Allied Health Analysis Australia - Case Study Example

Allied Health Analysis Australia Name Institution Abstract Primary care refers to the health care at a basic rather than specialised level for individuals seeking to make an initial approach to a nurse or doctor for subsequent treatment. Primary care plays critical roles in relation to improvement of health of the society members. Primary care provides health promotion, prevention of diseases, maintenance of health, substantive education to the patients, counselling, and diagnosis, as well as treatment of chronic and acute illness in diverse health care contexts. Some of the service providers in primary care include nurses, doctors, and allied health practitioners. The purpose of this report is to assess and analyse allied health practice in the case of Australia. Table of Contents Abstract 2 Table of Contents 3 Introduction 4 Role of Allied Health in Primary Care 4 Demography of Allied Health Worker 5 Table 1: Registered allied health practitioners, by practitioner type (number), 20111 and 2012 6 Access of Allied Health Professional Primary Care 6 Data and Epidemiology on Service 6 Medicare Criteria about Access to Allied Health 7 Referral Issues from GP to Allied Health 8 Cost of Allied Health 9 Gaps of the Current System 9 Recommendation 10 References 11 Introduction In understand the context and definition of primary care; it is essential to describe the nature of services to the patients prior to illustration of the providers of the primary care. Primary care refers to the health care at a basic rather than specialised level for individuals seeking to make an initial approach to a nurse or doctor for subsequent treatment (Report Brief 2012, p. 1). From this perspective, primary care is the patient’s first point of entry into the health care system, as well as the continuing focal point for the necessary healthcare services. It is critical to note that patient is central to the concept of primary care. Primary care plays critical roles in relation to improvement of health of the society members. For instance, primary care offers patients with the ready access to their personal physicians. Moreover, primary care provides health promotion, prevention of diseases, maintenance of health, substantive education to the patients, counselling, and diagnosis, as well as treatment of chronic and acute illness in diverse health care contexts (Australian Medicare Local Alliance 2013, p. 16). Some of the service providers in primary care include nurses, doctors, and allied health practitioners. Role of Allied Health in Primary Care According to Raven (2014, p. 1), “Allied health is an umbrella term encompassing workers (other than doctors, nurses, and dental professionals) who are trained to help people achieve their optimal health.” Allied health practitioners (AHPs) are significant healthcare providers who tend to work with individual patients, as well as consumers in the diagnosis and treatment of diverse health conditions, especially chronic illnesses (Fitzpatrick, Smith, & Wilding, C. (2012, p. 461). In addition, allied health practitioners contribute to promotion of health. In most cases, AHPs work in the primary care context as private entities (Haines et al, 2010, p. 32). This relates to operating as sole practitioners, as well as engaging in community health centres and other health care facilities in providing diverse range of services. Some of these services include assessment, rehabilitation, provision of specialised treatment, and self-care education. According to Australian Medicare Local Alliance (2013, p. 14), allied health practitioners tend to have a longstanding, as well as significant role within the primary care setting. This is through working individually or closely alongside the GPs, nurses, social care staff, and other health practitioners to offer access and effective care for the patients (Whitford, Smith, & Newbury, 2012, p. 235). Demography of Allied Health Worker According to the survey by Australian Institute of Health and Welfare (2013, p. 11), in relation to the allied health workforce in 2012, there are 126,788 total number of registered allied health practitioners in Australia. Out of this number, 29,387 (23.2%) were psychologists, 27,025 (21.3%) were pharmacists, 23,934 (18.9%) were physiotherapists, and 14,307 (11.3%) were optometrists (Australian Institute of Health and Welfare 2013, p. 11). In addition, 4,533 (3.6%) were chiropractors, 3,885 (3.1%) were Chinese medicine practitioners, 3,783 (3.1%) were podiatrists, 1,729 (1.4%) were osteopaths, and 265 (0.2%) were Aboriginal and Torres Strait Islander health practitioners (Australian Institute of Health and Welfare 2013, p. 11). According to this data, there was substantial increase in relation to number of practitioners between 2011 and 2012 for all professions. It is essential to note that most allied health professions have had more women in comparison to their male counterparts with the exception of chiropractors and optometrists (34.8% and 48.2% women respectively (Australian Institute of Health and Welfare 2013, p. 12). Similarly, the professions with the highest proportion of women were occupational therapists (91.5%), Aboriginal and Torres Strait Islander health practitioners (71.9%), and (76.7%) psychologists (Raven 2014, p. 1). Table 1: Registered allied health practitioners, by practitioner type (number), 20111 and 2012 Practitioner type 2011 2012 Pharmacist 26,196 27,025 Psychologist 28,440 29,387 Physiotherapist 22,874 23,934 Occupational therapist 14,307 Medical radiation practitioner 13,376 Optometrist 4,505 4,564 Chiropractor 4,358 4,533 Chinese Medicine Practitioner 3,885 Podiatrist 3,579 3,783 Osteopath 1,635 1,729 Aboriginal and Torres Strait Islander health practitioner 265 Access of Allied Health Professional Primary Care Data and Epidemiology on Service According to Allied Health Professions Australia (2013, p. 10), approximately 18 percent of the total health workforce are allied health professional, thus representing a similar proportion to doctors. Allied health practitioners tend to offer over 200 million services per year with the intention of improving the quality and life expectancy of the consumers. It is essential to note that most of the allied health practitioners offer primary care services. Nevertheless, there are limited MBS packages. The consumers, thus the significant ‘gap’ payment, pay for most of the primary care services by the allied health practitioners in full. In addition, consumers can fund their access to the allied health services through private health insurance. Moreover, people who are on the GPMP and TCA programs have the chance and opportunity to access allied health services. Australiana with chronic illnesses such as heart diseases, diabetes, chronic respiratory issues, hypertension, stroke, lipid disorder, and asthma have access to allied health services under the influence of insurance programs. According to the analysis of 2007-2008 National Health Survey data, approximately 24 percent of people had visited physiotherapist, chiropractor, podiatrist, and dietitian the previous year (Raven 2014, p. 2). In addition, women are more likely in comparison to their men counterparts to access the AHPs, especially in older age groups. The difference major associates with the provision of podiatrist services. It is essential to note that factors such as non-English-speaking backgrounds, unemployment, lower educational levels, and lack of ancillary health insurance were essential in lowering utilisation of the AHPs (Raven 2014, p. 2). Furthermore, people with diabetes tend to have the highest utilisation of dietitians and podiatrists. However, people with other elements of chronic diseases had lower utilisation, but the exploitation was twice as high as that the consumers without chronic diseases (Raven 2014, p. 2) Medicare Criteria about Access to Allied Health Medicare allied health initiative provides the opportunity for the chronically ill people under the management of their general practitioner (GP) within the Chronic Disease Management (CDM) plan to access Medicare rebates for the allied health services. From this perspective, chronic ill patients have to be on the GP Management Plan (GPMP) to access the allied health services and products in accordance with the Medicare criteria. Similarly, such patients can access allied health services if they are on the Team Care Arrangements (TCAs). AHPs in private practice limit the number of people with chronic illnesses, who are eligible for only a few categories of Medicare rebates (Raven 2014, p. 1). For patients to access Medicare for allied health, he or she must be assessed as having a mental disorder or chronic diseases prior to referral by a GP who is managing the patient under the GP Mental Health Treatment Plan. In addition, it is essential to refer such patients under psychiatrist assessment and management plan (Information for allied health professionals 2013, p. 1). Psychiatrists or paediatricians can also refer eligible patients for the Medicare program in relation to the allied health. Furthermore, allied health practitioners can contact the referring medical practitioner if they are not sure about the eligibility of their patients. It is possible to continue to see patients who are not eligible. Nevertheless, such patients cannot access the Medicare benefits for the services by the allied health practitioners. Referral Issues from GP to Allied Health In the course of executing their roles and responsibilities within the primary care, allied health practitioners tend to face or encounter social, economic, political, historical, technological, and ethical factors, which are barriers to access of such services. According to Jennifer Boddy et al (2013, p. 40), there are patient-centred barriers tend to affect accessibility to allied health services. Some of these barriers include lack of substantial information and knowledge, a ‘small window of opportunity’, accessibility issues, demographic influences, and emotional reactions to ACP, as well as facing mortality. In addition, GP and allied health practice tend to encounter practitioner-centred barriers with reference to lack of accurate information, inadequate knowledge, and sensitivity of the practitioner. In the third aspect, there are systemic-centred barriers, which include delegation issues, legislative issues, and procedural barriers (Jennifer Buddy et al., 2013, p. 41). According to Michele Foster et al (2009, p. 326), there are diverse restrictions in relation to enhanced primary care for allied health practitioners, which are essential in affecting planning and delivery of services to the citizens of Australia. There is substantial evidence of under-referral, as well as inappropriate referral (Raven 2014, p. 2). Moreover, numerous international medical graduates in Australia have no prior experience with the AHPs. Such graduates tend to be unsure of their roles, thus limitation of the effectiveness and efficiency in handling the demands and expectations of the customers (Chan et al 2011, p. 463). Cost of Allied Health According to Cant and Foster (2011, p. 468), Medicare Chronic Disease Management program has been essential in offering Australian patients with chronic or complex disease access to 13 allied health profession since 2004 via private clinics on referral from the general practitioner. According to Skinner et al (2014, p. 10), it is essential to note that the program subsidises the costs of such services by Medicare. According to Pearce-Brown et al (2011, p. 131), financial costs of physiotherapy, podiatry, and dietitians were variable with the cost of the initial appoint higher than the subsequent appoints in 92 percent of the practices. In addition, the average out of pocket expenses for assessment and three follow-up appoints ranged from $258 to $302. The availability of Medicare rebate was essential towards reduction of the value to $58 and $106 (Pearce-Brown et al, 2011, p. 131) Gaps of the Current System From the critical execution of this assignment and literature review, there is still critical need for the allied health practitioners to gain a critical percentage in the health care sector in Australia to enhance outcomes for consumers (Australian Medicare Local Alliance, 2013, p. 4). There are also gaps evident in the legislative issues and lack of adequate knowledge concerning these services within the primary care. It is critical for researchers to execute diverse studies in determination of appropriate ways to overcome challenges and barriers to access to allied health services. According to Raven (2014, p. 1), there is relatively little research by and about AHPs, which associates with limited administrative data. Similarly, there are major gaps in data concerning integration of AHPs in private practice since they are eligible for only a few categories of Medicare rebates, thus the usual exclusion from Medicare data. Alternatively, there is little health services research focusing on AHP interactions, as well as collaborations with other health practitioners (Raven 2014, p. 1) Recommendation From the above discussion, it is appropriate to make the following recommendations on the improvement of the allied health practice in the case of Australia (AHPA 2013, p. 3): i. According to Raven (2014, p. 1), it is essential to generate numerous health services research focusing on the AHPs interactions and collaborations with other health professionals. ii. Similarly, there is substantial need for the APHs to generate data about the practice in association with the administrative data. This is vital in bridging of the major gaps in relation to integration of AHPs in private practice (Raven 2014, p. 1). iii. There is substantial need to recognise the allied health professions or practitioners as critical stakeholders in primary care to improve outcomes for the consumers. iv. It is essential for allied health practitioners to work collaboratively with governments in the course of implementing reforms to improve outcomes, as well as encourage consumer-led models of care to enhance accessibility to services by the APHs. v. There is substantial demand for incorporation of appropriate measures aiming at the improvement of equity of access to primary care services in the case of Australia. References AHPA, (2013), “Policy Paper: Accessible allied health primary care services for all Australians.” Allied Health Professions Australia, pp. 1-16. Australian Institute of Health and Welfare (2013). Allied health workforce 2012. National health workforce series no. 5. Cat. no. HWL 51. Canberra: AIHW. Australian Medicare Local Alliance (2013), “Guide to Allied Health Professions in the Primary Care Setting.” AML Alliance, pp. 2-61. Boddy, J., Chenoweth, L., McLennan, V., & Daly, M. (2013). It’s just too hard! Australian health care practitioner perspectives on barriers to advance care planning. Australian journal of primary health, 19(1), 38-45. Cant, R. P., & Foster, M. M. (2011). Investing in big ideas: utilisation and cost of Medicare Allied Health services in Australia under the Chronic Disease Management initiative in primary care. Australian Health Review, 35(4), 468-474. Chan, B., Proudfoot, J., Zwar, N., Davies, G. P., & Harris, M. F. (2011). Satisfaction with referral relationships between general practice and allied health professionals in Australian primary health care. Australian journal of primary health, 17(3), 250-258. Fitzpatrick, S., Smith, M., & Wilding, C. (2012). Quality allied health clinical supervision policy in Australia: a literature review. Australian Health Review, 36(4), 461-465. Foster, M. M., Cornwell, P. L., Fleming, J. M., Mitchell, G. K., Tweedy, S. M., Hart, A. L., & Haines, T. P. (2009). Better than nothing? Restrictions and realities of enhanced primary care for allied health practitioners. Australian Journal of Primary Health, 15(4), 326-334. Haines, T. P., Foster, M. M., Cornwell, P., Fleming, J., Tweedy, S., Hart, A., & Mitchell, G. (2010). Impact of Enhanced Primary Care on equitable access to and economic efficiency of allied health services: a qualitative investigation. Australian Health Review, 34(1), 30-35. Pearce-Brown, C. L., Grealish, L., McRae, I. S., Douglas, K. A., Yen, L. E., Wells, R. W., & Wareham, S. (2011). A local study of costs for private allied health in Australian primary health care: Variability and policy implications. Australian journal of primary health, 17(2), 131-134. Raven M., (2014), “Allied health practitioners in Australian primary health care.” PHCRIS Research Round-Up, pp. 1-2. Skinner, E. H., Foster, M., Mitchell, G., Haynes, M., O'Flaherty, M., & Haines, T. P. (2014). Effect of health insurance on the utilisation of allied health services by people with chronic disease: a systematic review and meta-analysis. Australian journal of primary health, 20(1), 9-19. Whitford, D., Smith, T., & Newbury, J. (2012). The South Australian Allied Health Workforce survey: helping to fill the evidence gap in primary health workforce planning. Australian journal of primary health, 18(3), 234-241. Information for allied health professionals, (2013), “Medicare requirements for Better Access to Mental Health Care. Retrieved from https://www.medicareaustralia.gov.au/provider/business/education/files/medicare- requirements-for-better-access-to-mental-health-care-better-access-initiative-qrg-for- ahp.pdf Report Brief, (2012), “Primary Care and Public Health: Exploring Integration to Improve Population Health.” Institute of Medicine of the National Academies, 1-4. Read More