Medical homes and chronic care: consumer lessons for regional Australia

Medical home models of care, including Australia's Health Care Homes, have the potential to improve health service delivery. This qualitative study explored the primary healthcare experience of people living with chronic conditions in a regional community. The study aim was to use consumer perspectives to inform the further development of a medical home-type model for regional Australia. Participants were recruited from the emergency department of a north Queensland hospital. Twenty-one adults (aged ≥18 years) participated in interviews, using a semi-structured schedule. Inductive, deductive and abductive analyses were guided by grounded theory methods. Participants were committed to an individual GP, rather than a practice organisation. This finding has implications for medical homes, as individuals may choose not to access team-based practice care. Most participants perceived they currently received high-quality GP care, although challenges were identified. These challenges included disconnected after-hours care and uncertainty around the cost of care. Those living with complex, uncommon, chronic conditions felt the most disenfranchised from existing care models, and could benefit from increased engagement with a medical home-type model. Strengthening the continuity of care between GPs both within and outside the practice may enhance service delivery. Involving consumers in the design of care models supports health services that are fit-for-purpose.