Developments in Australian general practice 2000–2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

Australia and New Zealand Health Policy - Tập 3 Số 1 - 2006
Gawaine Powell Davies1, Wendy Hu1, Julie McDonald2, John Furler3, Elizabeth Harris4, Mark Harris4
1Centre for General Practice Integration Studies, School of Public Health and Community Medicine, University of New South Wales, NSW 2052, Australia
2Julie McDonald & Associates, PO Box 98, Jamberoo, NSW 2533, Australia
3Department of General Practice, University of Melbourne, Victoria, 3010, Australia
4Centre for Health Equity, Training, Research and Evaluation, School of Public Health and Community Medicine, University of New South Wales, NSW 2052, Australia

Tóm tắt

Abstract Background In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000–2002, using a normative model of primary health care and data from a descriptive study to evaluate progress. Results There was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be based in and focus on a single jurisdiction, and build capacity chiefly within the services funded through that jurisdiction. As a result, the overall effect was patchy, with similar difficulties being noted across all jurisdictions and little gain in overall system capacity for effective primary health care. Conclusion Efforts to develop more effective primary health care need a more balanced approach to reform, with a better balance across the different elements of primary health care and greater integration across programs and jurisdictions. One way ahead is to form a single funding agency, as in the UK and New Zealand, and so remove the need to work across jurisdictions and manage their competing interests. A second, perhaps less politically challenging starting point, is to create an agreed framework for primary health care within which a collective vision for primary health care can be developed, based on population health needs, and the responsibilities of different sectors services can be negotiated. Either of these approaches would be assisted by a more systematic and comprehensive program of research and evaluation for primary health care.

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Australia and New Zealand Health Policy

Tập 3 Số 1

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