National Health and Hospital Reform Commission final report and patient-centred suggestions for reform
Tanisha Jowsey A C , Laurann Yen A , Robert Wells A and Stephen Leeder BA Australian Primary Health Care Research Institute and Menzies Centre for Health Policy, Australian National University, 62 Eggleston Road, Australian National University, Acton, ACT 0200, Australia.
B Menzies Centre for Health Policy, University of Sydney, D02 – Coppleson Building, Camperdown, NSW 2006, Australia.
C Corresponding author. Email: tanisha.jowsey@anu.edu.au
Australian Journal of Primary Health 17(2) 162-168 https://doi.org/10.1071/PY10033
Submitted: 26 July 2010 Accepted: 10 December 2010 Published: 7 June 2011
Abstract
The final report of the National Health and Hospital Reform Commission (NHHRC) called for a strengthened consumer voice and empowerment. This has salience for the development of health policy concerning chronic illnesses. This paper compares the recommendations for chronic illness care made in the NHHRC final report with suggestions made by people with chronic illness and family carers of people with chronic illness in a recent Australian study. Sixty-six participants were interviewed in a qualitative research project of the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with type II diabetes mellitus, chronic obstructive pulmonary disease or chronic heart failure. Family carers were also interviewed. Content analysis was undertaken and participants’ recommendations for improving care were compared with those proposed in the NHHRC final report. Many suggestions from the participants of the SCIPPS qualitative research project appeared in the NHHRC final report, including the need to improve care coordination, health literacy and the experience of Indigenous Australians. The research project also identified important issues of family carers, immigrants and people with multiple illnesses, which were not addressed in the NHHRC final report. More specific attention is needed in health reform to improve the experience of family carers, Indigenous peoples, immigrants to Australia and people with multiple illnesses. To align more closely with their needs, health reform must be explicitly informed by the voices of people with chronic illness and their family carers. The NHHRC recommendations must be supplemented with proposals that address the needs of these people for support and the problems associated with poor care coordination.
Additional keywords: chronic disease, health reform, health services, qualitative.
References
Australian Bureau of Statistics (2006) 2006 census of population and housing. Available at http://www.abs.gov.au/CDATAOnline [Verified 25 May 2010]Department of Health and Ageing (2010) A national health and hospitals network: further investments in Australia’s health. Commonwealth of Australia, Canberra; April 2010. Contract No. P3-6523.
Essue B, Jowsey T, Jeon Y-H, Mirzaei M, Pearce-Brown C, Aspin C, et al (2010) Informal care and the self-management partnership: implications for Australian health policy and practice. Australian Health Review 34, 414–422.
| Informal care and the self-management partnership: implications for Australian health policy and practice.Crossref | GoogleScholarGoogle Scholar | 21108901PubMed |
Jeon Y-H, Essue B, Jan S, Wells R, Whitworth J (2009) Economic hardship associated with managing chronic illness: a qualitative inquiry. BMC Health Services Research 9, 182
| Economic hardship associated with managing chronic illness: a qualitative inquiry.Crossref | GoogleScholarGoogle Scholar | 19818128PubMed |
Jeon Y-H, Jowsey T, Yen L, Glasgow NJ, Essue B, Kljakovic M, et al (2010) Achieving a balanced life in the face of chronic illness. Australian Journal of Primary Health 16, 66–74.
| Achieving a balanced life in the face of chronic illness.Crossref | GoogleScholarGoogle Scholar | 21133301PubMed |
Jowsey T, Jeon Y-H, Dugdale P, Glasgow NJ, Kljakovic M, Usherwood T (2009) Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study. Australia and New Zealand Health Policy 6, 1–8.
Jowsey T, Gillespie J, Aspin C (2011) Effective communication is crucial to self-management: the experiences of immigrants to Australia living with diabetes. Chronic Illness 7, 6–19.
| Effective communication is crucial to self-management: the experiences of immigrants to Australia living with diabetes.Crossref | GoogleScholarGoogle Scholar | 21078683PubMed | 6
Kidd MR (2009) Bigger is not always better: what the National Health and Hospitals Reform Commission report means for general practice. The Medical Journal of Australia 191, 448–449.
Lincoln YS, Guba EG (1985) ‘Naturalistic inquiry.’ (Sage Publications: California)
Morse JM, Field PA (1995) ‘Qualitative research methods for health professionals.’ 2nd edn. (Sage Publications: California)
National Health and Hospitals Reform Commission (2009) A healthier future for all Australians: final report June 2009, Canberra. Report No. P3–5499.
Penington DG (2009) Does the National Health and Hospitals Reform Commission have a real answer for public hospitals? The Medical Journal of Australia 191, 446–447.
Roberts T, Bryan S, Heginbotham C, McCallum A (1999) Public involvement in health care priority setting: an economic perspective. Health Expectations 2, 235–244.
| Public involvement in health care priority setting: an economic perspective.Crossref | GoogleScholarGoogle Scholar | 11281900PubMed |
Scott IA (2009) The NHHRC final report: view from the hospital sector. Medical Journal of Australian 191, 450–453.
van der Pol M, Shiell A, Au F, Jonhston D, Tough S (2009) Eliciting individual preferences for health care: a case study of perinatal care. Health Expectations 13, 4–12.
| Eliciting individual preferences for health care: a case study of perinatal care.Crossref | GoogleScholarGoogle Scholar | 19691462PubMed |
Wagner E (1998) Chronic disease management: what will it take to improve care for chronic illness? Effective Clinical Practice 1, 2–4.
Yen L, Gillespie J, Jeon Y-H, Kljakovic M, Brien J, Jan S, et al (2010) Health professionals, patients and chronic illness policy: a qualitative study. Health Expectations 14, 10–20.
| Health professionals, patients and chronic illness policy: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
