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Revenue effects of practice nurse-led care for chronic diseases

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Open access
Authors
Iles, R.
Eley, D.
Hegney, Desley
Patterson, E.
Young, J.
Del Mar, C.
Synnott, R.
Scuffham, P.
Date
2014
Type
Journal Article

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Iles, R. and Eley, D. and Hegney, D. and Patterson, E. and Young, J. and Del Mar, C. and Synnott, R. et al. 2014. Revenue effects of practice nurse-led care for chronic diseases. Australian Health Review. 38 (4): pp. 363-369.
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Australian Health Review
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School of Nursing and Midwifery
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This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by-nc-nd/4.0/deed.en_US. Please refer to the licence to obtain terms for any further reuse or distribution of this work.

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Abstract

Objective: To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. Methods: A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urban, one regional and one rural. Patients (n =254; >18 years of age) with chronic conditions (type 2 diabetes, hypertension, ischaemic heart disease) but without unstable or major health problems were randomised into usual general practitioner (GP) or PN-led care for management of their condition over a period of 12 months. After the 12-month intervention, total MBS item charges were evaluated for patients managed for their stable chronic condition by usual GP or PN-led care. Zero-skewness log transformation was applied to cost data and log-linear regression analysis was undertaken. Results: There was an estimated A$129 mean increase in total MBS item charges over a 1-year period (controlled for age, self-reported quality of life and geographic location of practice) associated with PN-led care. The frequency of GP and PN visits varied markedly according to the chronic disease. Conclusions: Medicare reimbursements provided sufficient funding for general practices to employ PNs within limits of workloads before the new Practice Nurse Incentive Program was introduced in July 2012.