Carlisle Karen, Fleming Rhonda, Berrigan Alison
College of Medicine and Dentistry, James Cook University, Douglas, Qld 4814, Australia.
Townsville-Mackay Medicare Local, Clinical Practice Building, 1 James Cook Drive, Douglas, Qld 4814, Australia.
Aust J Prim Health. 2016;22(1):22-25. doi: 10.1071/PY15036.
A strong primary healthcare system that is effective and efficient is a priority for health reform in Australia. Commissioning to support primary healthcare delivery has received increasing attention as part of healthcare reform in Australia and beyond. The aim of this paper is to present a case study of transitioning to an activity-based model for the provision of GP after-hours services in Australia. The GP After-Hours Program utilised a commissioning model that comprised of needs assessment, service development, provider engagement and evaluation. Evaluation of the new model showed a 17% increase in after-hours services, with service providers indicating that they were satisfied with the new process. Examination of the experience of implementation suggests that the commissioning model provided a useful framework for guiding activity-based funding for after-hours services. However, relational factors, such as engagement with the community, knowledge of the wider context and legitimacy of the commissioning body, can affect the implementation process.
一个高效且有效的强大基层医疗体系是澳大利亚医疗改革的首要任务。作为澳大利亚及其他地区医疗改革的一部分，支持基层医疗服务提供的委托工作受到了越来越多的关注。本文旨在呈现澳大利亚向基于活动的模式转变以提供全科医生非工作时间服务的案例研究。全科医生非工作时间项目采用了一种委托模式，该模式包括需求评估、服务开发、提供者参与和评估。对新模式的评估显示，非工作时间服务增加了17%，服务提供者表示他们对新流程感到满意。对实施经验的审视表明，委托模式为指导非工作时间服务的基于活动的资金投入提供了一个有用的框架。然而，诸如与社区的互动、对更广泛背景的了解以及委托机构的合法性等关系因素，可能会影响实施过程。
