Factors affecting the embedding of integrated primary–secondary care into a health district
Geoffrey K. Mitchell A E , Charlotte E. Young B , Tina Janamian C , Kylie M. Beaver D , Joanne L. K. Johnson D , Clare Hannan-Jones B and Allyson J. Mutch BA Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Herston Road, Herston, Qld 4006, Australia.
B School of Public Health, Faculty of Medicine, The University of Queensland, Herston Road, Herston, Qld 4006, Australia.
C Australian General Practice Accreditation Limited (AGPAL), 1/20 Railway Terrace, Milton, Qld 4064, Australia.
D West Moreton Hospital and Health Service, Chelmsford Avenue, Ipswich, Qld 4305, Australia.
E Corresponding author. Email: g.mitchell@uq.edu.au
Australian Journal of Primary Health 26(3) 216-221 https://doi.org/10.1071/PY18177
Submitted: 30 April 2019 Accepted: 4 March 2020 Published: 12 June 2020
Abstract
With the aging population, the tide of chronic disease is rising with attendant increases in health service need. Integrated care and patient-centred approaches, which established partnerships between a regional Hospital and health service (HHS), the local primary health network and local general practitioners (GPs), were identified as exemplars of an approach needed to support growing community health needs. This paper summarises the findings from a process evaluation of four GP–specialist care integration programs with the aim of identifying recommendations for embedding integrated GP–specialist care into routine practice within the HHS. The process evaluation of the integration programs drew on input from a multidisciplinary expert advisory group and data collected through face-to-face semi-structured interviews with key stakeholders, as well as surveys of participating GPs and patients. Overarching findings were identified and grouped under six themes: interdisciplinary teamwork; communication and information exchange; the use of shared care guidelines or pathways; training and education; access and accessibility; and funding. Within each theme, key challenges and enablers emerged. The findings of this study highlight benefits and challenges associated with the establishment of integrated care between primary and secondary care providers, leading to the development of key recommendations for routine integration.
Additional keywords: clinical governance, health services needs and demands, planning techniques, primary health care, program development.
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