Conference Presentations

Conference Presentations

Are your systems an Asset or a Liability from Stat Health

Presented at the AAPM Conference October 2012
Presenters: Carla Doolan + Cameron Jaffrey – Stat Health
Geoff Boyce + Gerard Buscombe – Precision Cloud

General Practice / Pharmacist Patient Centred Integrated Care
A model to consider

Completing the Paperless Journey

Dr Ian Williams and Mrs Jan Chaffey
AGPAL Conference
Melbourne May 2010

Incentives and Disincentives in General Practice Chronic Disease Management

Chronic disease is responsible for 80% of the total burden of disease in Australia Chronic disease management (CDM) is a major challenge for General Practice, it has been suggested that only 50% of chronic disease patients receive optimal quality care.

Patients with chronic disease have complex needs requiring planned regular clinical reviews. Their are  financial incentives for GPs to improve care for chronically ill patients.  These medical benefit schedule item numbers and practice incentive payments  are to remunerate GPs for time spent on management planning and co-ordination of care, with the intention of achieving the ultimate goal of quality health outcomes.

This study aims to identify barriers and enablers to the use of the CDM incentives in general practice; and identify service models that can enhance the uptake of CDM items.

Methods

An exploratory qualitative design was used to explore perceptions and experiences of using CDM incentives in General Practice.  Using focus groups in the first phase of the study informed the development of a structured questionnaire that was employed in the second phase of data collection through in-depth interviews with practice managers, practice nurses and GPs.

Results

This research identified several issues including:

• Conflicting views on financial viability of incentives.
• Medicare disincentives, i.e. inconsistent and or poor access to information on patient eligibility.
• Variation in practice structures, role delineation, software systems and referral networks.
• Variable barriers and rewards for the practice nurse.
• Reported increased care monitoring, reduced acute care episodes and improved quality of care (Practice drivers vary between patient outcomes or tick and flick approaches)
• The fine balance between patient care and practice sustainability.

Implications

Informing the debate about General Practice funding emphasis on episodes of care, instead of quality health outcomes in Australia.