From coordinated care trials to medicare locals: What difference does changing the policy driver from efficiency to quality make for coordinating care?
-
Altmetric Citations
Gardner, Karen; Yen, Laurann; Banfield, Michelle; Gillespie, James; McRae, Ian; Wells, Robert
Description
The terms coordination and integration refer to a wide range of interventions, from strategies aimed at coordinating clinical care for individuals to organizational and system interventions such as managed care, which contract medical and support services. Ongoing debate about whether financial and organizational integration are needed to achieve clinical integration is evident in policy debates over several decades, from a focus through the 1990s on improving coordination through structural...[Show more]
dc.contributor.author | Gardner, Karen | |
---|---|---|
dc.contributor.author | Yen, Laurann | |
dc.contributor.author | Banfield, Michelle | |
dc.contributor.author | Gillespie, James | |
dc.contributor.author | McRae, Ian | |
dc.contributor.author | Wells, Robert | |
dc.date.accessioned | 2015-12-13T22:16:20Z | |
dc.identifier.issn | 1353-4505 | |
dc.identifier.uri | http://hdl.handle.net/1885/70815 | |
dc.description.abstract | The terms coordination and integration refer to a wide range of interventions, from strategies aimed at coordinating clinical care for individuals to organizational and system interventions such as managed care, which contract medical and support services. Ongoing debate about whether financial and organizational integration are needed to achieve clinical integration is evident in policy debates over several decades, from a focus through the 1990s on improving coordination through structural reform and the use of market mechanisms to achieve allocative efficiencies (better overall service mix) to more recent attention on system performance to improve coordination and quality. We examine this shift in Australia and ask how has changing the policy driver affected efforts to achieve coordination?Care planning, fund pooling and purchasing are still important planks in coordination. Evidence suggests that financial strategies can be used to drive improvements for particular patient groups, but these are unlikely to improve outcomes without being linked to clinical strategies that support coordination through multidisciplinary teamwork, IT, disease management guidelines and audit and feedback. Meso level organizational strategies might align the various elements to improve coordination.Changing the policy driver has refocused research and policy over the last two decades from a focus on achieving allocative efficiencies to achieving quality and value for money. Research is yet to develop theoretical approaches that can deal with the implications for assessing effectiveness. Efforts need to identify intervention mechanisms, plausible relationships between these and their measurable outcomes and the components of contexts that support the emergence of intervention attributes. | |
dc.publisher | Oxford University Press | |
dc.source | International Journal for Quality in Health Care | |
dc.subject | Keywords: article; Australia; case management; centralization; clinical effectiveness; clinical trial (topic); cost control; government; health care cost; health care planning; health care policy; health care quality; health care utilization; integrated health care Health policy; Health system reform; Health-care system | |
dc.title | From coordinated care trials to medicare locals: What difference does changing the policy driver from efficiency to quality make for coordinating care? | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 25 | |
dc.date.issued | 2013 | |
local.identifier.absfor | 111700 - PUBLIC HEALTH AND HEALTH SERVICES | |
local.identifier.ariespublication | f5625xPUB2427 | |
local.type.status | Published Version | |
local.contributor.affiliation | Gardner, Karen, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Yen, Laurann, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Banfield, Michelle, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Gillespie, James, University of Sydney | |
local.contributor.affiliation | McRae, Ian, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | Wells, Robert, College of Medicine, Biology and Environment, ANU | |
local.description.embargo | 2037-12-31 | |
local.bibliographicCitation.issue | 1 | |
local.bibliographicCitation.startpage | 50 | |
local.bibliographicCitation.lastpage | 57 | |
local.identifier.doi | 10.1093/intqhc/mzs069 | |
dc.date.updated | 2016-02-24T08:58:23Z | |
local.identifier.scopusID | 2-s2.0-84873453016 | |
local.identifier.thomsonID | 000314707600007 | |
Collections | ANU Research Publications |
Download
File | Description | Size | Format | Image |
---|---|---|---|---|
01_Gardner_From_coordinated_care_trials_2013.pdf | 123.46 kB | Adobe PDF | Request a copy |
Items in Open Research are protected by copyright, with all rights reserved, unless otherwise indicated.
Updated: 17 November 2022/ Responsible Officer: University Librarian/ Page Contact: Library Systems & Web Coordinator