Integrated and consumer-directed care: a necessary paradigm shift for rural chronic ill health
Nicole E. Ranson A , Daniel R. Terry B , Kristen Glenister C , Bill R. Adam B and Julian Wright B D
+ Author Affiliations
- Author Affiliations
A Melbourne Medical School, Level 2 West, Medical Building (181), University of Melbourne, Vic. 3010, Australia.
B Department of Rural Health, University of Melbourne, PO Box 6500 Shepparton, Vic. 3632, Australia.
C Department of Rural Health, University of Melbourne, PO Box 386 Wangaratta, Vic. 3676, Australia.
D Corresponding author. Email: julian.wright@unimelb.edu.au
Submitted: 2 April 2015 Accepted: 5 November 2015 Published: 9 May 2016
Abstract
Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care.
Additional keywords: chronic disease, integrated care, quality of health care, rural health.
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