration between different levels of care. Gate-keeping can offer advantages to patients, providers and the health system so long as important organisational and patient management factors are taken into account.

The Expert Panel emphasizes the importance of ensuring that primary care services are accessed by the population without facing financial hardship and notes that there is little evidence that user charges lead to more appropriate use and cost control. When user charges are present, there should be mechanisms to protect people with low incomes and those who regularly use health care.

European Union (EU) health systems show a trend towards blended provider payment systems in primary care, combining risk-adjusted capitation with some fee-for-service reimbursement. The Expert Panel describes factors that may contribute to the effectiveness of pay-for-performance (P4P) programs and implementation features that may weaken the effectiveness of financial incentives.

Finally, the Expert Panel formulates general research questions in relation to the development of primary care in Europe, specific research questions in relation to referral
and financing and strategic directions at different levels. ”

doi:10.2772/33238

 

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Transforming Primary Care: Safe, proactive, personalised care for those who need it most – England, Department of Health – 14 April 2014

Posted on April 15, 2014. Filed under: General Practice, Primary Hlth Care |

Transforming Primary Care: Safe, proactive, personalised care for those who need it most – England, Department of Health – 14 April 2014

“Department of Health and NHS England’s joint plan to provide personalised, proactive care for people who need it most.

‘Transforming Primary Care’ sets out plans for more proactive, personalised and joined up care, including the Proactive Care Programme, providing the 800,000 patients with the most complex health and care needs with:

a personal care and support plan
a named accountable GP
a professional to coordinate their care
same-day telephone consultations

The plan builds on the role of primary care in keeping patients well and independent. It explains how professionals across the healthcare system can work together to transform care to become more proactive and tailored to patients’ individual need.”

 

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Practical Playbook – Public Health . Primary Care. Together. – CDC – Duke University School of Medicine , de Beaumont Foundation

Posted on March 10, 2014. Filed under: General Practice, Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: |

Practical Playbook – Public Health . Primary Care. Together. – CDC – Duke University School of Medicine , de Beaumont Foundation

“What is the Practical Playbook?

The Practical Playbook is a stepping stone in the next transformation of health, in which primary care and public health groups collaborate to achieve population health improvement and reduced health care costs. It supports increased collaborations between primary care and public health groups by guiding users through the stages of integrated population health improvement. Throughout each stage, the Practical Playbook provides helpful resources such as success stories from across the country, lessons-learned from existing partnerships, and further guidance from industry experts.

We use the playbook metaphor because improving collaboration between public health and primary care takes a thoughtful game plan. Like a sports playbook, the Practical Playbook defines the role of each team member as well as actions for different situations. As a playbook, it’s neither a rulebook nor a set of peer-reviewed guidelines. It’s something more practical – because we need real-life, flexible guidance to help us apply the theoretical principles of integration to our work.”

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Which doctors take up promising ideas? New insights from open data – Nesta – 28 January 2014

Posted on March 4, 2014. Filed under: Evidence Based Practice, General Practice, Knowledge Translation, Primary Hlth Care | Tags: , |

Which doctors take up promising ideas? New insights from open data – Nesta – 28 January 2014

“The report looks at early adoption of promising new ideas across primary care in England and argues that analysing open data can help public services gain a greater understanding of their take up of innovations.

Key findings
No single group of GP practices were serial early adopters of all the innovations reviewed, but groups of early adopters were identified around specific types of innovations.
Larger GP practices are in a better position to explore and introduce new innovations, while neighbouring practices tended to have similar rates and patterns of adopting new innovations.
GPs rely on a range of resources to identify and learn about innovations – including informal local networks, personal relationships, and information systems. Fellow GPs and national guidance were particularly influential sources of information.
Local intermediaries – such as Academic Health Science Networks and Clinical Commissioning Groups – have an important role to play in the adoption process.

This report demonstrates a rising opportunity to inform practitioners and patients by making use of open data. Analysis of primary care open data shows the potential to chart GP surgeries’ uptake of promising innovations in technologies, drugs and practices.”

… continues

 

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Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

Posted on February 21, 2014. Filed under: General Practice, Primary Hlth Care | Tags: , , |

Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

“As England’s population both expands and ages, so the demands on primary care will grow. Within the current commissioning and funding system innovative models of primary care provision are already being used. This report describes examples of these through four case studies in different areas of England. It also highlights how the existing system is imperfectly understood, particularly regarding contracts.

Building on ideas articulated in previous work, the report argues for a new approach that brings together funding for general practice with funding for many other services. It would entail new forms of commissioning, with GPs innovating in how care is delivered. Over time, the report foresees ‘family care networks’ emerging that provide forms of care well beyond what is currently available in general practices.”

 

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Integrated care – policy issue reviews – Primary Health Care Research and Information Service – September 2013

Posted on October 24, 2013. Filed under: Primary Hlth Care | Tags: , |

Integrated care – policy issue reviews – Primary Health Care Research and Information Service – September 2013

Integrated care: What policies support and influence integration in health care in Australia? Report 1

Integrated care: What policies support and influence integration in health care across New Zealand, England, Canada and the United States? Report 2

Integrated care: What strategies and other arrangements support and influence integration at the meso/organisational level? Report 3

Medicare Locals: A model for primary health care integration? Report 4

Integrated care: What can be done at the micro level to influence integration in primary health care? Report 5

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Securing the future of general practice: new models of primary care – The King’s Fund and the Nuffield Trust – 18 July 2013

Posted on July 24, 2013. Filed under: General Practice, Primary Hlth Care | Tags: , , |

Securing the future of general practice: new models of primary care – The King’s Fund and the Nuffield Trust – 18 July 2013

“This report from the Nuffield Trust and The King’s Fund examines the new GP organisations forming to allow care provision at greater scale.”

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Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study – PLoS One 12 June 2013

Posted on June 18, 2013. Filed under: Emergency Medicine, General Practice, Primary Hlth Care |

Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study – PLoS One 12 June 2013

“Background

The number of visits to hospital emergency departments (EDs) in England has increased by 20% since 2007-08, placing unsustainable pressure on the National Health Service (NHS). Some patients attend EDs because they are unable to access primary care services. This study examined the association between access to primary care and ED visits in England.”

Citation: Cowling TE, Cecil EV, Soljak MA, Lee JT, Millett C, et al. (2013) Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study. PLoS ONE 8(6): e66699. doi:10.1371/journal.pone.0066699

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Improving Primary Health Care Through Collaboration: Briefing 3 -Measuring the Missed Opportunity – Conference Board of Canada – June 2013

Posted on June 7, 2013. Filed under: Chronic Disease Mgmt, Primary Hlth Care | Tags: |

Improving Primary Health Care Through Collaboration: Briefing 3 -Measuring the Missed Opportunity – Conference Board of Canada – June 2013

17 pages, Briefing by Thy Dinh, Fares Bounajm

“This briefing is the third in a series of four that aims to provide an analysis of the impact of interprofessional teams on the Canadian primary health care system.

Document Highlights

The existing and future health care needs of the Canadian population are largely about managing chronic conditions. Better management of patients with chronic conditions in the primary care system can reduce the burden in the more costly acute or hospital care system. If the enhanced use of interprofessional primary care (IPC) teams can be shown to be cost-effective, they should become the preferred model of care for chronic conditions in all provinces and territories.

This briefing aims to assess whether IPC teams could become a central component of a health care services delivery strategy for chronic conditions. It provides the results of an empirical analysis of the impact of enhanced IPC teams on the health and economic burden of Type 2 diabetes and depression in Canada.

Other briefings in the Improving Primary Health Care Through Collaboration series:

Briefing 1—Current Knowledge About Interprofessional Teams in Canada
Briefing 2—Barriers to Successful Interprofessional Teams”

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Hospital bed management and primary preventive health – Tasmanian Audit Office – May 2013

Posted on May 31, 2013. Filed under: Preventive Healthcare, Primary Hlth Care | Tags: , |

Hospital bed management and primary preventive health – Tasmanian Audit Office – May 2013

Summary brochure

“Executive summary

Background

In the Australian public health sector there is a persistent demand for hospital beds that is fuelled by numerous factors that include an ageing population and increasing rates of illness caused by lifestyle factors.

To ensure that government achieves maximum value for its investment in public health, maximising the use of existing hospital beds is an important strategy. In this audit, we took the approach that more efficient use of existing facilities could be attained through two strategies at opposite ends of the health care spectrum; improving patient throughput in hospitals and preventing people acquiring chronic conditions that could lead to hospitalisation in future years.

Patient throughput in hospitals could be aided through the use of out-of-hospital alternatives (e.g. outpatient treatment, clinics, Hospital in The Home (HITH), aged care or home care), minimising the length of stay and inter-hospital transfers (to free up beds in busy hospitals).

With a focus on improving public health into the future, we examined two areas of primary preventive health; vaccination and encouraging healthier lifestyle choices. Accordingly, the objective of the audit was to assess the effectiveness of the Department of Health and Human  Services’ (DHHS) efforts to improve patient throughput in hospitals and to prevent people acquiring chronic conditions through primary preventive health strategies. ”

… continues

ISBN 978‐0‐9775898

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Progress Report 2013: Health care renewal in Canada – Health Council of Canada – May 2013

Posted on May 29, 2013. Filed under: Aboriginal TI Health, Chronic Disease Mgmt, Health Mgmt Policy Planning, Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: |

Progress Report 2013: Health care renewal in Canada – Health Council of Canada – May 2013

“In Progress Report 2013: Health care renewal in Canada, the Health Council reports on the progress made by jurisdictions in five priority areas of the health accords:

access and wait times;
primary health care reform and electronic health records;
pharmaceuticals management;
disease prevention, health promotion and public health; and
Aboriginal health”

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Primary care and general practice in Australia 1990-2012. A Chronology of Federal Government strategies, policies, programs and funding – ANU – March 2013

Posted on April 18, 2013. Filed under: General Practice, Primary Hlth Care | Tags: , , |

 

Primary care and general practice in Australia 1990-2012. A Chronology of Federal Government strategies, policies, programs and funding – ANU – March 2013

by Dr Lesley Russell

 

Opinion piece on this

Recommended reading on the history of primary care reform (and what can be learnt from it) – Croakey – 17 April 2013

 

 

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Healthy Communities: Australians’ experiences with primary health care in 2010-11 – National Health Performance Authority – 7 March 2013

Posted on March 7, 2013. Filed under: General Practice, Primary Hlth Care | Tags: |

Healthy Communities: Australians’ experiences with primary health care in 2010-11 – National Health Performance Authority – 7 March 2013

“This is the National Health Performance Authority’s first report on community-based health care services in the 61 Medicare Local areas across Australia. It looks at how Australians view their health and examines use and patient experiences with a range of GP-type services at the local level.”

Read Healthy Communities: Australians’ experiences with primary health care in 2010-11 HTML | PDF 7621 

Read Healthy Communities: Australians’ experiences with primary health care in 2010-11 Technical Supplement HMTL | PDF 247

Read our Media Release: Healthy Communities report finds five-fold variations in accessibility of GP care | PDF 142

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General practice in London: supporting improvements in quality – King’s Fund – 5 December 2012

Posted on December 10, 2012. Filed under: General Practice, Primary Hlth Care | Tags: , |

General practice in London: supporting improvements in quality – King’s Fund – 5 December 2012

Veena Raleigh, Yang Tian, Nick Goodwin, Anna Dixon, James Thompson, Christopher Millet, Michael Soljak

“General practice in London face a number of demographic and socio-economic challenges in addition to the unprecedented financial pressures facing the NHS as a whole.

NHS London commissioned an independent report to provide a fresh analysis of those challenges and the improvements that will be needed to address them. The report has been prepared by a team of researchers at The King’s Fund and Imperial College London.

It is a companion piece to a framework that NHS London will be co-creating with practices across the capital as a resource for clinical commissioning groups in taking on their new responsibilities for continuously improving primary care services.

The King’s Fund and Imperial College London are also providing clinical commissioning groups with more detailed data on the indicators used in this report, along with guidance on how to interpret and use the data, as a starting point from which to understand priorities at local level.”

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Strengthening Primary Health Care through Primary Care and Public Health Collaboration – McMaster University – October 2012

Posted on November 20, 2012. Filed under: Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: |

Strengthening Primary Health Care through Primary Care and Public Health Collaboration – McMaster University – October 2012

final report for CHSRF – Canadian Health Services Research Foundation

ISBN 978-1-927565-02-5 (print)
ISBN 978-927565-03-2 (pdf)

Extract from the Key Messages for Decision-Makers

“Interest in collaboration between primary care (PC) and public health (PH) and how it can improve the health of populations and quality and eff ectiveness of health care systems has grown substantially over the past four years.
• Evidence supports the benefi ts of collaboration between PC and PH in the following areas: maternalchild programs, communicable disease prevention and control, health promotion and health protection, chronic disease prevention and management, youth health, women’s health, and working with vulnerable populations.
• Collaboration between PC and PH increases accessibility to health promotion and illness prevention programs and services and decreases the cost of immunization programs through reduced wastage.”

… continues on the site

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Urgent Care Centres: What works best? – Primary Care Foundation – October 2012

Posted on November 13, 2012. Filed under: Primary Hlth Care | Tags: , |

Urgent Care Centres: What works best? – Primary Care Foundation – October 2012

Extract from the executive summary:

“Urgent care centres of various types have evolved as a way of meeting these needs. But we found little published evidence that they reduce attendances at A&E and some suggestion that they might increase the total burden on the NHS. Certainly many are meeting primary care needs (though some count these cases as urgent) and they are now firmly established. Many have the loyal support of local users who rally to defend their local centre when commissioners attempt to replace it.

This discussion paper looks at the different models for providing urgent care services and evaluates their impact.”

Primary Care Foundation UK

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Primary Care Teams are not as Effective as they Could be Because of Three Sets of Barriers – Conference Board of Canada – 31 October 2012

Posted on November 2, 2012. Filed under: Primary Hlth Care | Tags: , , |

Primary Care Teams are not as Effective as they Could be Because of Three Sets of Barriers – Conference Board of Canada – 31 October 2012

Improving Primary Health Care Through Collaboration: Briefing 1—Current Knowledge About Interprofessional Teams in Canada – The Conference Board of Canada

Improving Primary Health Care Through Collaboration: Briefing 2—Barriers to Successful Interprofessional Teams

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What does the community want from after hours care? – Croakey – 23 October 2012

Posted on October 24, 2012. Filed under: General Practice, Primary Hlth Care | Tags: |

What does the community want from after hours care? – Croakey – 23 October 2012

“What are the community’s priorities and concerns when it comes to after hours care? Some useful insights were gleaned from a citizen’s jury held in Tasmania earlier this year, including the need for much better information for the public about what services are available.”

… continues on the Croakey site

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High-intensity primary care: lessons for physician and patient engagement – National Institute for Health Care Reform Research Brief no. 9 – October 2012

Posted on October 16, 2012. Filed under: Chronic Disease Mgmt, Primary Hlth Care | Tags: |

High-intensity primary care: lessons for physician and patient engagement – National Institute for Health Care Reform – October 2012

“To prevent costly emergency department visits and hospitalizations, a handful of care-delivery models offer high-intensity primary care to a subset of patients with complex or multiple chronic conditions, such as diabetes, congestive heart failure, obesity and depression. Early assessments of high-intensity primary care programs show promise, but these programs’ success in improving quality of care and lowering costs rests on the engagement of both physicians and patients. A number of factors can foster physician and patient engagement in high-intensity primary care programs, according to a new qualitative study by the Center for Studying Health System Change (HSC). For physicians, key factors include financial commitment and administrative support from health plans and well-designed financial incentives for quality and outcome improvements. In addition, allowing physicians to help identify patients who would benefit from intensive primary care may improve physician comfort and buy in. To encourage patient engagement, a personal invitation from physicians to join a high-intensity primary care program, as well as rapid access to physicians and care coordinators, appear to be highly successful approaches.”

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Evaluation of the GP Super Clinics Program 2007-2008 – CONSAN Consulting – August 2012

Posted on October 16, 2012. Filed under: General Practice, Health Systems Improvement, Primary Hlth Care |

Evaluation of the GP Super Clinics Program 2007-2008 – CONSAN Consulting – August 2012

Extract from the executive summary

“The GP Super Clinics Program was one part of the health reforms, including primary care reforms, implemented by a newly-elected Labor government in 2007. The localities of the GP Super Clinics were based on criteria relating to need. The program provided grant funds to the value of $181.7 million for the construction or refurbishment of existing infrastructure for the first 36 GP Super Clinics, across 37 localities.

This evaluation addressed three aspects of the GP Super Clinics Program 2007-2008:
 Implementation: administration of the Program by the Department of Health and Ageing
 Establishment: the planning and construction of the 36 GP Super Clinics over 37 sites established in the 2007-2008 tranche
 Operations: service delivery in the seven clinics which were operational for a minimum of six months prior to the commencement of the evaluation.

In the context of these three aspects, the evaluation aimed to describe the historical context and processes for the implementation and the processes and influences which impacted on the construction of the GP Super Clinics. In the operational aspect it aimed to identify the short term impacts, and the activities being implemented to achieve the GP Super Clinics Program objectives. Learnings were also identified with regard to the three aspects of the program and the potential for informing further investment in primary health care  infrastructure and services.

Methods for the evaluation were tailored to each of the aspects of the GP Super Clinics Program. Common methods across each aspect included desk reviews, surveys and interviews with representatives of key stakeholder groups. A value-for-money assessment tool was also developed for the establishment aspect.”

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Behavioral Health Roundtable: Using Information Technology to Integrate Behavioral Health and Primary Care – Office of the National Coordinator for Information Technology – September 2012

Posted on September 27, 2012. Filed under: Chronic Disease Mgmt, Health Informatics, Mental Health Psychi Psychol, Primary Hlth Care | Tags: |

Behavioral Health Roundtable: Using Information Technology to Integrate Behavioral Health and Primary Care – Office of the National Coordinator for Information Technology – September 2012

Extract from the introduction:

“The burden of behavioral health conditions (including mental illness and substance use disorders) in the United States remains great. Consider the prevalence and treatment of mental illness. By 2009, almost 20 percent of adults in the United States had suffered from a mental health condition at some point in their lives. Mental illness is a source of significant comorbidity in the chronically ill, particularly for patients with diabetes or cardiovascular disease. Diabetes patients, for instance, are twice as likely to suffer from depression as the general population. Mental illness is also associated with higher rates of substance abuse. In 2010, approximately 23 million people ages 12-64 reported symptoms of substance use disorders, while only 11 percent received treatment at a specialty facility. Moreover, a substantial volume of behavioral health care is delivered in primary care settings. General and internal medicine physicians cared for 34 percent of patients with a primary mental health diagnosis in 2008 alone. Given the burden of illness and the volume of behavioral health care delivered in primary care settings, better integration between behavioral health and primary care is needed.

Health information technology (health IT), including electronic health records (EHRs), personal health records (PHRs), health information exchange (HIE), mobile health, and other technologies that support health and wellness are key enablers of this integration. However, behavioral health clinicians currently have limited adoption of interoperable information systems. In a recent study, just over 20 percent of 505 behavioral health organizations surveyed indicated that they had fully adopted an EHR. Behavioral health organizations cited as barriers to EHR adoption concerns over initial productivity losses, lack of qualified IT and project management staff, provider resistance, and privacy laws.”

… continues

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Primary care for the 21st century: learning from New Zealand’s independent practitioner associations – Nuffield Trust – 26 September 2012

Posted on September 27, 2012. Filed under: Primary Hlth Care | Tags: |

Primary care for the 21st century: learning from New Zealand’s independent practitioner associations – Nuffield Trust – 26 September 2012

“As the English NHS prepares to give GPs a leading role in planning and purchasing local health services, this report offers insights from the experience of organised general practice in New Zealand.

Over the past two decades, many GPs and other primary care clinicians in New Zealand have worked collaboratively in independent practitioner associations (IPAs). These networks of primary care providers developed in the early 1990s from the grassroots of general practice.

Although IPAs have not held budgets on the scale of that planned for clinical commissioning groups (CCGs) in England under the Health and Social Care Act 2012, they nevertheless demonstrate the significant potential of organised general practice to enable innovation and expansion in the local provision of care, and to help in the development of more integrated services.”

… continues on the site

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Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions – Primary Health Care Research & Information Service – July 2012

Posted on September 4, 2012. Filed under: Primary Hlth Care | Tags: , |

Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions – Primary Health Care Research & Information Service – July 2012

Katterl R, Anikeeva O, Butler C, Brown L, Smith B, Bywood P. (2012). Potentially avoidable hospitalisations in Australia: Causes for hospitalisations and primary health care interventions.  PHC RIS Policy Issue Review. Adelaide: Primary Health Care Research & Information Service.

ISBN 978-0-9808191-9-9

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Australian Medicare Local Alliance launched 16 August 2012

Posted on August 17, 2012. Filed under: General Practice, Primary Hlth Care |

Australian Medicare Local Alliance launched 16 August 2012

“Australians can look forward to more effective and cohesive primary health care with the launch of a new national body to lead the network of Medicare Locals.

Minister for Health Tanya Plibersek and Minister for Mental Health and Ageing Mark Butler today attended the launch of the Australian Medicare Local Alliance in Parliament House, Canberra.

Ms Plibersek said the Australian Medicare Local Alliance will play a key role in ensuring Medicare Locals function effectively and efficiently and work as a cohesive group, responsive to changing Government priorities.”

… continues

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HealthLandscape Australia – Australian Primary Health Care Research Institute, ANU

Posted on June 19, 2012. Filed under: Health Informatics, Primary Hlth Care |

HealthLandscape Australia – Australian Primary Health Care Research Institute, ANU

National Centre for Geographic & Resource Analysis in Primary Health Care (GRAPHC)

“Background

GRAPHC uses location data, spatial analytic methodologies and online mapping to analyse, interpret and display information in ways that promote better understanding of primary health care and the forces that affect it.

APHCRI’s National Centre for Geographic & Resource Analysis in Primary Health Care (GRAPHC) was established in November 2011 after over 18 months consultation with national reference group representatives, comprising government, academic and health care professionals.

The adoption of a geographic approach to primary health care research facilitates the development of the evidence base to inform locally relevant and equitable solutions for targeting health resources and services. The aim is to support community, health care service providers, academia, and policy makers to improve equity and access to health care services through better resource allocation.”

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Dimensions of health care system quality in Finland – Government Institute for Economic Research – 28 May 2012

Posted on June 12, 2012. Filed under: Health Economics, Primary Hlth Care | Tags: , |

Dimensions of health care system quality in Finland – Government Institute for Economic Research – 28 May 2012

“This paper evaluates the determinants of quality – cost relationship in primary health care. We first summarize information from various indicators of care by principal component analysis (PCA), effectively producing quality of care indicators: accessibility, coverage and allocative efficiency. We then regress the costs of care against these indicators to evaluate their relationship. Our results suggest that PCA may be used to produce quality of care indicators. Furthermore, the relationship between the costs and quality of care is complex. Better accessibility is reflected in higher costs, whereas the efficient allocation of resources will bring some cost savings.”

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The Economic Impact of Improvements in Primary Healthcare Performance – Canadian Health Services Research Foundation – 22 May 2012

Posted on May 28, 2012. Filed under: Primary Hlth Care | Tags: |

The Economic Impact of Improvements in Primary Healthcare Performance – Canadian Health Services Research Foundation – 22 May 2012

Full report

Key Messages

“The performance of Canada’s primary healthcare (PHC) system lags behind that of other industrialized countries. Well-targeted investments in PHC can improve the health of individuals and populations, which can in turn have a positive impact on macro-economic indicators, such as employment rates, productivity and economic growth.
There are important gaps in Canadian PHC systems that require improvement. These include accessibility of PHC services, technical quality of care, quality improvement initiatives andpractice organization.
Various interventions and investments have been shown to enhance the performance of PHC, improve the quality of care and produce economic savings. These include incorporating pharmacists into PHC teams, case-management strategies to enhance chronic disease management, and electronic medical records that include patient recall and provider reminders for preventive care and chronic disease management.
This report presents the results of four different approaches to evaluate the economic impact of enhancements to PHC: 1. A synthesis of the literature on the macro- and micro-economic effects of good health, with specific relevance to PHC performance. 2. A systematic review of the economic impact of incorporating a pharmacist into a PHC practice. 3. A simulation exercise that evaluates the economic impact of improvements to influenza immunization rates for older adults brought about by provider reminder systems in PHC. 4. A literature review of reductions in burden of illness associated with four specific enhancements to chronic disease management in PHC that produce health benefits. These include PHC improvements that result in improved blood pressure control, enhanced diabetes management, increased uptake of cancer screening and improved continuity of care.”

… continues on the site

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Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships – Canadian Health Services Research Foundation – April 2012

Posted on May 21, 2012. Filed under: Primary Hlth Care | Tags: |

Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships – Canadian Health Services Research Foundation – April 2012

Cathie Scott, Laura Lagendyk

“This report examines Alberta’s experience in the development of Primary Care Networks (PCNs) over the period 2007 to 2011.”

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Primary care: Today and tomorrow. Improving general practice by working differently – Deloitte – May 2012

Posted on May 14, 2012. Filed under: General Practice, Primary Hlth Care | Tags: |

Primary care: Today and tomorrow. Improving general practice by working differently – Deloitte – May 2012

“Primary care, and in particular care delivered by general practice, has been a cornerstone of the United Kingdom’s healthcare system since the inception of the National Health Service (NHS) in 1948. Indeed, good quality primary care is considered an essential
feature of all cost-effective healthcare systems. Patient satisfaction with primary care delivered through general practice has traditionally been high, albeit with local variations in both patient experience and quality of care.

The general practice delivery model has evolved slowly with most general practitioners (GPs) working in single or dual practices until the 1990s. The promotion of a ‘primary care led NHS’ during the 1990s and the implementation of new contract models from 2003 onwards, have resulted in the majority of GPs now working in larger group practices and health centres. Nevertheless, the delivery model still  relies largely on face-to-face consultations between the patient and GP or, for a limited but growing number of interventions, between the patient and practice nurse.

The focus of this report is on the general practice as a provider of primary care services, and while it is based on the English NHS, many of the solutions could apply equally to general practice in the rest of the United Kingdom.

In this report we acknowledge general practice and its registered patient list system as a strong foundation upon which different models of care can be built. We propose a range of solutions involving new business models and incentives, and accelerated use of technologies, which shift the focus of primary care from providers to consumers. While some of the proposed solutions are already being trialled by a number of GPs, and the challenge is to increase the scale of adoption, others have yet to be adopted in any meaningful way. What they all have in common is the need for primary care staff to work differently.”

… continues

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Patient Centred Community Designed Team Delivered. A framework for achieving a high performing primary health care system in Saskatchewan – 8 May 2012

Posted on May 11, 2012. Filed under: Primary Hlth Care |

Patient Centred Community Designed Team Delivered. A framework for achieving a high performing primary health care system in Saskatchewan – 8 May 2012

“Executive Summary

Purpose

This framework synthesizes the perspectives of more than 400 people – community leaders, patients, providers, policy-makers and managers. It outlines their shared vision for a sustainable primary health care system that will provide a superior patient experience and result in an exceptionally healthy Saskatchewan population.

The framework has been developed for communities, patients and providers, Regional Health Authorities and other service delivery partners.

It is the beginning of a province-wide effort to achieve a high performing primary health care system. It is an invitation to work together, designing a system that works best for patients, families, communities, physicians and other health care providers. As such, it serves as a “where to” rather than a “how to.” The “how to” will be developed at the community and regional level by partners working together to decide how to best implement this vision.”

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Involving primary care clinicians in quality improvement – The Health Foundation [UK] – April 2012

Posted on May 8, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, General Practice, Primary Hlth Care | Tags: |

Involving primary care clinicians in quality improvement – The Health Foundation [UK] – April 2012

An independent evaluation of the Health Foundation’s Engaging with Quality in Primary Care programme

ISBN 978-1-906461-37-9

“This is the report of an independent evaluation of our Engaging with Quality in Primary Care (EwQPC) improvement programme.

In 2007 we launched the EwQPC improvement programme. The programme funded nine projects that would increase the capacity for clinical quality improvement in primary care and engage primary care clinicians in clinical quality improvement. Building upon a previous initiative in secondary care (the Engaging with Quality Initiative), it aimed to engage primary care clinicians in clinical quality measurement and enable them to contribute to the knowledge base on improvement.

The independent evaluation, undertaken by a team from RAND Europe, identified a wide set of benefits. The projects secured and maintained the involvement of clinicians and were associated with changes in clinicians’ attitudes, behaviours and understanding. Patient involvement was an important and successful element of the programme. The projects also learned a lot about the challenges and opportunities of implementing improvement efforts. Measureable benefits for patients were found, but overall they were modest and patchy.

This thoughtful report highlights the lessons to be drawn from the programme and also offers a candid critique of quality improvement approaches and evaluation methods.”

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Benchmark of out of hours. An overview across the services. Report from the Primary Care Foundation – 19 April 2012

Posted on April 24, 2012. Filed under: Emergency Medicine, General Practice, Primary Hlth Care | Tags: , |

Benchmark of out of hours. An overview across the services. Report from the Primary Care Foundation – 19 April 2012

Prepared by Henry Clay

[Urgent care in general practice – benchmark report from April 2012]

Using data to Improve Care: A new national benchmark for Out of Hours services

“The Department of Health were keen to drive reliable comparisons of performance across out of hours services in England, building on the established national quality requirements, but breaking new ground in measuring outcomes as well as process.  Following a competitive tender, the Primary Care Foundation were appointed in November 2007 to develop a benchmark of out of hours services that would be seen as credible by commissioners and providers alike and would serve as a basis for service improvement.  The overall aim was to make accurate comparisons across different services so that providers and commissioners were in a position to recognise and take action to improve care for their patients.”

… continues

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Training in interprofessional collaboration. Pedagogic innovation in family medicine units – Canadian Family Physician – April 2012

Posted on April 24, 2012. Filed under: Educ for Hlth Professions, Multidisciplinary Care, Primary Hlth Care | Tags: |

Training in interprofessional collaboration. Pedagogic innovation in family medicine units – Canadian Family Physician – April 2012

“Abstract

Problem addressed
A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area.

Objective of the program
The training program was developed within family medicine units affi liated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care.

Program description
Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit  professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training  program.

Conclusion
The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is
an important issue that must be considered when planning practical interprofessional training.”

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Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10 – Institute for Clinical Evaluative Sciences – March 2012

Posted on April 4, 2012. Filed under: Emergency Medicine, Primary Hlth Care | Tags: |

Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10 – Institute for Clinical Evaluative Sciences – March 2012

Glazier, R.H., Zagorski, B.M., & Rayner, J.

“ISSUE
Are there differences between Ontario’s primary care models in who they serve and how often their patients/clients go to the emergency department (ED)?
STUDY
This study examined patients/clients enrolled in: Community Health Centres (CHCs, a salaried model), Family Health Groups (FHGs, a blended fee-for-service model), Family Health Networks (FHNs, a blended capitation model), Family Health Organizations (FHOs, a blended capitation model), Family Health Teams (FHTs, an interprofessional team model composed of FHNs and FHOs), ‘Other’ smaller models combined, as well as those who did not belong to a model. Electronic record encounter data (for CHCs) and routinely collected health care administrative data were used to examine sociodemographic composition, patterns of morbidity and comorbidity (case mix) and ED use. ED visits rates were adjusted to account for differences in location and patient/client characteristics.”

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Data briefing: Emergency hospital admissions for ambulatory care-sensitive conditions. Identifying the potential for reductions – King’s Fund – 3 April 2012

Posted on April 4, 2012. Filed under: Chronic Disease Mgmt, Emergency Medicine, Primary Hlth Care | Tags: |

Data briefing: Emergency hospital admissions for ambulatory care-sensitive conditions. Identifying the potential for reductions – King’s Fund – 3 April 2012

“Summary

Ambulatory care-sensitive conditions (ACSCs) are conditions for which effective management and treatment should limit emergency admission to hospital. Nevertheless, ACSCs currently account for more than one in six emergency hospital admissions in England. These emergency admissions cost the NHS £1.42 billion each year.

High levels of admissions for ACSCs often indicate poor co-ordination between the different elements of the health care system, in particular between primary and secondary care. An emergency admission for an ACSC is a sign of the poor overall quality of care, even if the ACSC episode itself is managed well.

This data briefing considers patterns of admissions for ACSCs in terms of age, sex, condition, socioeconomic group and local authority area. The authors analyse these patterns and assess the potential for reducing emergency admissions for ACSCs, highlighting the disease areas and patient groups where the greatest reduction can be achieved.

The briefing concludes that the number of emergency hospital admissions for ACSCs could be reduced by:

18 per cent (potentially saving £238 million) if all local authorities performed at the level of the best-performing local authorities
8 per cent (potentially saving £96 million)  if each local authority improved their service to the level of the next best  local authorities
11 per cent (potentially saving £136 million) if the poorer (than the average) performing local authorities performed at the level of the better (than the average) ones.

This briefing highlights for commissioners the opportunities for improving the quality of care and saving costs that reducing emergency hospital admissions for ACSCs presents. To realise the potential savings, changes will be needed in the management and prevention of these conditions.”

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Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways – AHRQ – 29 February 2012

Posted on March 29, 2012. Filed under: Community Services, Preventive Healthcare, Primary Hlth Care | Tags: , , |

Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways – AHRQ – 29 February 2012

AHRQ = Agency for Healthcare Research and Quality

“Developed by: Community Care Coordination Learning Network

This quick start guide is a reference and resource for public and private stakeholders engaged in improving the system for identifying and connecting at-risk individuals within a community to appropriate health and social services. The target audience includes all those involved in the design, implementation, and financing of care coordination services. This Quick Start guide complements Connecting Those at Risk to Care: A Guide to Building a Community “HUB” To Promote a System of Collaboration, Accountability, and Improved Outcomes.

Contents:

Overview

Why Create a Community HUB and Pathways?
Reason #1: To Promote the Goals of Health Care Reform
Reason #2: To Close the Nation’s Cost and Quality Gap by Paying for Value, Not Volume

A Quick Guide to Creating and Using a Community HUB and Pathways
Key Elements of an Effective Community HUB
A Step-by-Step Process for Using a Pathway

Examples of Six Core Pathways
Core Pathway 1: Medical Home
Core Pathway 2: Medical Referral
Core Pathway 3: Social Service Referral
Core Pathway 4: Health Insurance
Core Pathway 5: Medication Assessment
Core Pathway 6: Pregnancy

Other Resources

Appendix A: Pathways Compendium

Exhibits
Exhibit A-1: Sample Demographic and Referral Form
Exhibit A-2: Sample Care Planning Checklists
Exhibit A-3: Followup Adult Checklist
Exhibit A-4: Examples of Reports for the Community HUB and Participating Agencies”

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Primary Care and Public Health: Exploring Integration to Improve Population Health – Institute of Medicine – 28 March 2012

Posted on March 29, 2012. Filed under: Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: , |

Primary Care and Public Health: Exploring Integration to Improve Population Health – Institute of Medicine – 28 March 2012

Full text

“Primary care and public health have critical roles in providing for the health and well-being of communities across the nation. Although they each share a common goal, historically they have operated independently of each other. However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health.

The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs. The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards.”

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Canada, Australia and New Zealand establish a new research partnership – Australian Health Workforce Institute – 20 March 2012

Posted on March 27, 2012. Filed under: Chronic Disease Mgmt, Primary Hlth Care, Research | Tags: , , |

Canada, Australia and New Zealand establish a new research partnership – Australian Health Workforce Institute – 20 March 2012

“Ottawa (March 20, 2012) – The Canadian Institutes of Health Research (CIHR), the Australian Primary Health Care Research Institute (APHCRI) at the Australian National University and the Health Research Council of New Zealand (HRC NZ) are partnering to fund research on innovative models of Community-based Primary Healthcare (CBPHC). As part of CIHR’s Signature Initiative, funded teams will examine how to better prevent and manage chronic disease, as well as improve access to care for vulnerable populations.”

Read more:http://www.cihr-irsc.gc.ca/e/45078.html

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Early Evidence on Patient-Centered Medical Home – AHRQ – February 2012

Posted on March 14, 2012. Filed under: Primary Hlth Care | Tags: , |

Early Evidence on Patient-Centered Medical Home – AHRQ – February 2012

AHRQ = Agency for Healthcare Research and Quality [US]

“The patient-centered medical home (PCMH, or medical home) aims to reinvigorate primary care and achieve the triple aim of better quality, lower costs, and improved experience of care. This study systematically reviews the early evidence on effectiveness of the PCMH.”

Patient Centered Medical Home Resource Centre – Evidence and Evaluation

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Disparities in Primary Health Care Experiences Among Canadians With Ambulatory Care Sensitive Conditions – Canadian Institute for Health Information – March 2012

Posted on March 13, 2012. Filed under: Chronic Disease Mgmt, Primary Hlth Care | Tags: |

Disparities in Primary Health Care Experiences Among Canadians With Ambulatory Care Sensitive Conditions – Canadian Institute for Health Information – March 2012

“This report uses the 2008 Canadian Survey of Experiences With Primary Health Care to fill an important gap in our knowledge of primary health care for individuals who have ambulatory care sensitive conditions. An examination of differences in access, use and appropriateness of care
according to income, geography, health conditions and sex reveals the following:

Individuals with ambulatory care sensitive conditions in the lowest income group, in rural areas or with multiple chronic conditions were twice as likely to report that their last visit to an emergency department was for a condition that they perceived as being treatable by their primary health care provider.
Women with ambulatory care sensitive conditions were less likely than men to report receiving all four recommended tests for chronic disease monitoring, to have medication side effects explained or to be provided with tools to self-manage their condition.
Compared with those in the highest income group, individuals with ambulatory care sensitive conditions in the lowest income group were less likely to report that their primary health care physician involved them in clinical decisions or helped them make a treatment plan to manage their conditions.”

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Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes – Commonwealth Fund – 27 February 2012

Posted on February 29, 2012. Filed under: Primary Hlth Care | Tags: , |

Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes – Commonwealth Fund – 27 February 2012

“Executive Summary

A robust primary care sector is the foundation of a more effective and efficient health care system. However, achieving a robust primary care sector will require widespread practice transformation. A growing consensus supports the patient-centered medical home (PCMH) model, proposed as joint principles by the major primary care professional associations, as the blueprint for practice transformation. Under these principles, a PCMH would provide each person with a personal physician who leads a team that takes responsibility for ongoing care for all health issues and coordinates care with other service providers. Medical homes would also ensure the quality and safety of their care through performance measurement and continuous quality improvement and provide their patients with enhanced access. Finally, payment systems would reward the added value provided by medical homes. While these joint principles describe the general expectations of a PCMH, they do not make concrete suggestions for how primary care organizations can change their practices to become one.

As part of The Commonwealth Fund’s Safety Net Medical Home Initiative (SNMHI), this report sought to develop a more detailed and concrete definition that describes the changes that most practices would need to make to become PCMHs. After reviewing the literature, the study team proposed eight characteristics of medical homes—called change concepts—which provide general directions for transforming a practice. We further identified more specific practice modifications called key changes for each change concept. A technical expert panel assembled for the SNMHI reviewed the change concepts and key changes and suggested alterations. A second panel, convened for another PCMH transformation project, also provided feedback.

Many, but not all, of the change concepts and key changes are supported by evidence of positive effects on important outcomes. Therefore, the following eight change concepts should be viewed as general guidance for transforming the practice as well as opportunities for innovation and adaptation.”

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Canadian Primary Healthcare Policy: The Evolving Status of Reform – Canadian Health Services Research Foundation – 16 January 2012

Posted on January 17, 2012. Filed under: Primary Hlth Care | Tags: |

Canadian Primary Healthcare Policy: The Evolving Status of Reform – Canadian Health Services Research Foundation – 16 January 2012

by  Mable, Ann L.; Marriott, John

“The key findings for decision-makers on the current state of Canadian primary healthcare (PHC) policies, and the perceptions thereof, offer insights for renewed direction and action.

■All jurisdictions have maintained some focus on PHC policy. Although the extent and complexity of PHC application varies, the glass is half-full, not half-empty.
■The combined information that can be found about PHC at the federal, provincial and territorial levels provides a foundation of PHC policy direction that could be built upon for a more cohesive PHC strategy across Canada.
■The many links between current PHC activity and work done under prior national initiatives confirm the continuity and legitimacy of direction that, in turn, strengthen the foundations for current PHC reform.
■The system would benefit from renewal of an overarching framework for PHC reform across Canada to provide guidance and a reference point for aligning with principles and objectives and understanding progress.
■Different PHC delivery models, elements and capacity building—many showing considerable innovation—have emerged in jurisdictions across Canada. Their successes should be showcased and problems addressed from a high level to recognize good work and relieve pressures on the ground.
■Given the diverse activity under way and issues of clarity about and between primary healthcare and primary care, there is a perception by key informants of a lack of coherence in reform across Canada.
■Continued tensions between old and new ways of care delivery are affecting PHC reform progress at all levels and require resolution if reform is to achieve desired goals.
■Despite good work under way, the situation is not well served by the unsatisfactory state of data, lack of interoperable information systems and insufficient available research across the country.”

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Primary Care Partnerships Integrated Health Promotion 2011 Report – Victoria. Department of Health – 4 November 2011

Posted on December 13, 2011. Filed under: General Practice, Primary Hlth Care, Public Hlth & Hlth Promotion |

Primary Care Partnerships Integrated Health Promotion 2011 Report – Victoria. Department of Health – 4 November 2011

“This document sets out the achievements of Primary Care Partnerships (PCP) strategy to deliver Integrated Health Promotion (IHP) in Victoria. This document draws on findings from an evaluation conducted in 2008 on the impact of the PCP IHP strategy. Case studies have been included to demonstrate the range of health promotion programs and activities being led by PCPs, and the breadth of work that can be undertaken when organisations work in partnership.”

 

 

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EHR-Based Care Coordination Performance Measures in Ambulatory Care – The Commonwealth Fund – November 2011

Posted on November 21, 2011. Filed under: Chronic Disease Mgmt, Health Informatics, Primary Hlth Care | Tags: |

EHR-Based Care Coordination Performance Measures in Ambulatory Care – The Commonwealth Fund – November 2011
K. S. Chan, J. P. Weiner, S. H. Scholle et al

“Overview
Good coordination of care in the ambulatory setting has the potential to reduce unnecessary or duplicative use of health services, prevent hospitalizations for ambulatory care–sensitive conditions, improve patient safety, and potentially reduce costs. Unfortunately, coordination failures are common across the health care system. Using performance measures can drive practice improvement, particularly if reimbursement aligns with measurement. However, there are few well-developed, standardized measures of care coordination. This study sought to develop electronic health record–based measures to assess the quality of coordination during the primary care physician-to-specialist referral process, one of the most common transitions across providers in health care. Using input from interviews with primary care physicians and experts, the authors developed a core set of five electronic measures for use in primary care and specialist settings. Through a preliminary evaluation, they determined that the measures are valid with practicing physicians and two are ready for implementation.”

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Strengthening Primary Care: Recent Reforms and Achievements in Australia, England, and the Netherlands – The Commonwealth Fund – 15 November 2011

Posted on November 17, 2011. Filed under: Primary Hlth Care | Tags: |

Strengthening Primary Care: Recent Reforms and Achievements in Australia, England, and the Netherlands – The Commonwealth Fund – 15 November 2011

S. Willcox, G. Lewis, and J. Burgers, Strengthening Primary Care: Recent Reforms and Achievements in Australia, England, and the Netherlands, The Commonwealth Fund, November 2011.

“Overview
Recent reforms in Australia, England, and the Netherlands have sought to enhance the quality and accessibility of primary care. Quality improvement strategies include postgraduate training programs for family physicians, accreditation of general practitioner (GP) practices, and efforts to modify professional behaviors—for example, through clinical guideline development. Strategies for improving access include national performance targets, greater use of practice nurses, assured after-hours care, and medical advice telephone lines. All three countries have established midlevel primary care organizations both to coordinate primary care health services and to serve other functions, such as purchasing and population health planning. Better coordination of primary health care services is also the objective driving the use of patient enrollment in a single general practice. Payment reform is also a key element of English and Australian reforms, with both countries having introduced payment-for-quality initiatives. Dutch payment reform has stressed financial incentives for better management of chronic disease.”

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Electronic Consultations Between Primary and Specialty Care Clinicians: Early Insights – The Commonwealth Fund – October 2011

Posted on October 20, 2011. Filed under: Health Informatics, Primary Hlth Care | Tags: |

K. Horner, E. Wagner, and J. Tufano, Electronic Consultations Between Primary and Specialty Care Clinicians: Early Insights, The Commonwealth Fund, October 2011.
Overview

“Electronic consultation (e-consultation) is an emerging tool that primary care clinicians can use to communicate with specialists about patients asynchronously—that is, at different times that are convenient for each physician. To conduct an e-consultation, clinicians use either a Web-based program or a shared electronic medical record. Early adopters of e-consultation describe positive experiences for patients, clinicians, and health systems, including improved continuity of care, access to specialists, convenience, and information transfer. E-consultation presents opportunities to improve health care quality and reduce specialty care costs, but dissemination will be limited unless incentives are created and clinicians are encouraged to use e-consultation through financial reimbursement.”

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A Vision for Canada: Family Practice – The Patient’s Medical Home. Position Paper – College of Family Physicians of Canada – September 2011

Posted on September 23, 2011. Filed under: Community Services, Primary Hlth Care | Tags: |

A Vision for Canada: Family Practice – The Patient’s Medical Home. Position Paper – College of Family Physicians of Canada – September 2011

“In October 2009, the College of Family Physicians of Canada (CFPC) presented its discussion paper Patient-Centred Primary Care in Canada: Bring it on Home. It described the pillars of a model of family practice focused on meeting patient needs.

Feedback from a broad cross-section of stakeholders including family physicians, other health professionals and their associations, governments, and the public provided important perspectives that are now incorporated into this vision paper describing family practices throughout Canada serving as Patients’ Medical Homes.”

Full text pdf of the paper

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Does Better Disease Management in Primary Care Reduce Hospital Costs? – Centre for Health Economics, University of York – August 2011

Posted on September 16, 2011. Filed under: Chronic Disease Mgmt, General Practice, Primary Hlth Care |

Does Better Disease Management in Primary Care Reduce Hospital Costs? – Centre for Health Economics, University of York – August 2011

Mark Dusheiko et al

“Abstract
We apply cross-sectional and panel data methods to a database of 5 million patients in 8,000 English general practices to examine whether better primary care management of 10 chronic diseases is associated with reduced hospital costs. We find that only primary care performance in stroke care is associated with lower hospital costs. Our results suggest that the 10% improvement in the general practice quality of stroke care between 2004/5 and 2007/8 reduced 2007/8 hospital expenditure by about £130 million in England. The cost savings are due mainly to reductions in emergency admissions and outpatient visits, rather than to lower costs for patients treated in hospital or to reductions in elective admissions.”

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Care Planning – Improving the Lives of People with Long Term Conditions – Royal College of General Practitioners – 7 September 2011

Posted on September 16, 2011. Filed under: Chronic Disease Mgmt, Primary Hlth Care |

Care Planning – Improving the Lives of People with Long Term Conditions – Royal College of General Practitioners – 7 September 2011

…” focuses on people with long term physical health problems and provides guidance to help GPs and their teams better support such patients in gaining more control over their health and improving the quality of their lives.

It moves the focus from the clinician “doing”, to the clinician “enabling” the patient to manage the challenges of their own condition, fully supported by their GP surgery.

People with LTCs account for more than 50% of all general practice appointments, 65% of outpatient appointments and over 70% of inpatient bed days, amounting to 70% of the total health and social care spend in England. 1

The RCGP claims that incorporating the model of ‘care planning’ into daily general practice will not only improve the health outcomes and wellbeing of patients but will save the NHS time and money by reducing hospital admissions,  A&E attendance and medication expenditure.”  … continues

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Patient Centered Medical Home: Performance Metrics for Employers – Patient-Centered Primary Care Collaborative – 2011

Posted on August 26, 2011. Filed under: Primary Hlth Care |

Patient-Centered Primary Care Collaborative. (2011). Patient Centered Medical Home: Performance Metrics for Employers. Washington, DC: Sherman, B., Parry, T., & Hanson, J.

Extract from the executive summary:

“In this white paper, authors from the Patient-Centered Primary Care Collaborative, the Integrated Benefits Institute, and Thomson Reuters present the conceptual foundation for different categories of metrics and their role in evaluating PCMH program implementation from an employer perspective. Metrics categories in the discussion include: population health, healthcare utilization and costs, absence, presenteeism, patient satisfaction/experience, and patient involvement in self-care. A discussion of a relative timeline for observing the impact of PCMH on these metrics is also included.”

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Independent Evaluation of the Nurse-led ACT Health Walk-in Centre – August 2011

Posted on August 23, 2011. Filed under: Nursing, Primary Hlth Care |

Independent Evaluation of the Nurse-led ACT Health Walk-in Centre – August 2011

“This Independent Evaluation of the Nurse-led ACT Health Walk-in Centre report was compiled by representatives of the Australian Primary Health Care Research Institute and The Australian National University.

This report confirms that the implementation of this first nurse led Walk-in Centre is having a positive impact on patients and practitioners across the Territory.

The report highlights that 84% of patients surveyed would definitely recommend the Walk-in Centre to family and friends, with 82% stating that they would definitely use the Walk-in Centre again.

There are many positive findings in the report and there are also some areas of improvement.

The ACT Government will use this information to inform the continued development of this service.”

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Taking Care of Business: Corporate Services for Indigenous Primary Health Care Services – Overview Report, a Summary Report and Case Studies – Lowitja Institute – August 2011

Posted on August 22, 2011. Filed under: Aboriginal TI Health, Health Economics, Health Mgmt Policy Planning, Primary Hlth Care | Tags: |

Taking Care of Business: Corporate Services for Indigenous Primary Health Care Services – Overview Report, a Summary Report and Case Studies – Lowitja Institute – August 2011

These reports are products of the Support Systems Project, which focused on corporate support for Aboriginal Community Controlled Health Services (ACCHSs). The project will also produce a web tool, which will be available soon.

The Overview Report highlights the capacity of the ACCHS sector to develop innovative solutions to difficult issues while working in a quickly changing environment.  It was written by Kate Silburn, Alister Thorpe and Ian Anderson. A four page Summary Report is also available.

The Case Studies focuses specifically on existing models for sharing corporate services and highlights the different ways those working in the sector have developed strategies for addressing their specific needs.  They were written by Kate Silburn, Alister Thorpe and Ian Anderson with Bila Muuji Health Services Incorporated, Central Australian Aboriginal Congress, Katherine West Health Board, and Queensland Aboriginal and Islander Health Council.

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The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care – AHRQ – July 2011

Posted on July 20, 2011. Filed under: Chronic Disease Mgmt, Community Services, Primary Hlth Care | Tags: |

The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care – AHRQ – July 2011

Highlights opportunities to improve patient engagement in primary care.  The brief focuses on involvement at three levels: the engagement of patients and families in their own care, in quality improvement activities in the primary care practice, and in the development and implementation of policy and research related to the patient-centered medical home (PCMH).

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Better, Sooner, More Convenient Health Care in the Community – NZ Ministry of Health – June 2011

Posted on June 14, 2011. Filed under: Community Services, Primary Hlth Care |

Better, Sooner, More Convenient Health Care in the Community – NZ Ministry of Health – June 2011

ISBN number: 978-0-478-37469-8 (online)

Summary of publication

“This booklet looks at a new policy direction for health, introduced two years ago, which creates an environment where health professionals in the community are actively encouraged to work with one another, and with hospital-based clinicians to deliver health care in a co-ordinated and co-operative manner so that more services are delivered in the community, people wait less for services and are kept healthier in the community.

Treatments which were once hospital-only are increasingly being performed in the community by GPs and practice nurses who have received additional training from hospital specialists. Examples you’ll see in this booklet include intravenous antibiotics to treat the serious skin disease cellulitis, surgery to remove skin lesions and giving GPs direct access to diagnostic imaging (instead of having to refer patients to hospital for that imaging).

Professional boundaries are also changing, enabling tasks to be done in a way which frees up the time of our most highly trained professionals and our hospital services to focus on patients with the most complex needs.

The booklet includes examples of the innovation and ingenuity which community-based health professionals have already brought to this new approach to health – things they are now able to do to provide better, sooner and more convenient health services to the people of this country.

‘Better, Sooner, More Convenient Health Care in the Community’ is dedicated to New Zealand’s primary health care workforce – the GPs, nurses, pharmacists, physiotherapists and other health professionals in our communities who are making a real difference in creating better health services in your community.”

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Common mental health disorders: identification and pathways to care – NICE – 26 May 2011

Posted on May 31, 2011. Filed under: Mental Health Psychi Psychol, Primary Hlth Care | Tags: |

Common mental health disorders: identification and pathways to care – NICE – 26 May 2011

“Description
This clinical guideline offers evidence-based advice on the care and treatment of adults who have common mental health disorders, with a particular focus on primary care. It brings together advice from existing guidelines and combines it with new recommendations on access to care, assessment and developing local care pathways for common mental health disorders. Common mental health disorders include depression, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder and social anxiety disorder.”

About the guidance

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Developing Federally Qualified Health Centers into Community Networks to Improve State Primary Care Delivery Systems – Commonwealth Fund – 5 May 2011

Posted on May 10, 2011. Filed under: Health Mgmt Policy Planning, Primary Hlth Care |

Developing Federally Qualified Health Centers into Community Networks to Improve State Primary Care Delivery Systems – Commonwealth Fund – 5 May  2011  [US]

“Overview
By fostering connections between federally qualified health centers (FQHCs) and other private primary care providers, states may be able to connect Medicaid beneficiaries with services needed to help them manage their health and reduce costly visits to hospitals. FQHCs’ mandate to provide a comprehensive scope of primary and preventive health care and support services, coupled with their access to federal funds, gives them expertise and resources that might be leveraged in collaborative relationships with states and private practices. FQHCs may find that by entering into collaborative relationships with states and private practices, they strengthen their own financial position, advance their quality goals, improve their staffing mix, enhance the continuum of care and the kinds of services available to their patients, and further their mission.”

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The Quality and Outcomes: Framework (QOF): does it reduce health inequalities? – NHS National Institute for Health Research – April 2011

Posted on April 29, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, General Practice, Health Status, Primary Hlth Care, Public Hlth & Hlth Promotion |

The Quality and Outcomes: Framework (QOF): does it reduce health inequalities? – NHS National Institute for Health Research – April 2011

Dixon A, Khachatryan A, Wallace A, Peckham S, Boyce T, Gillam S The Quality and Outcomes Framework: does it reduce health inequalities? Final report. NIHR Service Delivery and Organisation programme; 2010.

Extract from the document:

“This research study set out to evaluate the impact of the Quality and Outcomes Framework (QOF) on the public health activities of general practices in deprived areas, and whether the QOF has contributed to reducing the gap in life  expectancy as defined in national targets.”

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Building a 21st Century Primary Health Care System: Australia’s First National Primary Health Care Strategy – February 2011

Posted on April 1, 2011. Filed under: National Health Strategies, Primary Hlth Care |

Building a 21st Century Primary Health Care System: Australia’s First National Primary Health Care Strategy – February 2011

ISBN: 978-1-74241-224-5
Online ISBN: 978-1-74241-225-2

“The National Primary Health Care Strategy (the Strategy) represents the first comprehensive national policy statement for primary health care in Australia. It provides a road map to guide current and future policy and practice in the Australian primary health care sector.

Release of the Strategy comes at a time when the Australian Government is building a National Health and Hospitals Network, which includes taking full funding and policy responsibility for primary health care services in Australia.”

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A shared agenda in the new world: The role of GP consortia and public health in improving health and wellbeing and delivering effective health care – NHS Alliance – February 2011

Posted on March 4, 2011. Filed under: General Practice, Health Mgmt Policy Planning, Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: |

A shared agenda in the new world: The role of GP consortia and public health in improving health and wellbeing and delivering effective health care – NHS Alliance – February 2011

Final report of a national colloquium

“A Colloquium took place in January 2011, sponsored by the NHS Alliance and QIPP Right Care Team and organised by Solutions for Public Health (NHS). The scale of national changes, and current uncertainties in precise processes and delivery mechanisms, provided significant potential to influence thinking and shape the future direction for relationships and interactions between public health and primary care to deliver health improvement and better health care within the new systems.”

…continues

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Improving Primary Health Care for All Australians – booklet – 22 February 2011

Posted on February 22, 2011. Filed under: Primary Hlth Care | Tags: |

Improving Primary Health Care for All Australians – booklet – 22 February 2011

“This booklet explains why primary health care is important; why it needs to be improved and what the changes will mean. It also provides further details on Medicare Locals, and their central role in improving the primary health care system.

This booklet explains why primary health care is important; why it needs to be improved and what the changes will mean. It also provides further details on Medicare Locals, and their central role in improving the primary health care system.”

ISBN: 978-1-74241-420-1
Online ISBN: 978-1-74241-421-8
Publications Number: D0264

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Do quality improvements in primary care reduce secondary care costs? – The Health Foundation (UK) – 15 February 2011

Posted on February 16, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics, Neurology, Primary Hlth Care | Tags: |

Do quality improvements in primary care reduce secondary care costs? – The Health Foundation (UK) – 15 February 2011

Primary research into the impact of the Quality and Outcomes Framework on hospital costs and mortality

“A leading edge study published by the Health Foundation today shows an association between achievement of the Quality and Outcomes Framework (QOF) indicators and a reduction in hospital costs and lives saved, particularly for stroke care.

The primary research, which analyses newly available data to establish the impact of QOF on hospital costs and mortality, finds that a single point increase in the QOF stroke score, across England, could lead to 2,385 fewer deaths in a year.

Do quality improvements in primary care reduce secondary care costs?‘ also estimates that improvements in primary care for stroke may have reduced secondary care costs by £165 million, over a four year period from 2004 to 2008, measured by a 10 per cent increase in the mean practice QOF stroke score.”

Full report
Summary

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Primary care economics – Institute of Health Economics, Alberta Canada – September 2010

Posted on October 14, 2010. Filed under: General Practice, Health Economics, Primary Hlth Care |

Primary care economics – Institute of Health Economics, Alberta Canada – September 2010

Extract from the summary

“Reforms of primary care hold promise in influencing health outcomes, especially among the chronically ill, but there is little supporting evidence about what these initiatives will cost. This paper addresses how our primary care resources are currently utilized and what they cost, what are the current funding systems established to support these resources, and what are the economic aspects of suggested reforms.”

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Regional and Racial Variation in Primary Care and the Quality of Care among Medicare Beneficiaries – The Dartmouth Institute for Health Policy and Clinical Practice, Center for Health Policy Research – 9 September 2010

Posted on September 14, 2010. Filed under: Primary Hlth Care | Tags: |

Regional and Racial Variation in Primary Care and the Quality of Care among Medicare Beneficiaries – The Dartmouth Institute for Health Policy and Clinical Practice, Center for Health Policy Research – 9 September 2010

“Summary
With the passage of the 2010 Patient Protection and Affordable Care Act, the nation has a remarkable opportunity to widen access to health care while also improving quality and affordability. Several provisions in the legislation are aimed at improving primary care, which is considered a crucial step towards creating a high-functioning, effective health care delivery system. But simply increasing access to primary care may not be enough to realize improvements in the quality of care or in health outcomes. As this Dartmouth Atlas report shows, neither a greater supply of primary care physicians in an area nor a regular visit to a primary care clinician is, by itself, a guarantee that a patient will get recommended care or experience better outcomes. This report also shows that increasing access to primary care may not be enough to overcome racial disparities in quality and outcomes. Achieving the benefits of primary care is likely to require both improving the services provided by primary care clinicians and more effective integration and coordination with other providers.”

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The impact of incentives on the behaviour and performance of primary care professionals – NHS National Institute for Health Research – Service Delivery and Organisation programme – 4 August 2010

Posted on September 14, 2010. Filed under: General Practice, Health Economics, Primary Hlth Care | Tags: |

The impact of incentives on the behaviour and performance of primary care professionals – NHS National Institute for Health Research – Service Delivery and Organisation programme – 4 August 2010

“Aims: To explore and explain the impact of incentives in primary care on professional behaviours and performance. To examine these impacts on primary care professionals (PCPs) as providers of primary care and as commissioners of primary care and other services.” …continues

Commissioning brief Download (PDF 123Kb)
Executive summary Download (PDF 37Kb)
Final report Download (PDF 924Kb)

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Aboriginal and Torres Strait Islander Health Services Report, 2008-09: OATSIH Services Reporting – Key Results – AIHW – 13 September 2010

Posted on September 14, 2010. Filed under: Aboriginal TI Health, Primary Hlth Care | Tags: |

Aboriginal and Torres Strait Islander Health Services Report, 2008-09: OATSIH Services Reporting – Key Results – AIHW – 13 September 2010

The main findings from the 2008-09 OATSIH Services Reporting data collection show that Aboriginal and Torres Strait Islander: – primary health care services provided 2.1 million episodes of health care to around 375,000 clients – substance use specific services provided treatment and assistance to address substance use issues to about 23,200 clients – Bringing Them Home and Link Up counselling services provided counselling to about 8,400 clients.

Australian Institute of Health and Welfare

Published 13 September 2010; ISBN-13 978-1-74249-055-7; AIHW cat. no. IHW 31; 116pp

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Policy Implications of the Use of Retail Clinics – RAND – 2010

Posted on August 20, 2010. Filed under: Preventive Healthcare, Primary Hlth Care | Tags: |

Policy Implications of the Use of Retail Clinics – RAND – 2010
 
By: Robin M. Weinick, Craig Evan Pollack, Michael P. Fisher, Emily M. Gillen, Ateev Mehrotra
Pages: 92
Document Number: TR-810-DHHS

“Retail clinics, located within larger retail stores, treat a limited number of acute conditions and offer a small set of preventive services. Although there are nearly 1,200 such clinics in the United States, a great deal about their utilization, relationships with other parts of the health care system, and quality of care remains unknown. The federal government has taken only limited action regarding retail clinics, and little evidence exists about the potential costs and benefits of integrating retail clinics into federal programs and initiatives.

Through a literature review, semistructured interviews, and a panel of experts, the authors show that retail clinics have established a niche in the health care system based on their convenience and customer service. Levels of patient satisfaction and of the quality and appropriateness of care appear comparable to those of other provider types. However, we know little about the effects of retail clinic use on preventive services, care coordination, and care continuity. As clinics begin to expand into other areas of care, including chronic disease management, and as the number of patients with insurance increases and the shortage of primary care physicians continues, answering outstanding questions about retail clinics’ role in the health care system will become even more important. These changes will create new opportunities for health policy to influence both how retail clinics function and the ways in which their care is integrated with that of other providers.”

Full Document (File size 0.4 MB, 2 minutes modem, < 1 minute broadband)

Summary Only  (File size 0.1 MB, < 1 minute modem, < 1 minute broadband)

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Patient safety in primary health care – Australian Commission on Safety and Quality in Health Care – August 2010

Posted on August 18, 2010. Filed under: General Practice, Patient Safety, Primary Hlth Care | Tags: |

Patient safety in primary health care – Australian Commission on Safety and Quality in Health Care – August 2010

Discussion Paper – Draft for Public Consultation

“The field of patient safety emerged following Australian and international research showing that a large number of harmful, but potentially preventable, incidents occur in hospitals.1-3 This was emphasised by a number of high profile inquiries into incidents at specific hospitals.4-5 These origins mean that the focus of early patient safety work was mostly on issues that were particularly relevant for acute care settings, and there has been little examination of the patient safety risks that exist in primary health care.

However, most health care in Australia is provided in primary health care settings. Almost one in five people visit a general practitioner (GP), and one in ten visit an allied health professional in any given two week period.6 Given the size and importance of this sector, it is essential that the care provided in it is safe, and that risks of unnecessary harm associated with the delivery of health care are minimised.

There are a large number of organisations that have a role in quality and safety in primary health care in Australia, and many programs and initiatives are in place to improve care provided in this sector. One of these organisations is the Australian Commission on Safety and Quality in Health Care (the Commission), which was established in 2005 to lead and coordinate improvements in safety and quality nationally.

The purpose of this paper is to stimulate discussion about patient safety in primary health care in Australia. The Commission wants to raise awareness of these issues, and supports coordinated national action to address them. Improving patient safety in primary health care requires a new approach and new thinking that includes a greater emphasis on safety and prevention from harm.

The Commission would like to work with primary health care stakeholders to identify priority areas for improving safety, and to take action to address these priorities. The development of this paper and subsequent consultation process is the first step in this process and the outcomes of the consultation will be used to guide the Commission’s actions to support patient safety in primary health care.”

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Snapshot of Australian primary health care research 2010

Posted on August 4, 2010. Filed under: Primary Hlth Care, Research |

Snapshot of Australian primary health care research 2010

Edwina Light, and others Primary Health Care Research and Information Service

This snapshot of recent Australian research projects demonstrates the potential for primary health care research to improve the health of Australians.

Snapshot of Australian primary health care research 2010 is a collaborative venture involving representatives from PHC RIS, the Australian Government Department of Health and Ageing, Australian Primary Health Care Research Institute, Australian Association for Academic General Practice, Royal Australian College of General Practitioners.

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Community mental health and primary mental health care – Background Paper – Mental Health Council of Australia – July 2010

Posted on July 28, 2010. Filed under: Community Services, Mental Health Psychi Psychol, Primary Hlth Care |

Community mental health and primary mental health care – Background Paper – Mental Health Council of Australia – July 2010

This background paper arose from the National Health and Hospitals Reform Commission (NHHRC) 2009 Final Report and its recommendations about future directions for primary health care. The recommendations for primary health care included ‘community mental health’, which led to concern that the scope and complexity of community mental health care had been overlooked or misunderstood.

This paper seeks to clarify points of overlap and difference between primary health care and community mental health. It also identifies how their linkages could be strengthened whilst ensuring maintenance of the capacity and integrity of specialist mental health services delivered in the community.

Associated with this background paper are new Community Mental Health Guiding Principles developed to clarify the nature and scope of community mental health care, and to provide principles to guide its further development across Australia.

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Feedback on potential boundaries for Medicare Locals and Local Hospital Networks – June 2010

Posted on July 1, 2010. Filed under: Health Systems Improvement, Primary Hlth Care | Tags: , |

Feedback on potential boundaries for Medicare Locals and Local Hospital Networks

“Context
As part of the health reforms, the Australian Government will invest $416.8 million over four years to establish a network of primary health care organisations (Medicare Locals) across Australia. This includes funding to improve access to after hours primary care through Medicare Locals.

Medicare Locals will be independent legal entities with strong links to local communities, health professionals and service providers, enabling them to respond more effectively to local need. Medicare Locals will support health professionals to provide more co-ordinated care, improve access to services, and drive integration across the primary health care, hospital and aged care sectors.

The first group of Medicare Locals (around 15 organisations) will commence operation in mid 2011, with the remainder commencing in mid 2012. The first group will be drawn from the Divisions of General Practice network.

Initial consultation on Local Hospital Network boundaries will be undertaken by the States and Territories. Following an initial consultation phase the Commonwealth will work with the States and Territories with the aim of producing a combined set of government endorsed LHN and Medicare Local boundaries for further consultation.”
…continues

Feedback sought

The closing date for comments or submissions is 30 September 2010.

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Health Care on Aisle 7: The Growing Phenomenon of Retail Clinics – RAND Corporation – June 2010

Posted on June 16, 2010. Filed under: Primary Hlth Care | Tags: |

Health Care on Aisle 7: The Growing Phenomenon of Retail Clinics – RAND Corporation – June 2010
 
By: Ateev Mehrotra, John L. Adams, Katrina Armstrong, Christine Eibner, Peter S. Hussey, Judith Lave, Hangsheng Liu, Elizabeth A. McGlynn, Craig Evan Pollack, M. Susan Ridgely, Rena Rudavsky, Leif I. Solberg, N. Marcus Thygeson, Margaret C. Wang

Presents information on the growing phenomenon of retail medical clinics, the types of patients they serve and the types of care they provide, and whether some common claims about retail clinics are supported by evidence.

Full Document (HTML) 
 
Full Document (PDF – File size 0.2 MB, < 1 minute modem, < 1 minute broadband)

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National Demonstration Project and the Patient-Centered Medical Home – Supplement issue of Annals of Family Medicine – 2010

Posted on June 10, 2010. Filed under: General Practice, Primary Hlth Care |

National Demonstration Project and the Patient-Centered Medical Home – Supplement issue of Annals of Family Medicine – 2010

American Academy of Family Physicians (AAFP) – Patient-Centered Medical Home website

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Stocktake of Primary Health Care Research in Australia – ANU – May 2010

Posted on June 8, 2010. Filed under: General Practice, Primary Hlth Care |

Stocktake of Primary Health Care Research in Australia – ANU – May 2010

Primary Health Care Research and Information Service (PHC RIS)
Discipline of General Practice
Flinders University of South Australia

“In light of the development of Primary Health Care Research over the past 10 years, and the current agenda for reform, this work sets out to do three things: provide a stocktake of the current state of primary health care research in Australia; identify the current strengths and weakness of Australian primary health care research in light of current health priorities; identify ways in which current research gaps might be addressed.”

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At the tipping point: health leaders share ideas to speed primary health care reform [Canada] – 26 May 2010

Posted on May 28, 2010. Filed under: General Practice, Primary Hlth Care | Tags: |

At the tipping point: health leaders share ideas to speed primary health care reform [Canada] – 26 May 2010

Earlier this year, the Health Council of Canada sponsored a day-long discussion on primary health care reform through the McMaster Health Forum. Twenty health care leaders from across the country came together to talk about ways to strengthen primary health care in Canada.

Media release

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Strengthening Primary Care and Public Health Collaboration – Canadian website

Posted on April 20, 2010. Filed under: Primary Hlth Care, Public Hlth & Hlth Promotion |

Strengthening Primary Care and Public Health Collaboration – Canadian website

“About the Project
 
Primary health care is the critical approach to care and service delivery as articulated at the WHO conference at Alma Ata in 1978. Across Canada, there have been rapidly changing structures in the delivery of public health, as well as a variety of approaches to primary care renewal. Despite this, and the recent increase in research activity in multidisciplinary collaboration in primary healthcare teams, there has been a paucity of research focusing on building collaborative relationships between primary care (PC) and public health (PH). This four-year program of research will investigate:

  • the structures and processes required to build successful collaborations between public health and primary care (at interactional, organizational and systemic levels);
  • roles that nurses and other health care practitioners play in building local collaborations between PC and PH;
  • factors that influence their capacity to foster such collaborations; and
  • the extent to which collaborative partnerships between primary care and public health that currently exist in Nova Scotia, Ontario, and British Columbia.”
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Primary Healthcare: Improving Canada’s primary healthcare: benefits and opportunities – Canadian Health Services Research Foundation – January 2010

Posted on January 27, 2010. Filed under: General Practice, Primary Hlth Care | Tags: |

Primary Healthcare: Improving Canada’s primary healthcare: benefits and opportunities – Canadian Health Services Research Foundation

“About the reports

These three reports summarize the current state of primary healthcare in Canada, investigate best international practices and provide concrete recommendations on how Canada can redefine its priorities in order to strengthen the system.

Commissioned by CHSRF and the Canadian Working Group for Primary Healthcare Improvement, the three reports will be used to guide activities in developing a pan-Canadian strategy for using evidence to improve the design and delivery of primary healthcare.

The Canadian Working Group for Primary Healthcare Improvement was formed at an April 2008 meeting of leaders in primary healthcare (researchers, practitioners, funders and policy makers) that was convened by CHSRF – the group’s lead agency.

The reports

What are the Critical Attributes and Benefits of a High-quality Primary Healthcare System?
Dale McMurchy
January 2009 (released January 2010)

This paper summarizes the key attributes and benefits of high-quality primary healthcare systems. It covers factors such as orientation and design, organization and process, effective governance, physician supply and the critical features unique to primary care delivery.

The Health and Economic Consequences of Achieving a High-quality Primary Healthcare System in Canada – “Applying What Works in Canada: Closing the Gap”
Alan Katz, Richard H. Glazier, Janani Vijayaraghavan
February 2009 (released January 2010)

Currently, there is a large gap between the ideal primary healthcare system – one that relies on evidence-based practice – and the reality of Canada’s system. This report analyzes the effects, both health-related and economic, of moving the reality toward the ideal.

A Structure for Co-ordinating Canadian Primary Healthcare Research
G. Russell, S. Johnston, P. Thille, R. Geneau, J. Conklin, W. Hogg, Y. Ikezawa
February 2009 (released January 2010)

If Canada wants a high-quality primary healthcare system that integrates emerging evidence into practice and policy, then it needs a co-ordinating body to support all those working to improve primary healthcare through evidence. The authors investigate international and domestic models, examine various frameworks and processes, compare the pros and cons, and explore the feasibility of implementing a network model in the Canadian context.”

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Evaluation of the Primary Mental Health Initiatives: Summary Report – NZ – published online August 2009

Posted on August 11, 2009. Filed under: Mental Health Psychi Psychol, Primary Hlth Care |

Evaluation of the Primary Mental Health Initiatives: Summary Report – NZ – published online August 2009
Date of publication (online): August 2009
ISBN numbers: 978-0-478-31908-8 (online), 978-0-478-31907-1 (print)

Summary of publication

“The Report describes the evaluation of the first 26 of the Ministry of Health’s funded Primary Mental Health initiatives which was conducted between June 2005 and November 2007. New funding allocated through the Primary Health Care Strategy funding recognised the need for development of primary mental health services in New Zealand.

The Evaluation has reported that the initiatives have been very successful. They have facilitated effective interdisciplinary team work, created new roles and at least 80 percent of patients receiving the funded services showed positive improvement.”

Evaluation of the Primary Mental Health Initiatives: Summary Report full text  (PDF, 3 MB)

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Experiences With Primary Health Care in Canada – in caring for chronic conditions – 23 July 2009

Posted on July 24, 2009. Filed under: Chronic Disease Mgmt, Primary Hlth Care |

Experiences With Primary Health Care in Canada

Pages:24
Date published: July 23, 2009

“Experiences With Primary Health Care in Canada, measures access to and quality of care from a patient perspective across Canada’s 10 provinces. The study is based on the responses of more than 11,000 people age 18 and older to Statistics Canada’s 2008 Canadian Survey of Experiences With Primary Health Care, which was co-funded by CIHI.”

Full Report
Download Experiences With Primary Health Care in Canada (PDF) 788 KB

Media Release
Most, but not all, Canadians with chronic conditions get clinically recommended tests

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The link between healthcare spending and health outcomes for the new English primary care trusts, London, The Health Foundation, 2009

Posted on July 6, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics, Primary Hlth Care | Tags: , |

The link between healthcare spending and health outcomes for the new English primary care trusts by Stephen Martin, Nigel Rice and Peter C. Smith, University of York.  London, The Health Foundation, 2009   ISBN 978-1-906461-09-6 64 p.

“This study was produced as part of the Quest for Quality and Improved Performance (QQUIP), an initiative of The Health Foundation.”

“Abstract

English programme budgeting data have yielded major new insights into the link between healthcare spending and health outcomes. This paper updates two recent studies that used programme budgeting data for 295 primary care trusts (PCTs) in England to examine the link between spending and outcomes for several programmes of care (Martin, Rice and Smith 2008a; 2008b). We use the same  economic model employed in the two previous studies.

The paper focuses on the dilemmas facing decision-makers who must allocate a fixed budget across programmes of care so as to maximise social welfare, given a health production function for each programme. We estimate two equations – a health outcome equation and an expenditure equation – for each programme (data permitting). The two previous studies employed expenditure data for 2004/05 and 2005/06 for 295 PCTs and found that in several care programmes – cancer, circulation problems, respiratory problems, gastro-intestinal problems, trauma burns and injury, and diabetes – expenditure had the anticipated negative effect on the mortality rate.

Each health outcome equation was used to estimate the marginal cost of a life year saved. In 2006/07 the number of PCTs in England was reduced – largely through a series of mergers – to 152. In addition, several changes were made to the methods employed to construct the programme budgeting data. This paper employs updated budgeting and mortality data for the new 152 PCTs to re-estimate health production and expenditure functions, and also presents updated estimates of the marginal cost of a life year saved in each programme. Although there are some differences the results we obtained are broadly similar to those presented in our two previous studies.”

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Group Health Cooperative: Reinventing Primary Care by Connecting Patients with a Medical Home, The Commonwealth Fund, July 2009

Posted on July 6, 2009. Filed under: Health Mgmt Policy Planning, Primary Hlth Care | Tags: |

D. McCarthy, K. Mueller, and I. Tillmann, Group Health Cooperative: Reinventing Primary Care by Connecting Patients with a Medical Home, The Commonwealth Fund, July 2009

Overview

“Group Health Cooperative (GHC) is a nonprofit, consumer-governed health care organization serving 580,000 members in Washington State and Idaho through an integrated multispecialty group practice and a network of community providers. Integrated financing and delivery—supported by a partnership between health plan administrators and medical group physicians—enable GHC to launch innovations and organize services in ways that make the most sense operationally and clinically. Exemplifying this approach is GHC’s implementation of a patient-centered medical home model of primary care that enhances the roles of a multidisciplinary care team and uses electronic health records to deliver proactive, coordinated care. Information technology is a key to improving patients’ communication with their care team, engaging them in evidence-based care, and reducing fragmentation of services. GHC is using “lean” techniques to involve care teams and other frontline staff in standardizing their work, an approach that can likely be expanded to include other organizations.”

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Organizational Learning in Primary Health Care Innovation – Canadian report – 30 March 2009

Posted on June 30, 2009. Filed under: Health Systems Improvement, Primary Hlth Care | Tags: |

Organizational Learning in Primary Health Care Innovation
This research was funded by: The Canadian Institutes of Health Research (CIHR) With matching funding from: The Alberta Heritage Foundation for Medical Research (AHFMR) March 30, 2009

Executive Summary

“Our research was designed to provide new insights about how organizations engage in processes of innovation and learn to spread and institutionalize good ideas about providing primary health care (PHC). This is important because finding new and better ways to deliver PHC is essential for long term sustainability of publicly funded health care. There have been many successful innovation projects over the years, but health organizations have found it difficult to transfer the learning from these projects to the broader delivery of PHC services.”

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Unmet needs for primary care in the context of a universal healthcare system: the case of Quebec. – April 2009

Posted on May 20, 2009. Filed under: Primary Hlth Care | Tags: , |

Unmet needs for primary care in the context of a universal healthcare system.  The case of Quebec. Hani Guend, Anne-Laure Tesseron   (pdf – 196 KB)
Centre – Urbanisation Culture Societe, Institut national de la recherche scientifique, Montreal, Quebec, Canada – April 2009   Working papers, 2009-04.

“Even under a universal regime of healthcare insurance, some people find it difficult to access primary healthcare.  This research aims to identify individual and social factors that contribute to these difficulties in the province of Quebec.”

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Reviews published on primary care information for the public 13 May 2009 – University of Birmingham Health Services Management Centre

Posted on May 18, 2009. Filed under: Patient Participation, Primary Hlth Care |

Reviews published on primary care information for the public 13 May 2009

University of Birmingham Health Services Management Centre (HSMC)

HSMC has recently completed a series of evidence reviews exploring the provision of public information about the quality of primary care services. Each review addresses a specific question including: what information about the quality of primary care services do patients and the public want; which information formats are most accessible and effective; and how can information be presented to empower patients to make an informed choice of primary care provider?

The reviews were commissioned by Project 6 of NHS West Midlands’  Investing for Health programme, which is planning to disseminate information to the public about the quality of local primary care services during 2009/2010.

Public information about quality of primary care services – Summary (pdf)

User and public perspectives on the quality of primary care (pdf)

Information about health services and the impact on patients and the public (pdf)

Making health service information accessible (pdf)

The impact of information presented in different formats (pdf)

Designing and presenting web-based information (pdf)

Empowering patients and the public to choose a primary care provider (pdf)

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Urgent care: a practical guide to transforming same day care in general practice – May 2009 report from the UK Primary Care Foundation

Posted on May 18, 2009. Filed under: Primary Hlth Care |

Urgent care: a practical guide to transforming same day care in general practice

The Primary Care Foundation was commissioned by the UK Department of Health to undertake this review of urgent care in general practice. The Department’s Next Stage Review (known as the Darzi report) in July 2008 pledged: ‘Every member of the public should be able to expect integrated local services that provide access to urgent care, 24 hours a day and 365 days a year.’ This project explores the practical steps that GPs and their staff are taking to improve patient care and reduce pressure on the wider healthcare system.

Primary Care Foundation – publications

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Teams in Action: Primary Health Care Teams for Canadians April 2009 Health Council of Canada

Posted on May 1, 2009. Filed under: Multidisciplinary Care, Primary Hlth Care | Tags: , , |

Teams in Action: Primary Health Care Teams for Canadians  April 2009 Report from the Health Council of Canada

Health Council of Canada. (2009). Teams in Action: Primary Health Care Teams for Canadians. Toronto: Health Council.
ISBN: 978-1-897463-56-7

As Canada’s health care system deals with an aging population, collaborative health care teams are an effective way to treat the increasing number of Canadians with chronic health conditions.  Collaborative team care is a significant shift in the way Canadians are receiving their primary health care. Many Canadians may not know that this type of health care service is available to them, but they should – both as taxpayers and people who use health care services.

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COAG Report on Government Services Published 30 January 2009

Posted on April 8, 2009. Filed under: Aboriginal TI Health, Acute Care, Aged Care / Geriatrics, Health Mgmt Policy Planning, Health Systems Improvement, Mental Health Psychi Psychol, Obstetrics, Primary Hlth Care | Tags: |

Council of Australian Governments.  This report was released on 30 January 2009.

It has been produced by the Steering Committee for the Review of Government Service Provision (SCRGSP).  The report has been published in two volumes. Also released with the report are attachment tables, which are not part of the printed report but are available in the report sections.

Fact sheets:

Ambulance services
Public Hospitals
Maternity Services
Primary and Community Health
Breast cancer detection and management
Mental health
Aged care services
Services for people with a disability
Supported accommodation and assistance services
Government services and Indigenous people (PDF – 99 Kb)

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A Scoping Literature Review of Collaboration between Primary Care and Public Health: A Report to the Canadian Health Services Research Foundation

Posted on April 8, 2009. Filed under: Primary Hlth Care, Public Hlth & Hlth Promotion |

A Scoping Literature Review of Collaboration between Primary Care and Public Health: A Report to the Canadian Health Services Research Foundation
Dr. Ruth Martin-Misener & Dr. Ruta Valaitis
September 30, 2008

Purpose:
The purpose of this scoping review was to determine what is known from existing primary studies, literature reviews and descriptive accounts about:
• structures and processes required to build successful collaborations between PH and PC;
• outcomes of collaborations between PH and PC;and
• markers of successful collaboration between PH and PC.

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