Medicine & Health Centre for Primary Health Care and Equity

Impact of care plans on tertiary health service use

Identified as a priority for investigation at the 2016 Research Priorities Forum hosted by CPHCE in collaboration with partners SLHD, SESLHD and CESPHN.

Project Rationale

The number of people living with chronic health conditions is increasing in Australia. The Chronic Disease Management program was introduced to Medicare Benefits Schedule (MBS) to provide a more structured approach to managing patients with chronic conditions and complex care needs but is it making a difference.

Project Aim/s

To describe the profile of participants who claimed for GPMPs and/or TCAs in Central and Eastern Sydney (CES) and explore if GPMPs and/or TCAs are associated with fewer emergency hospitalisations (EH)s or potentially preventable hospitalisations (PPH)s over the following 5 years

Project Design and Method

The study was a prospective cohort design. The study used the CES-P&CH Linkage resource based on the 45 and Up Study linked to MBS data for the period 2006–2014. It also includes data from the Admitted Patient Data Collection, Emergency Department Data Collection and Deaths Registry linked by the NSW Centre for Health Record Linkage.

Outcomes/Outputs

The use of GPMPs and/or TCAs in the CES area appears well-targeted towards those with chronic and complex care needs. There was no evidence to suggest that the use of GPMPs and /or TCAs overall had any impact on preventing hospitalisations in the CES region. However, accessing physiotherapy services through TCAs did prevent hospitalisations.
School

CPHCE (CES-P&CH Collaboration)

Research Area

Health System Integration and Primary Health Care Development

Barr ML, Welberry H, Comino EJ, Harris-Roxas BF, Harris E, Lloyd J, Whitney S, O’Connor C, Hall J, Harris MF

Reports

Conference presentations

  • McDonald J, Comino E, Harris E, Bruce T, Hansen N, Donnelly D, et al.. Integrated care for participants attending general practice: a record linkage study based on the 45 and Up population cohort study. International Journal of Integrated Care. 2017;17(3):A78. DOI: http://doi.org/10.5334/ijic.3190
  • Welberry HJ; Comino E; Harris M, 2017, 'Exploring Access to Chronic Disease Management Services in Central and Eastern Sydney', in Exploring Access to Chronic Disease Management Services in Central and Eastern Sydney, 45 & Up Study Annual Forum, Sydney, presented at 45 & Up Study Annual Forum, Sydney, October 2017
  • Welberry HJ; Comino E; Harris MF, 2017, 'Chronic Disease Management in NSW: Examining patterns of MBS claims to inform care planning.', presented at GP17 - The RACGP Conference for General Practice, Sydney, October 2017
  • Welberry HJ; Comino E; Harris MF, 2017, 'Chronic Disease Management in NSW: Who receives a care plan through General Practice and does care planning reduce hospitalisation?', presented at 2017 Primary Health Care Research Conference, Brisbane, Australia, August 2017, https://az659834.vo.msecnd.net/eventsairaueprod/production-phcris-public/2cc7093894634371b7693ebdc2c5c69d

 Journal Articles

  • Barr ML, Welberry H, Comino EJ, Harris-Roxas BF, Harris E, Lloyd J, Whitney S, O’Connor C, Hall J, Harris MF. Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis. Primary Health Care Research & Development 2019; 20(e141): 1–9. doi: 10.1017/S146342361900077X.
  • Welberry H, Barr ML, Comino EJ, Harris-Roxas BF, Harris E, Dutton S, Jackson T, Donnelly D, Harris MF. Do general practice management and/or team care arrangements reduce avoidable hospitalisations in Central and Eastern Sydney, Australia? BMC Health Services Research 2019; 19:811 https://doi.org/10.1186/s12913-019-4663-3   
  • Welberry H; Barr ML; Comino EJ; Harris-Roxas BF; Harris E; Harris MF, 2019, 'Increasing use of general practice management and team care arrangements over time in New South Wales, Australia', Australian Journal of Primary Health, http://dx.doi.org/10.1071/PY18113

Margo Barr Phone: 02 9065 6041

Email: margo.barr@unsw.edu.au

Sydney Local Health District, South Eastern Sydney Local Health District, Central and Eastern Sydney.

Sydney Local Health District, South Eastern Sydney Local Health District, Central and Eastern Sydney.