How Modelling could Contribute to Reforming Primary Care-- Tweaking "the Ecology of Medical Care" in Australia

Sturmberg, Joachim P.; McDonnell, Geoff M.
May 2016
AIMS Medical Science;2016, Vol. 3 Issue 3, p298
Academic Journal
The Australian Ecology of Medical Care indicates that 255/1,000 Australians consult a GP 1.8 times/month (466 consultations/month) resulting in 42 specialist, 1.4 ED and 1.9 hospital referrals, 478 prescriptions, 220 pathology and 48 radiology tests, costing the Government $ 72,009 (2012–13). Government believes this to be unsustainable and controllable by setting price signals. Objectives: To investigate the impact of ‗small changes‘ to health service utilisation and/or resource use. Method: Modelling the impact of increases and decreases to healthcare utilisation/resource use over a 5-year period. Results: Strategies targeting only one variable had a small and linear impact on healthcare expenditure (±0.6–7.2%); combining changes had an exponential effect, achieving an up to 15% reduction or an over 20% rise in expenditure. Discussion: Change invariably results in trade-offs; modelling is a tool that can provide a basis to engage in shared discussions about the ‗yes, but/yes, and’ considerations of reform propositions.


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