BMJ  2005;330:662-665 (19 March), doi:10.1136/bmj.330.7492.662

Education and debate

Health reform through coordinated care: SA HealthPlus

Malcolm W Battersby, senior lecturer in psychiatry1, and the SA HealthPlus Team

1 Flinders Human Behaviour and Health Research Unit, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia malcolm.battersby@flinders.edu.au

How can care for chronic illness best be coordinated? An Australian study sought to move towards collaborative and patient centred planned care

The first 150 words of the full text of this article appear below.

Introduction

Chronic illnesses contribute 60% of the global burden of disease, which by the year 2020 will increase to 80%.1 With ageing populations, no developed country can afford the projected increase in costs of chronic illness. To address this crisis, governments and healthcare organisations in developed countries have initiated programmes aimed at shifting the focus of health care from acute illness to chronic illness. Australian governments have initiated health reform using trials of coordinated care. We describe the largest of these trials, SA HealthPlus, its aims, outcomes, and lessons learnt.

The problem

In Australia, state and commonwealth governments share the financing of health—the states being responsible for hospitals and the commonwealth being responsible for primary care. This has provided financial and clinical barriers to the management of care for people with chronic illnesses. General practice is funded on a fee for service basis, reinforcing a reactive rather than a planned model of care. . . . [Full text of this article]

The questions

The evidence

Implementation

Inclusion criteria

The model of care

Results

Lessons from the trial

Conclusions


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