Primary Health Care & General Practice

Conference Week 7 Monday (11am)

Di OHalloran

Primary health care:

Socially appropriate, universally accessible, scientifically sound first
level care provided by a suitably trained workforce supported by
integrated referral systems and in a way that gives priority to those
in most need, maximises community and individual self-reliance and
participation and involves collaboration with other sectors.
Includes:
Health promotion
Illness prevention
Care of the sick
Advocacy
Community development
When left to their own device, health systems do not gravitate to
primary health care this provides little towards equitable health
care and cost efficiency
General practice provides person centred, continuing,
comprehensive & coordinated whole person health care to
individuals and families in their communities. As a sector, GP and
their primary health care relationships comprise the
foundations of an effective health care system. GPs are defined by
the characteristics of their discipline which are:
Barbara Starfields studies showed good primary care is
associated with better health outcomes, lower costs & greater
health equity.
Increasing GPs in a town is associated with lower cost &
better outcomes
Increasing specialists in a town is associated with higher cost
& worse (or no change) in outcomes
RACGP Future Quality GP GPs should be financially rewarded for
meeting treatment goals

Medical Home

Basically a fancy name for GP mega clinics

GP centred care with specialists & allied
health which wrap around that.

4 Fold Model of Overview of Holistic Integrated Care

Model
Quadruple Aim of Holistic Integrated Care Model:
Improve peoples experience of care
Improve health of population
Improve cost effectiveness
Joy in practice (doctors enjoying their work)
Risk stratification and register of patients
Very low risk (most patients) low risk moderate risk high risk

very high risk (least

patients)
Use risk modification to determine:
1. Self management
2. Care planning and MDT
3. Care navigation
4. Case management
Key

enablers:
Patient engagement
Funding and incentives
IT and communications (incl linking GPs and hospital)
Governance and quality improvement
Clinical engagement and redesign