Thinking outside the system: the integrated care experience in Queensland, Australia
Linda Mundy A C and Kaye Hewson BA School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide, SA 5000, Australia.
B Genetic Health Queensland, Critical Care and Clinical Support Services, Metro-North Hospital and Health Service, Queensland Department of Health, Level 14, Block 7, Herston, Qld 4006, Australia.
C Corresponding author. Email: linda.mundy@adelaide.edu.au
Australian Journal of Primary Health 25(4) 303-309 https://doi.org/10.1071/PY18161
Submitted: 8 October 2018 Accepted: 19 May 2019 Published: 23 August 2019
Abstract
Health policy-makers are faced with a demand for health care that exceeds supply, driven in part by an ageing population and an increased prevalence of chronic disease. An integrated ‘people-centred’ model of care across primary, secondary and tertiary health care can strengthen the health system by streamlining services to improve the patient journey and outcomes. Integrated care offers an opportunity to reduce admissions and re-admissions to hospitals, reduce presentations to emergency departments and improve the capacity of outpatient clinics while delivering better outcomes to patients. Queensland’s $35 million Integrated Care Innovation Fund (ICIF) has provided seed funding to 24 projects covering a wide spectrum of chronic disease management and complex disease. Programs such as the ICIF offer an opportunity to provide a new approach to caring for vulnerable populations such as the frail and elderly; children with behavioural and developmental issues; children in out-of-home care; rural and remote populations; and people with mental health issues, whose care runs the risk of ‘falling through the cracks’ with conventional healthcare approaches.
Additional keywords: chronic disease, continuity of patient care, delivery of health care, health reform, primary health care.
References
Australian Institute of Health and Welfare (AIHW) (2016) Australia’s health 2016. (Australian Institute of Health and Welfare: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/getmedia/9844cefb-7745-4dd8-9ee2-f4d1c3d6a727/19787-AH16.pdf.aspx?inline=true [Verified 07 February 2018]Australian Institute of Health and Welfare (AIHW) (2017) Health expenditure Australia 2015–16. (Australian Institute of Health and Welfare: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2015-16/contents/dynamic-data [Verified 07 February 2018]
Clinical Excellence Division (2017) Integrating care. (Queensland Heath: Brisbane, Qld, Australia) Available at https://www.health.qld.gov.au/__data/assets/pdf_file/0027/671472/integrating-care-spring-2017.pdf [Verified 15 January 2018]
Collins S, Beilby J, Fardy J, Burgess T, Johns R, Booth B (1998) The national asthma audit. Bridging the gap between guidelines and practice. Australian Family Physician 27, 907–913.
Connor M, Cooper H, McMurray A (2016) The Gold Coast Integrated Care Model. International Journal of Integrated Care 16, 2.
| The Gold Coast Integrated Care Model.Crossref | GoogleScholarGoogle Scholar | 28435415PubMed |
Dwyer JM, Duckett SJ (2016) Restructuring primary health care in Australia. The Medical Journal of Australia 205, 435–436.
| Restructuring primary health care in Australia.Crossref | GoogleScholarGoogle Scholar | 27852174PubMed |
Goodwin N (2016) Understanding integrated care. International Journal of Integrated Care 16, 6.
| Understanding integrated care.Crossref | GoogleScholarGoogle Scholar | 28316546PubMed |
Hall J (2015) Australian health care–the challenge of reform in a fragmented system. The New England Journal of Medicine 373, 493–497.
| Australian health care–the challenge of reform in a fragmented system.Crossref | GoogleScholarGoogle Scholar | 26244304PubMed |
Ham C, Alderwick H (2015) Place-based systems of care: a way forward for the NHS in England. (The King’s Fund: London, UK) Available at https://www.kingsfund.org.uk/publications/place-based-systems-care [Verified 12 January 2018]
Martin E (2015) Rationing in healthcare. (Deeble Institute for Health Policy Research, Australian Healthcare and Hospital Association: Deakin, ACT, Australia) Available at https://ahha.asn.au/sites/default/files/docs/policy-issue/deeble_issues_brief_no_8_martin_e_rationing_in_healthcare.pdf [Verified 28 January 2018]
McRae IS, Butler JR, Sibthorpe BM, Ruscoe W, Snow J, Rubiano D, Gardner KL (2008) A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia. BMC Health Services Research 8, 205.
| A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia.Crossref | GoogleScholarGoogle Scholar | 18834551PubMed |
Organisation for Economic Co-operation and Development (OECD) (2015) OECD Health Policy Overview: health policy in Australia. (Organisation for Economic Co-operation and Development: Paris, France) Available at http://www.oecd.org/health/health-systems/Health-Policy-in-Australia-December-2015.pdf [Verified 19 January 2018]
Primary Health Care Advisory Group (2015) Primary Health Care Advisory Group Report: better outcomes for people with chronic and complex health conditions. (Department of Health, Australian Government: Canberra, ACT, Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/primary-phcag-report [Verified 18 January 2019]
Reddy S (2016) Integrated health care: it’s time for it to blossom. Australian Health Review 40, 428–430.
| Integrated health care: it’s time for it to blossom.Crossref | GoogleScholarGoogle Scholar | 26803320PubMed |
Steven ID, Wing L (1999) Control and cardiovascular risk factors of hypertension. An assessment of a sample of patients. Australian Family Physician 28, 45–48.
Sturgess I (2016) Frailty and deconditioning; risks and opportunities. (Queensland Heath: Brisbane, Qld, Australia) Available at https://www.health.qld.gov.au/publications/clinical-practice/engagement/qcs-pp-1611-sturgess.pdf [Verified 29 January 2018]
Sturmberg JP, Overend D (1999) General practice based diabetes clinics. An integration model. Australian Family Physician 28, 240–245.
World Health Organization (WHO) (2016) Integrated care models: an overview. (World Health Organization: Copenhagen, Denmark) Available at http://www.euro.who.int/en/health-topics/Health-systems/health-services-delivery/publications/2016/integrated-care-models-an-overview-2016 [Verified 04 January 2018]