ABSTRACT
BACKGROUND: Divisions of general practice are key structures for integration between general practice and other health services in Australia. AIM: To compare the views of divisions of general practice toward integration of care with those of hospitals and community health services. METHOD: Representative national samples of public hospitals and community health centres (CHCs) and a census of divisions of general practice (DGP) were surveyed on their current collaborations and links as well as barriers to and factors that enhance integration between general practitioners and other health services. RESULTS: There is wide agreement on the need for greater integration. Personal links (via letter, phone and face to face) were thought to be useful. However, general practice liaison officers were seen as especially useful. All organizations rated different accountabilities and responsibilities as a highly significant barrier. Resources, structures for collaboration and high level organisational support were rated as being more useful in enabling greater integration. CONCLUSION: Formalizing collaboration will require changes to funding and accountability. However there is also a need for cultural change to support greater integration of patient care between general practice and both hospitals and community health services.
Subject(s)
Community Health Services/organization & administration , Family Practice/organization & administration , Health Services Administration/organization & administration , Hospital Administration , Interinstitutional Relations , AustraliaABSTRACT
This paper discusses the design and implementation of a multidisciplinary research project and associated field trials to test the hypothesis that functional health status amongst the elderly can be accurately determined remotely by continuously monitoring relatively simple parameters that measure the interaction between participants and their environment. In this study we propose that changes in such simple measures as mobility, sleep patterns, and utilisation of cooking, washing and toilet facilities, can identify changes in functional health status. One of the primary end goals of the project will be to automatically prompt appropriate, timely and cost-effective intervention of medical and community based services to help reduce morbidity and maintain an independent high quality of life for the elderly. Targeted intervention will diminish the demand for high cost medical services. This will have large potential economic implications in helping to contain and reduce the increasing cost of providing health care services to the aged.
Subject(s)
Health Status , Monitoring, Physiologic , Telemetry , Activities of Daily Living , Aged , Baths , Clinical Trials as Topic , Community Health Services , Computer Communication Networks , Cooking , Cost Control , Cost-Benefit Analysis , Health Services for the Aged , Home Care Services , Humans , New South Wales , Pilot Projects , Quality of Life , Sleep , Toilet FacilitiesABSTRACT
The hypothesis that functional health status amongst the elderly can be accurately determined remotely by continuously monitoring relatively simple parameters that measure the interaction between the participant and his or her environment was examined. Changes in such simple measures as mobility, sleep patterns, utilization of cooking, washing, and toilet facilities can identify changes in functional health status and prompt appropriate, timely, and cost-effective intervention of medical and community-based services to help reduce morbidity and maintain an independent, high quality of life. We discuss the design and implementation of a multidisciplinary research project and an associated field trial to unobtrusively monitor and correlate interaction with the home environment and functional health status.
