Enhanced primary care pilot program benefits type II diabetes patients

Area of Science:

• Primary Care
• Chronic Disease Management
• Diabetes Mellitus Type 2

Background:

• The Australian Medicare Enhanced Primary Care (EPC) initiative supports integrated allied health (AH) and general medical practitioner (GP) care for chronic disease management (CDM).
• Limited examples exist on operationalizing EPC in private practice, with minimal evidence on service utilization or patient acceptability.
• This paper details a 2007 pilot program integrating GP and private sector AH services for Type II diabetes, aligned with Medicare EPC guidelines.

Purpose of the Study:

• To describe the operationalization of an integrated GP/AH pilot program for Type II diabetes.
• To report on service utilization patterns within the pilot program.
• To assess patient perspectives and perceived benefits of participating in the integrated care model.

Main Methods:

• Patients with Type II diabetes were referred by their GP to credentialed diabetes educators (CDEs), dietitians, or podiatrists via a Medicare-approved team care arrangement (TCA).
• AH providers, including dietitians and CDEs, offered services on a sessional basis within GP clinics; podiatrists operated from their own clinics.
• Care was guidelines-based, focusing on patient education, disease ownership, and self-management, with providers accepting only the Medicare Plus rebate.

Main Results:

• An average of 2.3 AH consultations per patient were utilized by 588 patients; 59 patients were interviewed.
• Patients valued convenient, no-cost access to AH services, integrated GP/AH care, and active involvement in disease management.
• A significant proportion (approx. 60%) of interviewed patients had no prior AH consultation for diabetes and perceived improved disease awareness, knowledge, and self-management from the integrated care.

Conclusions:

• Integrated AH/GP care, delivered within GP clinics, appears cost-efficient for managing Type II diabetes.
• The model shows potential for enhancing patient access to AH services and promoting the value of integrated care.
• The pilot suggests improved patient education and self-management outcomes are achievable through this integrated care approach.