Factors affecting the embedding of integrated primary-secondary care into a health district.

With the aging population, the tide of chronic disease is rising with attendant increases in health service need. Integrated care and patient-centred approaches, which established partnerships between a regional Hospital and health service (HHS), the local primary health network and local general practitioners (GPs), were identified as exemplars of an approach needed to support growing community health needs. This paper summarises the findings from a process evaluation of four GP-specialist care integration programs with the aim of identifying recommendations for embedding integrated GP-specialist care into routine practice within the HHS.

Are care plans suitable for the management of multiple conditions?

Background: Care plans have been part of the primary care landscape in Australia for almost two decades. With an increasing number of patients presenting with multiple chronic conditions, it is timely to consider whether care plans meet the needs of patients and clinicians.

Objectives: To review and benchmark existing care plan templates that include recommendations for comorbid conditions, against four key criteria: (i) patient preferences, (ii) setting priorities, (iii) identifying conflicts and synergies between conditions, and (iv) setting dates for reviewing the care plan.

Why do people with chronic disease not contact consumer health organisations? A survey of general practice patients.

Unlabelled: Aim Consumer health organisations (CHOs) are non-profit or voluntary sector organisations that promote and represent the interests of patients and carers affected by particular conditions. The purpose of this study was to examine, among patients with chronic disease, what differentiates those who contact CHOs from those who do not and what stops people from making contact.

Background: CHOs can enhance people's capacity to manage chronic disease by providing information, education and psychosocial support, but are under-utilised.

Incorporating patient preferences in the management of multiple long-term conditions: is this a role for clinical practice guidelines?

Background: Clinical practice guidelines provide an evidence-based approach to managing single chronic conditions, but their applicability to multiple conditions has been actively debated. Incorporating patient-preference recommendations and involving consumers in guideline development may enhance their applicability, but further understanding is needed.

Objectives: To assess guidelines that include recommendations for comorbid conditions to determine the extent to which they incorporate patient-preference recommendations; use consumer-engagement processes during development, and, if so, whether these processes produce more patient-preference recommendations; and meet standard quality criteria, particularly in relation to stakeholder involvement.

Relative Performance of Frequency Weighting W(h) and Candidates for Alternative Frequency Weightings for Predicting the Occurrence of Hand-transmitted Vibration-induced Injuries.

Exposure to hand-transmitted vibration is usually assessed according to International Standard ISO 5349-1:2001 using the frequency weighting W(h). This paper compares eight frequency weightings that might be used to supplement or replace W(h). The comparison is based on a data from two databases, one containing over 7200 measured hand-arm vibration (HAV) spectra from a wide range of industrial machines the other recording exposure history and injury for workers referred to the Health and Safety Laboratory.

Investigating referral pathways from primary care to consumer health organisations.

While chronic disease places an increasing burden on Australia's primary care system it is unrealistic to expect GPs to meet the range of support needs experienced by patients managing chronic conditions. Consumer health organisations (CHO) have the potential to augment clinical care by providing a variety of supportive services; however, they are underutilised by patients and GPs. This qualitative study investigates GPs' knowledge and perceptions of CHO and their contributions to chronic disease care.