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Type: Journal article
Title: Revenue effects of practice nurse-led care for chronic diseases
Author: Iles, R.
Eley, D.
Hegney, D.
Patterson, E.
Young, J.
Del Mar, C.
Synnott, R.
Scuffham, P.
Citation: Australian Health Review, 2014; 38(4):363-369
Publisher: CSIRO Publishing
Issue Date: 2014
ISSN: 0156-5788
Statement of
Richard A. Iles, Diann S. Eley, Desley G. Hegney, Elizabeth Patterson, Jacqui Young, Christopher Del Mar, Robyn Synnott, Paul A. Scuffham
Abstract: OBJECTIVE: To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. METHODS: A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urban, one regional and one rural. Patients (n =254; >18 years of age) with chronic conditions (type 2 diabetes, hypertension, ischaemic heart disease) but without unstable or major health problems were randomised into usual general practitioner (GP) or PN-led care for management of their condition over a period of 12 months. After the 12-month intervention, total MBS item charges were evaluated for patients managed for their stable chronic condition by usual GP or PN-led care. Zero-skewness log transformation was applied to cost data and log-linear regression analysis was undertaken. RESULTS: There was an estimated A$129 mean increase in total MBS item charges over a 1-year period (controlled for age, self-reported quality of life and geographic location of practice) associated with PN-led care. The frequency of GP and PN visits varied markedly according to the chronic disease. CONCLUSIONS: Medicare reimbursements provided sufficient funding for general practices to employ PNs within limits of workloads before the new Practice Nurse Incentive Program was introduced in July 2012.
Keywords: Chronic Disease
Description: Published online 8 July 2014
Rights: Journal compilation © AHHA 2014. Open Access. For any reuse or distribution, you must make clear to others the license terms of this work. The best way to do this is with a link to
DOI: 10.1071/AH13171
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Nursing publications

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