Care coordination and health sector reform

Abstract

THE PRODUCTIVITY COMMISSION (Productivity Commission 2004) has nominated nationally coordinated health sector reform as one of two top priorities (along with natural resource management) for extending the industry reform agenda under the aegis of National Competition Policy. This is in recognition of the importance of these areas for the wellbeing of Australians, and the level of resources they will require in future years. The Commission states that ?an independent review of Australia?s health system as a whole is a critical first step in achieving cooperative solutions to deep-seated structural problems? (p. XI). The fragmentation in health system governance that results from the national? state split is mirrored in the lack of coordinated care at many levels throughout the system. The Commission?s proposal has been welcomed by many in the health industry, no doubt with some nervousness, because of the broad and deep conviction that something has to change in the apparently intractable problem of split funding responsibilities. ?Today?s health-care delivery systems are not organized in ways that promote best quality. Service delivery is largely uncoordinated, requiring steps and patient ?hand-offs? that slow down care and decrease rather than improve patient safety? (OECD 2004). Improving care coordination is high on the list of issues to be addressed in any reform of the health sector. This issue of the journal features a collection of papers which address the sometimes jagged ?seams? in the current system. They offer insights into some of the consequences of the structural problems the Productivity Commission would like to see addressed, and document an energetic search for methods of enhancing the effectiveness of health care.