Care of patients with chronic disease: achievements in Australia over the past decade

Harris, Mark; Harris‐Roxas, Ben; Knight, Andrew

doi:10.5694/mja18.00333

Cited by 15 publications

(12 citation statements)

References 21 publications

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“…2 As in many other countries, much of the care and management of these individuals in Australia takes place in primary care settings, including general practice. 3 General practitioners (GPs) are among various health professionals who play a vital role in the care of patients at this level. GPs act as the gatekeeper, manager and coordinator of various health services for patients, in addition to directly providing care that includes prevention and early intervention.…”

Section: Introductionmentioning

confidence: 99%

What do consumers with chronic conditions expect from their interactions with general practitioners? A qualitative study of Australian consumer and provider perspectives

Song

Dennis

Lévesque

et al. 2020

Health Expectations

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Background: More than half of Australian adults manage one or more chronic conditions through ongoing interactions with general practitioners (GPs). Their experience of general practice interactions has important implications for their health outcomes and is thus important to explore in-depth. Consumer expectations have emerged as a key consideration in this regard. How well they met in care settings can inform consumers' satisfaction and response to the care received. However, consumer expectations in Australian general practice are not well researched.Objective: To identify key consumer expectations in clinical interactions in Australian general practice based on consumer and GP perspectives.Design: Qualitative, phenomenological approach using thematic analysis of semistructured interviews.Setting and participants: Thirty-one participants: 18 patients with one or more chronic (persisting > 6 months) conditions, 10 GPs and 3 GP registrars in Sydney, Australia.Results: Consumer expectations were strongly related to the context of their ongoing therapeutic relationship with a regular GP. Themes relating to some of the most commonly reported consumer expectations were as follows: (a) the importance of longevity and continuity; (b) having good rapport; (c) GP's respect for consumer opinions and expertise; (d) having effective communication; and (e) addressing mental health. Conclusion:Australian GPs and consumers prioritize a positive, long-term clinical relationship in which they respect one another and can communicate their expectations freely. This has implications for consumer satisfaction and in turn ensuring relational continuity, which is particularly relevant to the ongoing care and management of consumers with chronic conditions.

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Section: Introductionmentioning

confidence: 99%

What do consumers with chronic conditions expect from their interactions with general practitioners? A qualitative study of Australian consumer and provider perspectives

Song

Dennis

Lévesque

et al. 2020

Health Expectations

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“…Chronic health conditions affect more than half of the Australian adult population and are managed in the majority of cases during general practice encounters [7]. Chronic care management in Australia is primarily carried out by a team of professionals including the general practitioner (GP), practice nurses (PNs), and allied health professionals, working together in mainly privately-owned group practices [8–11].…”

Section: Introductionmentioning

confidence: 99%

What matters to people with chronic conditions when accessing care in Australian general practice? A qualitative study of patient, carer, and provider perspectives

et al. 2019

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Background Research underpinning the patient experience of people with chronic conditions in Australian general practice is not well developed. We aimed to ascertain the perspectives of key stakeholders on aspects of patient experience, more specifically with regards to accessing general practice in Australia. Methods Using a qualitative design, semi-structured interviews were conducted by telephone and face-to-face with people living with one or more chronic conditions, informal carers, and primary care providers between October 2016 and October 2017. Participants were recruited and selected from three demographically representative primary health networks across Sydney, Australia. Interview transcripts and researcher’s reflective fieldnotes were coded and analyzed for key themes of access. Analysis and interpretation of data were guided by Levesque’s model of access, a conceptual framework to evaluate access broadly and from corresponding patient- and provider-side dimensions. Results A total of 40 interviews were included in the analysis. Most participants had attended their general practices for 10 years or more and had regular primary care providers. People with chronic conditions reported access barriers predominantly in their ability to reach services, which were related to illness-related disabilities (limited mobility, chronic pain, fatigue, frailty) and limitations in the availability and accommodation of health services to address patient preferences (unavailability of after-hours services, lack of alternative modes of service delivery). While cost was not a major barrier, we found a lack of clarity in the factors that determined providers’ decisions to waive or reduce costs for some patients and not others. Conclusions People managing chronic conditions with a long-term primary care provider experienced access barriers in general practice, particularly in their ability to physically reach care and to do so on a timely basis. This study has important policy and practice implications, as it highlights patients’ experiences of accessing care and possible areas for improvement to appropriately respond to these experiences. Themes identified may be useful in the design of a patient experience survey tool specific to this population. While it incorporates perspectives from patients, carers and providers, this study could be further strengthened by including perspectives from culturally and linguistically underrepresented patient groups and more carers. Electronic supplementary material The online version of this article (10.1186/s12875-019-0973-0) contains supplementary material, which is available to authorized users.

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“…The health and aged care systems were developed largely in isolation from one another and have failed to resolve conflicts around medical and social models of care for older people. Health care systems are slowly adapting to this era of chronic disease and population ageing, 12 but person‐centredness and integration within and across acute, primary, community and residential aged care systems remain a challenge 11…”

Section: Australia’s Systems and Contextmentioning

confidence: 99%

We need a model of health and aged care services that adequately supports Australians with dementia

Low

Laver

Lawler

et al. 2021

Medical Journal of Australia

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Care of patients with chronic disease: achievements in Australia over the past decade

Cited by 15 publications

References 21 publications

What do consumers with chronic conditions expect from their interactions with general practitioners? A qualitative study of Australian consumer and provider perspectives

What do consumers with chronic conditions expect from their interactions with general practitioners? A qualitative study of Australian consumer and provider perspectives

What matters to people with chronic conditions when accessing care in Australian general practice? A qualitative study of patient, carer, and provider perspectives

We need a model of health and aged care services that adequately supports Australians with dementia

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