为2型糖尿病患者提供综合全科及联合健康护理。

Integrated GP and allied health care for patients with type 2 diabetes.

作者信息

Grimmer-Somers Karen, Dolejs Wendy, Atkinson Joanne, Worley Anthea

机构信息

Centre for Allied Health Evidence, University of South Australia.

出版信息

Aust Fam Physician. 2008 Sep;37(9):774-5, 777-9.

PMID:18797537

Abstract

BACKGROUND

Integrated general practitioner and allied health chronic disease management (CDM) has been supported by Australian Government Medicare initiatives since 2005. Practical ways of implementing CDM have been slow to develop.

METHODS

An integrated CDM program for patients with type 2 diabetes was piloted in 2006 by Central Northern Adelaide Health Service (South Australia), in conjunction with four divisions of general practice. Health providers included GPs, practice nurses, credentialed diabetes educators, dieticians and podiatrists. Eligible patients with Medicare approved Team Care Arrangements (TCAs) received allied health care for the Medicare Plus rebate only. This article reports on GP and staff perspectives of the processes, and the effectiveness and sustainability of the pilot.

RESULTS

Chronic disease management improved with integrated health care, reflected by appropriate allied health referrals and better quality TCAs, interprofessional communication, and patient satisfaction.

DISCUSSION

There are benefits for interested GPs, their staff, co-located allied health providers and diabetic patients if integrated multidisciplinary care is provided in the manner of this Enhanced Primary Care CDM model.

摘要

背景

自2005年以来，澳大利亚政府的医疗保险计划一直在支持全科医生与专职医疗人员相结合的慢性病管理（CDM）。然而，实施CDM的实用方法发展缓慢。

方法

2006年，阿德莱德北部中央卫生服务机构（南澳大利亚）与四个全科医疗部门合作，对2型糖尿病患者开展了一项综合CDM项目试点。医疗服务提供者包括全科医生、执业护士、注册糖尿病教育者、营养师和足病医生。符合医疗保险批准的团队护理安排（TCA）的患者仅可获得专职医疗服务，并享受医疗保险附加回扣。本文报告了全科医生及其工作人员对该过程的看法，以及试点的有效性和可持续性。