Small-scale rural pilot programs in chronic illness management - what next?

2003 ◽  
Vol 9 (3) ◽  
pp. 114
Author(s):  
PW Harve y ◽  
PD Mill s ◽  
G Misa n ◽  
K Warre n
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Illness ◽  
Self Management ◽  
Small Scale ◽  
Illness Management ◽  
Care Services ◽  
Primary Health ◽  
Pilot Programs ◽  
Chronic Illness Management

In recent years, rural SA has been the recipient of significant funding to support a range of new primary health care initiatives. Much of this funding, additional to normal recurrent budgets in our health system, has facilitated effective change and development through demonstration and research projects across the state. The resultant work involves programs such as: ? coordinated care trials (COAG) ? more allied health services (MAHS) ? Commonwealth regional health service initiatives (CRHS) ? quality use of medicines (QUM) ? community packages for aged care services ? Indigenous chronic disease self-management pilot programs (CDSM) ? chronic disease self-management (CDSM) programs - Sharing Health Care SA ? chronic disease self-management (CDSM) programs in Indigenous communities. In addition to the resources listed above, funding was also provided by the Commonwealth to establish the South Australian Centre for Rural and Remote Health (SACRRH) and develop the University Department of Rural Health in Whyalla. While this new funding has led to substantial developmental work in chronic illness management in particular, one needs to ask whether the time might not be right now for these hitherto small-scale change initiatives to be transformed into ongoing mainstream programs, informed and guided by research outcomes to date. Is it time to move beyond tentative chronic illness programs and into mainstream reform? We have shown that there is much to be gained, both for patients and for the system, from improved coordination of primary care services and initiatives such as self-management programs for patients with chronic conditions. Better management leads to improved patient health outcomes and can reduce demand for unplanned hospital and emergency services. Many admissions to rural hospitals requiring expensive services, in terms of infrastructure and staffing, could be either prevented, or patients could be managed more effectively in the community as part of a wider primary health care program.

scholarly journals PRIMARY HEALTH CARE IN CHINA: ADDRESSING CHRONIC ILLNESS MANAGEMENT IN OLDER PEOPLE

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 666-666
Author(s):  
C. Browning ◽  
S. Thomas ◽  
H. Yang ◽  
Q. Zeqi ◽  
A. Chapman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Older People ◽  
Illness Management ◽  
Primary Health ◽  
Chronic Illness Management

scholarly journals The Chronic Disease Self-Management Program: the experience of frequent users of health care services and peer leaders

2016 ◽  
Vol 33 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Catherine Hudon ◽  
Maud-Christine Chouinard ◽  
Fatoumata Diadiou ◽  
Danielle Bouliane ◽  
Mireille Lambert ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Management Program ◽  
Self Management ◽  
Peer Leaders ◽  
Frequent Users ◽  
Care Services

scholarly journals Modifying the PACIC to assess provision of chronic illness care: An exploratory study with primary health care nurses

2010 ◽  
Vol 2 (2) ◽  
pp. 118 ◽  
Author(s):  
Jenny Carryer ◽  
Claire Budge ◽  
Chiquita Hansen ◽  
Katherine Gibbs
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Care Delivery ◽  
Self Management ◽  
Chronic Illness Care ◽  
Management Support ◽  
Primary Health ◽  
Health Practitioners ◽  
Primary Health Care Nurses

INTRODUCTION: In line with Wagner’s Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioner’s perspective would enable individual practitioners to evaluate their own provision of self-management support, and would also enable a more direct comparison between care provided and care received within the chronic illness context. AIM: To explore the potential of a modified PACIC instrument to assess individual health practitioners’ delivery of care to chronic illness patients with a sample of primary health care nurses. METHODS: Seventy-seven primary care nurses completed the modified PACIC, reworded to ask about care provision rather than receipt of care. An additional seven cultural sensitivity items were included, as were questions about the suitability of the types of chronic illness care and who should be providing the care. RESULTS: The modified PACIC items appear to be appropriate for use with health practitioners. Agreement that the types of care described in the PACIC should be provided was almost unanimous, and the predominant view was that self-management support should be provided by both nurses and doctors. Mean scale scores were higher than those generally reported from studies using the PACIC. DISCUSSION: The results of this first evaluation of a modified PACIC suggest that the original items plus the cultural sensitivity items can be used to assess self-management support by individual health practitioners. KEYWORDS: Chronic illness; self-management; primary health care, nurses

Mental illness and "self"-management in rural Australia: caregivers' perspectives

2003 ◽  
Vol 9 (3) ◽  
pp. 90 ◽  
Author(s):  
Shari Siegloff ◽  
Rosalie Aroni
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Chronic Disease ◽  
Mental Health Care ◽  
Rural Areas ◽  
Personal Control ◽  
Self Management ◽  
Illness Management ◽  
Implicit And Explicit

Current models of chronic disease self-management incorporate an understanding that people with chronic illnesses, their carers and clinicians need to work together in addressing illness management issues (Von Korff, Gruman, Schaefer, Curry, & Wagner, 1997) and that this process enhances personal control of health (Lorig, Ritter et al., 2000). The question we ask is whether the understandings in these models, both implicit and explicit, apply to those people living with mental illness in rural areas in Australia. In-depth interviews were used to explore and examine the way in which carers of people living with mental illness in rural Victoria experienced and perceived the nature of chronic disease self-management. Our findings indicate that illness management in rural areas occurs predominantly as a partnership between the person with mental illness and the family members who act as caregivers, rather than a partnership with health professionals. This confirms that the lack of resources in the rural mental health care system results in a crisis-oriented service rather than a service that is able to respond to preventative and ongoing mental health care. This is recognised as a considerable burden for many families and requires further examination. In addition, a finding of considerable clinical and policy importance in this arena is the experience of family caregivers as partners in not only the support of the ?management? aspects of self-management of mental illness, but also in supporting the person living with mental illness in the maintenance of the ?self? aspect of self-management.

scholarly journals Community pharmacy and primary health care in Sweden - at a crossroads

2020 ◽  
Vol 18 (2) ◽  
pp. 1927 ◽  
Author(s):  
Tommy Westerlund ◽  
Bertil Marklund
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Significant Risk ◽  
Small Scale ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Physical Care

The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review

2013 ◽  
Vol 19 (1) ◽  
pp. 14 ◽  
Author(s):  
Janny Goris ◽  
Nera Komaric ◽  
Amanda Guandalini ◽  
Daniel Francis ◽  
Ellen Hawes
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Health Workers ◽  
Linguistically Diverse ◽  
Chronic Disease Prevention ◽  
Culturally And Linguistically Diverse ◽  
Self Management ◽  
Primary Health ◽  
Multicultural Health

With a large and increasing culturally and linguistically diverse (CALD) population, the Australian health care system faces challenges in the provision of accessible culturally competent health care. Communities at higher risk of chronic disease include CALD communities. Overseas, multicultural health workers (MHWs) have been increasingly integrated in the delivery of culturally relevant primary health care to CALD communities. The objective of this systematic review was to examine the effectiveness of MHW interventions in chronic disease prevention and self-management in CALD populations with the aim to inform policy development of effective health care in CALD communities in Australia. A systematic review protocol was developed and computerised searches were conducted of multiple electronic databases from 1 January 1995 until 1 November 2010. Thirty-nine studies were identified including 31 randomised controlled trials. Many of the studies focussed on poor and underserved ethnic minorities. Several studies reported significant improvements in participants’ chronic disease prevention and self-management outcomes and meta-analyses identified a positive trend associated with MHW intervention. Australian Government policies express the need for targeted inventions for CALD communities. The broader systemic application of MHWs in Australian primary health care may provide one of the most useful targeted interventions for CALD communities.

scholarly journals Primary health care services for patients with chronic disease in Newfoundland and Labrador: a descriptive analysis

CMAJ Open ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. E8-E14
Author(s):  
Richard Buote ◽  
Shabnam Asghari ◽  
Kris Aubrey-Bassler ◽  
John C. Knight ◽  
Julia Lukewich
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Newfoundland And Labrador ◽  
Health Care Services ◽  
Descriptive Analysis ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services
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