Improving Primary Health Care Outcomes - Article Example

Running Head: Improving Primary Health Care Outcomes via Current Government Strategies [Name] [Professor Name] [Course] [Date] Abstract Primary healthcare is an essential constituent of Australia’s health system and is one of the areas given prime focus in the country’s health reform agenda. A 2009 report by Department of Health and Ageing identified 10 key issues for health care reform. The issues can be grouped in four areas, which include improvement of access to health care and reduction of inequity, effective management of chronic diseases, increased focus on prevention and lastly improved health care quality, accountability, performance and safety (Australian Government, 2010). In 2011, the Commonwealth of Australia released another report outlining the government’s plans and actions to address the aforementioned key issues. This paper discusses the extent to which “The Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund” has addressed the key issues at local level to improve primary health care outcomes in Western Australia. For the purpose of this paper, the initiative will be referred simply as “The Fund.” Improving Primary Health Care Outcomes via Current Government Strategies Introduction Understanding the current status of Australia’s health care system is crucial if its role, performance and effectiveness of primary health care sector have to be effectively implemented using government strategies. In Western Australia, primary health care is delivered collaboratively through funding from the state, territory government and the Commonwealth. Private funding also plays a substantial role towards the same cause. While these collaborative efforts have played a significant role in the delivery of primary health care, a number of other initiatives have been developed through Medicare Locals Fund to address some service delivery gaps. Among the initiatives initiated include “The Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund”, otherwise known as The Fund. The initiative is in the process of allocating over $1.454 billion over a 4-year period, between 2011and 2015 through Australia’s 62 Medicare Locals (Australian Government, 2012b). Since it was launched in 2011, the initiative has been instrumental in addressing some key issues identified in the “The National Primary Health Care Strategy”, as discussed by this paper. This paper focuses on rural Western Australia, the largest Australian state with a population of around 2.2 million people and where 75 percent of the land is designated as rural and remote (West, 2011). National Primary Health Care Strategy “The National Primary Health Care Strategy” embodies Australia’s premier policy statement that is targeted at promoting primary healthcare across the country. It also offers a platform on which Australia can structure out an effective and efficient primary healthcare system for the future. Simply put, it offers a roadmap for Australia’s present and future primary healthcare sector (Australian Government, 2010). Since 2009, the Australian government has endeavored to implement the strategy by working jointly with stakeholders in the sector, as well as state and territory governments to implement Medicare Locals across the country to promote primary health care delivery and access at the local levels. One of the initiatives is the “Regionally Tailored Primary Health Care Initiatives through Medicare Locals Fund.” The initiative, which is also referred as “The Fund”, has been instrumental in funding Medicare Locals to enable “all” Western Australians to access the right care at the right time by ensuring the accessibility, integration, coordination and suitability of primary health care at the local community level (Australian Government, 2012b). The Fund has indeed been effective in rural regions of Western Australia, where it has been able to execute its five major objectives. This include; promotion of access to primary health care services, promotion of delivery of high quality services through supporting healthcare services providers and institutions, promotion of innovative interventions to health problems through promoting prevention and use of evidence-based strategies and assisting primary health care services providers and institutions to acquire and integrate technologies in their operations . Other objectives have also included promoting the development and discharge of primary healthcare initiatives specifically targeted at meeting the health needs of local communities, as well as prioritizing on educating, training and offering other support for Medicare Locals, to enhance their ability to deliver their respective strategic objectives (Australian Government, 2010). From the above objectives, it can be established that The Fund seeks to address some of the key issues suggested for the “National Primary Health Care Strategy”, among them including addressing enhanced health care access and minimization of inequity, increased focus on preventive measures and thirdly, improvement of health care quality, accountability, performance and safety (Australian Government, 2012b). Health access improvement and reduction of inequity Western Australia has an outstanding health care service system. However, in the rural regions, health care is generally inaccessible. In addition, there are insufficient primary health care services that use multidisciplinary approaches that can ensure equitable distribution of health care resources. For instance, the health needs of the Ageing population have not been met. In addition, there exists high prevalence to chronic conditions. The situation is apparent in the health gap between rural and metropolitan Western Australia (Humphreys & Wakerman, n.d.). To be consistent with the 2009 National Primary Health Care Strategy, the services should be both equitable and accessible. Since The Fund was started in 2011, it has endeavored to fund Medicare Locals to enable patients in rural Western Australia to access face-to-face after-hours care. Despite many rural initiatives operating in the region, the health needs of scores of Australian communities have not been sufficiently met. The remote communities had initially showed poorer health outcomes compared to individuals living in the metropolitan centers where many health facilities operate after-hours care (Humphreys & Wakerman, n.d.). On the other hand, health outcomes among indigenous communities have also been poor. It is within this vein that The Fund was started to prioritize in promoting access to health by funding after-hours care in the remote Australian regions, including in the far-flung Aboriginal communities. On the other hand, residents of the remote Australian regions faced difficulties in accessing proper care where integration and continuity of health care are awfully insufficient (Australian Indigenous HealthInfoNet, 2013b). The Fund has been instrumental in enabling many rural and remote health providers to recruit, train and retain considerable sufficient health workforce that can work beyond the normal work-hours and throughout the weekends. The Fund allocates funds to Medicare Locals with the expectation that the remote communities can receive variety of medical and primary health care (PHC) services in the same way as the communities in the urban centers (Bulletpoint, n.d.). Presently, a number of barriers inhibit the objectives of ensuring equitable access to the right primary health care at the right time to in rural and remote Western Australia. The major factors identified include the need to improve distribution as well as equitable primary health care access (Nuic, 2007). Nevertheless, the Fund has sought to improve access to satisfactory, sustainable and sufficiently resourced models of primary health care in remote regions where health outcomes are deemed as worse and where there is great fraction of indigenous communities. In a bid to ensure the primary health care inequities are reduced, The Fund seeks to ensure that the rural-urban health inequities are addressed to reach margins that are acceptable since the existing inequities mean that remote and rural communities are underprivileged (Australian Government, 2012b). Generally, health inequities in Western Australia, specifically among the Aboriginals, include higher incidences of chronic conditions, higher rates of many diseases, life expectancy and core risk factors, such as hypertension, undue consumption of alcohol and tobacco (Australian Indigenous HealthInfoNet, 2013). In a bid to improve access to healthcare and ease inequities in consistency with the National Primary Health Care Strategy, The Fund seeks to address inflexible funding streams, such as inability to shift resources through programs that limit the capacity of the health providers in the rural and remote regions to respond to community health needs. The Fund also seeks to address inadequate funding of the local health providers, as there is significant evidence of under-allocation of workforce shortage in rural and remote regions. Through sponsoring Medicare Locals, patients in rural Western Australia have been able to locate and find their way to the local health system to seek the health services they need (Australian Government, 2012a). Increased Focus on Prevention The Fund prioritizes in promoting innovative response to health needs, through funding Medicare Locals to promote health prevention using evidence-based strategies, such as model empirical techniques and information sharing (Moodie, 2013). This priority area is consistent with the key issue of the National Primary Health Care Strategy that emphasizes on “increased focus on prevention.” Australia spends an estimated $130 billion in the health sector each year, representing nearly 9.2 percent of the country’s GDP, with the expectation that life-expectancy of the country is elevated globally (Moodie, 2013). Despite the heavy spending, primary health care outcomes in rural Australia are still poor. For instance, rural communities in Western Australia experience relatively higher health risk factors compared to the metropolitan communities. The prevalence risk factors underscore the significance of disease prevention and increased attention to identifying and managing the risk factors (West, 2011). The Fund recognizes the importance of how the National Primary Health Care Strategy underpins the importance of promoting preventive care across Australia to improve health care in the rural regions and address particular health care issues. Indeed, within the concept of The Fund, prevention is defined as the collective efforts aimed at promoting, protecting and sustaining health of populations. By funding Medicare Locals to promote preventive care, the initiative views prevention as its core responsibility, along with palliative, restorative and curative functions (Moodie, 2013). Preventive care focuses on major health problems viewed as open to intervention. For instance, to prevent disability and illnesses, The Fund recognizes that Medicare Locals use the allocated funds to identify adjustable risks and to promote protective factors, such as promoting reduced consumption of alcohol (risk factor) and promoting resilience and self-efficacy (protective factor). In instances where the primary health care cannot be used in controlling health issues using upstream environmental measures (through elimination of the causal factors), the Fund recognizes that health providers should focus on modifying behaviors. On the other hand, in case both avenues are not feasible, the focus is on how to raise community resistance though passive or active prevention of spread of infectious diseases and through immunization (Bulletpoint, n.d.). Improved quality, accountability, performance and safety The Fund seeks to address the fourth key issue of National Primary Health Care Strategy by funding Medicare Locals to promote “improved quality, accountability, performance and safety.” The Fund recognizes that a key building block for reforming primary health care is having competent, skilled and motivated primary health care workforce. In the present day scenario, Western Australia experience health workforce shortages. The issue is specifically acute in the rural and remote regions, with 60 GPs per 100,000 people in the remote regions, compared to 200GPS per 100,000 in the metropolitan areas. The shortage and inequitable distribution of GPs alongside other health care professionals a major contributor to higher rates of hospitalization in the rural areas. The challenges exert pressures on the available primary health care professionals who are held accountable for the quality, accountability, performance and safety of primary health care (West, 2011). The Fund seeks to promote prioritize on improving quality, accountability, performance and safety by building on the government’s commitment to meet an estimated 60 percent of the cost of training workforce at the local hospital level. In addition, The Fund recognizes ICT as a critical constituent of primary healthcare in improving efficiency and quality of patient management through ensuring continuity of information among health institutions (Australian Government, 2012b). The Fund seeks to implement the government’s reform agenda by investing in Medicare Locals to introduce electronic health record systems at the hospital levels. The finances allocated are intended to fund the delivery of key national structure and standards to ensure that the electronic health systems, such as eHealth, are incrementally available in the rural areas (Bulletpoint, n.d.). Conclusion By addressing three of the four key issues of the “The National Primary Health Care Strategy”, The Fund, through the Medicare Locals, has been instrumental in introducing innovative and sustainable models that can be used in the remote and rural areas to prevent systematic barriers to the promotion of primary health acre accessibility (Australian Indigenous HealthInfoNet, 2013a). Before the initiative begun, many health care providers and residents of rural Western Australia were subjected to the application of urban primary health care models that have failed to address contextual issues of health access and equities. Regardless of the many evidences on the cost-effectiveness of the primary health care, there is a growing body of researches showing that the region continues to experience improved health outcomes, specifically among the Aboriginal Australians who face many risk factors compared to other Australians (Australian Government, 2012a). References Australian Government. (2012a). Background Paper: Medicare Locals Health Needs Assessment and Planning. Melbourne: Department of Health and Ageing. Web. Retrieved http://www.gpnnt.org.au/client_images/339323.pdf Australian Government. (2012b). Flexible Fund Guidelines for the Regionally Tailored primary healthcare Initiatives through Medicare Locals Fund. The Department of Health and Ageing. Web. Retrieved http://www.health.gov.au/internet/main/publishing.nsf/Content/79C20887FE9DB44DCA257A2200817EAA/$File/guidelines.pdf Australian Government.(11 May 2010). Overview: Australia’s First National Primary Health Care Strategy. Web. 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