Revenue effects of practice nurse-led care for chronic diseases
MetadataShow full item record
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.
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.
Showing items related by title, author, creator and subject.
Nicholas, Jennifer (2009)The rising incidence of chronic diseases such as diabetes, associated comorbidities, an ageing population and rising health expenditure are all creating a greater burden on the Australian health care system.Purpose of the ...
Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practiceEley, D.; Patterson, E.; Young, J.; Fahey, P.; Del Mar, C.; Hegney, Desley; Synnott, R.; Mahomed, R.; Baker, P.; Scuffham, P. (2012)The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease ...
Effectiveness of general practice nurse interventions in cardiac risk factor reduction amongst adultsHalcomb, E.; Moujalli, S.; Griffiths, R.; Davidson, Patricia (2007)Background: Cardiovascular disease is the leading cause of death for adults in Australia. In recent years there has been a shift in health service delivery from institutional to community-based care for chronic conditions, ...