SA HealthPlus, one of nine national Australian coordinated care trials, addressed chronic illness care by testing whether coordinated care would improve health outcomes at the cost of usual care. SA HealthPlus compared a generic model of coordinated care for 3,115 intervention patients with the usual care for 1,488 controls. Service coordinators and the behavioral and care-planning approach were new. The health status (SF-36) in six of eight projects improved, and those patients who had been hospitalized in the year immediately preceding the trial were the most likely to save on costs. A mid-trial review found that health benefits from coordinated care depended more on patients' self-management than the severity of their illness, a factor leading to the Flinders Model of SelfManagement Support.Keywords: Chronic disease, coordinated care, care plan, self-management, health outcomes. In Australia, the coordination of care for patients with multiple service needs may be hampered by mixed funding sources and the lack of integrated systems of care. Each of the commonwealth, state, and territory governments funds public health services: the commonwealth government administers the taxpayer-funded Medicare program to provide universal access to public health services by reimbursing general practitioners (GPs) and specialists on a fee-forservice basis, and the state governments support public hospitals. A mixture of state and commonwealth programs fund community care, including allied health services, and individuals can purchase private health insurance, which provides private hospital care and a range of ancillary services (physiotherapy, psychology, podiatry, etc.).In 1997, Australia's governments began trials of coordinated care to develop and test models of service delivery for chronic conditions (Commonwealth Department of Human Services and Health 1995). The impetus for reform was escalating health care costs driven by an aging population and advances in technology, a shift in emphasis of health care delivery from the tertiary-to the primary-care sector (World Health Organization 2002), and demands by consumers for more patientcentered care.The principal national hypothesis that the trials were asked to test within a two-year time frame was the following: Coordinating the care of people with multiple service needs, who receive their care through individual care plans and funds pooled from existing commonwealth, state, and joint programs, will improve their health and well-being using existing resources. The main purpose of the trials was to "develop and test different service delivery and funding arrangements, and to determine the extent to which the coordinated care model contributes to• Improved client outcomes.

This article analyses a nationally representative household dataset-the National Family Health Survey (NFHS-3) conducted in 2005 to 2006-to examine factors influencing the prevalence of overweight/obesity in India. The dataset was disaggregated into four sub-population groups-urban and rural females and males-and multi-level logit regression models were used to estimate the impact of particular covariates on the likelihood of overweight/obesity. The multi-level modelling approach aimed to identify individual and macro-level contextual factors influencing this health outcome. In contrast to most studies on low-income developing countries, the findings reveal that education for females beyond a particular level of educational attainment exhibits a negative relationship with the likelihood of overweight/obesity. This relationship was not observed for males. Muslim females and all Sikh sub-populations have a higher likelihood of overweight/obesity suggesting the importance of socio-cultural influences. The results also show that the relationship between wealth and the probability of overweight/obesity is stronger for males than females highlighting the differential impact of increasing socio-economic status on gender. Multi-level analysis reveals that states exerted an independent influence on the likelihood of overweight/obesity beyond individual-level covariates, reflecting the importance of spatially related contextual factors on overweight/obesity. While this study does not disentangle macro-level 'obesogenic' environmental factors from socio-cultural network influences, the results highlight the need to refrain from adopting a 'one size fits all' policy approach in addressing the overweight/obesity epidemic facing India. Instead, policy implementation requires a more nuanced and targeted approach to incorporate the growing recognition of socio-cultural and spatial contextual factors impacting on healthy behaviours.

Economic growth alone is unlikely to reduce the burden of malnutrition in India; accordingly, policy makers need to address the broader social determinants that contribute to higher underweight prevalence in specific demographic subgroups.

Abstract. This paper provides an analysis of the national Indigenous reform strategy -known as Closing the Gap -in the context of broader health system reforms underway to assess whether current attempts at addressing Indigenous disadvantage are likely to be successful. Drawing upon economic theory and empirical evidence, the paper analyses key structural features necessary for securing system performance gains capable of reducing health disparities. Conceptual and empirical attention is given to the features of comprehensive primary healthcare, which encompasses the social determinants impacting on Indigenous health. An important structural prerequisite for securing genuine improvements in health outcomes is the unifying of all funding and policy responsibilities for comprehensive primary healthcare for Indigenous Australians within a single jurisdictional framework. This would provide the basis for implementing several key mutually reinforcing components necessary for enhancing primary healthcare system performance. The announcement to introduce a long-term health equality plan in partnership with Aboriginal people represents a promising development and may provide the window of opportunity needed for implementing structural reforms to primary healthcare.

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