None listed
Conditions
Brief summary
The project will examine the effectiveness of co-located multidisciplinary primary care for the management of chronic conditions. The project aims to (1) explore, compared to stand-alone practices, whether GP practices with co-located primary care disciplines are more effective at reducing potentially preventable hospitalisations (PPH) and/or emergency presentations among patients with selected chronic conditions; (2) compare quality of life, patient experiences of care and health care use between a subset of patients with chronic conditions from multidisciplinary practices and stand-alone practices; (3) describe each practice’s approach to integrated multidisciplinary care and explore how this affects PPH, quality of life, healthcare use, and patient experiences of care. The study will recruit 12 GP clinics, with patients completing surveys at 4 time points, and a small subset of patients completing interviews at 2 time points. Clinicians will complete a survey and interview. Primary care data will be linked with admitted patient data to gauge health service outcomes. This study will provide information to inform policy decisions about which multidisciplinary models have the greatest potential for impact.
Interventions
A prospective cohort study will be used involving 12 practices. Six primary care practices with multiple co-located disciplines (hereafter ‘co-located practices’) that contribute data to Lumos will be identified and compared to 6 stand-alone GP practices in the catchment of the Hunter New England and Central Coast Primary Health Network. Lumos is a NSW statewide primary care data collection that involves the extraction of de-identified patient data from primary care medical records and the linka
A prospective cohort study will be used involving 12 practices. Six primary care practices with multiple co-located disciplines (hereafter ‘co-located practices’) that contribute data to Lumos will be identified and compared to 6 stand-alone GP practices in the catchment of the Hunter New England and Central Coast Primary Health Network. Lumos is a NSW statewide primary care data collection that involves the extraction of de-identified patient data from primary care medical records and the linkage of these records to other health datasets including the Admitted Patient Data Set. This project will use a subset of these data. For patients with one or more ambulatory care sensitive chronic condition at baseline, processes of care and outcomes will be compared prospectively between the co-located and stand-alone practices over 3 years. The project will examine the effectiveness of co-located multidisciplinary primary care for the management of chronic conditions. Aims: (1) explore, compared to stand-alone practices, whether GP practices with co-located primary care disciplines are more effective at reducing potentially preventable hospitalisations (PPH) and/or emergency presentations among patients with selected chronic conditions; (2) compare quality of life, patient experiences of care and health care use between a subset of patients with chronic conditions from multidisciplinary practices and stand-alone practices; (3) describe each practice’s approach to integrated multidisciplinary care and explore how this affects PPH, quality of life, healthcare use, and patient experiences of care. The duration of data collected from each individual participant is 36 months. Not all participants included in aim 1 will be included in aims 2 and 3. For aim 1, Lumos data will be collected over the same 3-year time period for all participating practices. The 3-year window will commence from the time of recruitment of the last practice. For Aims 2 and 3, individual participants will be followed-up for 3 years from the time of recruitment. Cross-sectional survey data and qualitative data on how integrated care is delivered will be collected from clinicians within the first 12 months of practice recruitment. Duration of observation: 3 years Exposure: General practices with co-located multidisciplinary primary care for the management of chronic conditions.
Sponsors
University of New England
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
PRACTICES: Co-located and stand-alone primary care practices in the Hunter New England or Central Coast region will be eligible to participate if they are contributing data to Lumos or be willing to sign up as a Lumos contributor. PATIENTS: To be eligible, patients must be active patients of the practice, aged 65 years and older with one or more of the following ambulatory care conditions: type 2 diabetes, asthma, hypertension, chronic obstructive pulmonary disease, congestive heart failure. Active patients are defined as those who have “attended the practice/service three or more times in the past two years”.
Exclusion criteria
For aim 1 (see primary outcome), all active patients who meet these criteria from participating practices will be included via their deidentified, grouped Lumos data. For aim 2 (see Secondary outcomes 1-3) patients will be excluded from participation if practice staff do not believe them to have capacity to consent and participate, for example, insufficient fluency in English or if the patient is receiving end-of-life care.
Outcome results
None listed