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Background
In Australia, primary healthcare is largely delivered through two parallel systems: Medicare supported primary care delivered by fee-for-service general practitioners, and state funded and managed community health services.
Methods
Semistructured interviews with 18 GPs to investigate the current links between GPs and local primary healthcare providers.
Results
Barriers to links include: communication and information, access and availability of services, GP lack of awareness and understanding of services provided in the state funded sector, and lack of time to gain information.
Discussion
General practitioners reported dealing with more complex and challenging patients. However, this did not appear to increase their likelihood of engaging with state funded primary healthcare services in case management. Medicare Locals are a once-in-a-generation chance to establish a genuinely coordinated and multidisciplinary primary healthcare sector. To be successful, Medicare Locals will need to bring together two parallel systems of care and improve integration and coordination.
Keywords: general practice; health policy; community health services; integrated delivery of health care
In Australia, primary healthcare (PHC) is largely delivered through two parallel systems: Medicare supported primary care delivered by fee-for-service general practitioners, and state funded and managed community based health services whose formation was shaped by the national Community Health Program of the Whitlam government.1 Recent measures have facilitated general practice collaboration with other private allied health providers such as diabetes educators, physiotherapists and psychologists through extensions to Medicare funding and divisions of general practice.
Primary healthcare reform in South Australia has focused on the GP Plus Health Care Strategy aimed at increasing collaboration between state run health services and GPs, and prioritising health promotion, illness prevention and early intervention.2 Under this initiative community health centres and women's health centres were rebadged as primary care services or GP Plus Health Care Centres. These services employ various combinations of community nurses, allied health workers, social workers and counsellors, health promotion and community development workers and a small number employ salaried GPs. They provide individual and group therapy and support for chronic disease, mental health and other health related issues. South Australian services have been restructured and governance arrangements changed several times in the past decade. In early 2011, all metropolitan PHC services were brought together in one centrally managed region.
Australia is in the process...