Improving processes that underpin Australian primary health care
Lauren BallAssociate Editor, Australian Journal of Primary Health
Australian Journal of Primary Health 23(1) i-ii https://doi.org/10.1071/PYv23n1_ED1
Published: 22 February 2017
High quality primary health care requires more than just an appropriately skilled workforce. The underlying processes that support and enable service delivery have the potential to affect people’s health care experiences and ultimately health outcomes. The research showcased in this issue demonstrates that there are numerous opportunities to improve the processes supporting Australian primary health care. This is exciting and promising in the journey towards enhanced health for all.
The funding arrangements for Australian primary health care services have been a focus of ongoing health reform over recent years. In this context, changes to processes should support cost savings as well as improved quality of care. Callander et al. (2017) have reviewed out-of-pocket costs for people with chronic conditions, suggesting some forego services because of high costs. This is a cause for concern, and is reinforced by the work of Lee et al. (2017), who argue that low use of primary care services can increase hospital length of stay for people with diabetes mellitus (Type 1 or Type 2). Similarly, McInnes et al. (2017) provide examples where the current fee-for-service funding model may be having a negative effect on the relationship between general practitioners and practice nurses. Commissioning in health and social and community services would also be enhanced through greater participation by clients, consumers and communities, as shown by Joyce (2017). Clearly there is further work to be done in this area.
Aboriginal health is another example where health gains are possible through improvements in health system processes. Panaretto et al. (2017) have reviewed people’s access to community-controlled primary care services in remote communities, suggesting the demand outweighs resident numbers. They argue that the model of care warrants further support, which reflects the need to have models appropriate to specific settings. Caffery et al. (2017) provide a sound rationale for alternative models of care for dental services in remote Indigenous communities. Sibthorpe et al. (2017) have proposed indicators that can be used for quality improvement initiatives targeting treatment of otitis media, thus supporting primary health care services.
This issue of Australian Journal of Primary Health also showcases areas of health care where clinicians’ scope of practice has evolved towards supporting people’s ongoing health. Examples include providing advice on nutrition (Ball et al. 2017), monitoring weight (McPhie et al. 2017), initiating follow up after gestational diabetes (Pennington et al. 2017), performing eye checks (Guymer et al. 2017), and participating in Advanced Care Planning (Fan and Rhee 2017); representing a shift away from curative care, to preventive care. Again, system-based processes that support these activities are essential.
Finally, Australian primary health care is advancing alongside contemporary societal changes. Manchikanti et al. (2017) and Benson et al. (2017) have explored the adequacy and acceptability of primary care for people who are refugees and new to Australia; and Robinson et al. (2017) have explored the growing trend of manufactured home villages for older people and their effect on primary health care access.
Such diversity, relevance and influence on outcomes for the community make this an exciting time to be involved in primary health care research. We hope you enjoy this issue of Australian Journal of Primary Health.
Lauren Ball
Associate Editor, Australian Journal of Primary Health
NHMRC Early Career Research Fellow, Menzies Health Institute Queensland, Griffith University
References
Ball L, Ball D, Leveritt M, Ray S, Collins C, Patterson E, Ambrosini G, Lee P, Chaboyer W (2017) Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses. Australian Journal of Primary Health 23, 53–60.| Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses.Crossref | GoogleScholarGoogle Scholar |
Benson J, Rahim RA, Agrawal R (2017) Newly arrived refugee children with Helicobacter pylori are thinner than their non-infected counterparts. Australian Journal of Primary Health 23, 92–96.
| Newly arrived refugee children with Helicobacter pylori are thinner than their non-infected counterparts.Crossref | GoogleScholarGoogle Scholar |
Caffery L, Bradford N, Meurer M, Smith A (2017) Association between patient age, geographical location, Indigenous status and hospitalisation for oral and dental conditions in Queensland, Australia. Australian Journal of Primary Health 23, 46–52.
| Association between patient age, geographical location, Indigenous status and hospitalisation for oral and dental conditions in Queensland, Australia.Crossref | GoogleScholarGoogle Scholar |
Callander EJ, Corscadden L, Levesque J-F (2017) Out-of-pocket healthcare expenditure and chronic disease – do Australians forgo care because of the cost? Australian Journal of Primary Health 23, 15–22.
| Out-of-pocket healthcare expenditure and chronic disease – do Australians forgo care because of the cost?Crossref | GoogleScholarGoogle Scholar |
Fan E, Rhee JJ (2017) A self-reported survey on the confidence levels and motivation of New South Wales practice nurses on conducting advance-care planning (ACP) initiatives in the general-practice setting. Australian Journal of Primary Health 23, 80–86.
| A self-reported survey on the confidence levels and motivation of New South Wales practice nurses on conducting advance-care planning (ACP) initiatives in the general-practice setting.Crossref | GoogleScholarGoogle Scholar |
Guymer C, Casson R, Howell C, Stocks N (2017) The AgED Study. Age-related eye disease (AgED) in South Australian general practice: are we blind to early detection and intervention? Australian Journal of Primary Health 23, 75–79.
| The AgED Study. Age-related eye disease (AgED) in South Australian general practice: are we blind to early detection and intervention?Crossref | GoogleScholarGoogle Scholar |
Joyce C (2017) Person-centred services? Rhetoric versus reality. Australian Journal of Primary Health 23, 10–14.
| Person-centred services? Rhetoric versus reality.Crossref | GoogleScholarGoogle Scholar |
Lee MH, Liprino L, Brooks J, Cayzer B, Weedon F, Bermingham K, Jenkins AJ, Rowley K, O’Neal DN (2017) Factors associated with duration of inpatient hospital stay for patients with diabetes mellitus admitted to a medical unit in a community public hospital. Australian Journal of Primary Health 23, 23–30.
| Factors associated with duration of inpatient hospital stay for patients with diabetes mellitus admitted to a medical unit in a community public hospital.Crossref | GoogleScholarGoogle Scholar |
Manchikanti P, Cheng I-H, Advocat J, Russell G (2017) Acceptability of general practice services for Afghan refugees in south-eastern Melbourne. Australian Journal of Primary Health 23, 87–91.
| Acceptability of general practice services for Afghan refugees in south-eastern Melbourne.Crossref | GoogleScholarGoogle Scholar |
McInnes S, Peters K, Bonney A, Halcomb E (2017) The influence of funding models on collaboration in Australian general practice. Australian Journal of Primary Health 23, 26–31.
| The influence of funding models on collaboration in Australian general practice.Crossref | GoogleScholarGoogle Scholar |
McPhie S, Skouteris H, Millar L, Olsson C, Campbell K, van der Pligt P, Dodd J, Hill B (2017) Preconception weight management: an untapped area of women’s health. Australian Journal of Primary Health 23, 61–65.
| Preconception weight management: an untapped area of women’s health.Crossref | GoogleScholarGoogle Scholar |
Panaretto KS, Dellit A, Hollins A, Wason G, Sidhom C, Chilcott K, Malthouse D, Andrews S, Mein J, Ahkee B, McDermott R (2017) Understanding patient access patterns for primary health-care services for Aboriginal and Islander people in Queensland: a geospatial mapping approach. Australian Journal of Primary Health 23, 37–45.
| Understanding patient access patterns for primary health-care services for Aboriginal and Islander people in Queensland: a geospatial mapping approach.Crossref | GoogleScholarGoogle Scholar |
Pennington AVR, O’Reilly SL, Young D, Dunbar JA (2017) Improving follow-up care for women with a history of gestational diabetes: perspectives of GPs and patients. Australian Journal of Primary Health 23, 66–74.
| Improving follow-up care for women with a history of gestational diabetes: perspectives of GPs and patients.Crossref | GoogleScholarGoogle Scholar |
Robinson K, Ghosh A, Halcomb E (2017) Manufactured home villages in Australia – a melting pot of chronic disease? Australian Journal of Primary Health 23, 97–103.
| Manufactured home villages in Australia – a melting pot of chronic disease?Crossref | GoogleScholarGoogle Scholar |
Sibthorpe B, Agostino J, Coates H, Weeks S, Lehmann D, Wood M, Lannigan F, McAullay D (2017) Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children. Australian Journal of Primary Health 23, 1–9.
| Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children.Crossref | GoogleScholarGoogle Scholar |
