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澳大利亚的初级医疗保健体系——改善协调的必要性及对医疗保险本地机构的影响

Australia's systems of primary healthcare - the need for improved coordination and implications for Medicare Locals.

作者信息

Wiese Marlene, Jolley Gwyneth, Baum Fran, Freeman Toby, Kidd Michael

机构信息

Southgate Institute, Flinders University, Adelaide, South Australia.

出版信息

Aust Fam Physician. 2011 Dec;40(12):995-9.

Abstract

BACKGROUND

In Australia, primary healthcare is largely delivered through two parallel systems: Medicare supported primary care delivered by fee-for-service general practitioners, and state funded and managed community health services.

METHODS

Semistructured interviews with 18 GPs to investigate the current links between GPs and local primary healthcare providers.

RESULTS

Barriers to links include: communication and information, access and availability of services, GP lack of awareness and understanding of services provided in the state funded sector, and lack of time to gain information. Discussion General practitioners reported dealing with more complex and challenging patients. However, this did not appear to increase their likelihood of engaging with state funded primary healthcare services in case management. Medicare Locals are a once-in-a-generation chance to establish a genuinely coordinated and multidisciplinary primary healthcare sector. To be successful, Medicare Locals will need to bring together two parallel systems of care and improve integration and coordination.

摘要

背景

在澳大利亚,初级医疗保健主要通过两个并行系统提供:由按服务收费的全科医生提供的医疗保险支持的初级保健,以及由州政府资助和管理的社区卫生服务。

方法

对18名全科医生进行半结构化访谈,以调查全科医生与当地初级医疗保健提供者之间的当前联系。

结果

联系的障碍包括:沟通与信息、服务的可及性与可得性、全科医生对州政府资助部门提供的服务缺乏认识和了解,以及缺乏获取信息的时间。讨论 全科医生报告称他们要应对更复杂、更具挑战性的患者。然而,这似乎并未增加他们在病例管理中参与州政府资助的初级医疗保健服务的可能性。医疗保险地方机构是一代人仅有一次的机会,可借此建立一个真正协调的多学科初级医疗保健部门。要取得成功,医疗保险地方机构需要整合两个并行的医疗保健系统,并改善整合与协调。

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