Towards the delivery of appropriate health care in Australia

Date

2012

Authors

Runciman, W.
Colera, E.
Day, R.
Hannaford, N.
Hibbert, P.
Hunt, T.
Westbrook, J.
Braithwaite, J.

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Journal article

Citation

Medical Journal of Australia, 2012; 197(2):78-81

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William B Runciman, Enrico W Coiera, Richard O Day, Natalie A Hannaford, Peter D Hibbert, Tamara D Hunt, Johanna I Westbrook, Jeffrey Braithwaite

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Abstract

For decades, there have been concerns about the extent to which the health system provides the right care to those who need it in a cost-effective, timely manner. In Australia, there has been much discussion¹ and marked improvements in some areas,²⁻⁴ but the provision of highly variable and often inappropriate care remains a nationwide problem.¹,⁵⁻⁷ We designed the CareTrack Australia study to determine the percentage of health care encounters at which Australians receive appropriate care (ie, care in line with evidence-based or consensus-based guidelines).⁸ Key results published in this issue of the Journal demonstrate that, although there are areas of excellent practice, there are also large gaps in the provision of appropriate care.⁹ Such gaps have been identified before,¹,³,⁴ but not in a population-based study across 22 of the most common conditions.⁹ In the long term, there is a clear need to move from oneoff studies such as CareTrack towards making the measurement of appropriateness of care routine and prospective. This would allow the community, health professions and payers such as government to better calibrate their approaches to health services improvement. Here, we discuss the operational lessons of the CareTrack study, identifying barriers to the surveillance of appropriate care, and make recommendations as to how they might be overcome at a national level.

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