This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.
Systems levers for commissioning primary mental health care: a rapid review
Background and Aims: Primary Health Networks (PHNs) are a new institution for health systems management in the Australian healthcare system. PHNs will play a key role in mental health reform through the planning and commissioning of primary mental health services at a regional level, specifically adopting a stepped care approach. Selected PHNs are also trialling a health care homes approach. Little is known about the systems levers that could be applied by PHNs to achieve these aims. Methods: A rapid review of academic and grey literature published 2006-2016 was undertaken to describe the use of systems levers in commissioning primary care services. Using a deductive-inductive approach, levers were identified and aggregated into types (organisation, engagement, enforcement, information, technology, and finance and payment). Literature was synthesised narratively. Results: Fifty-six documents met the inclusion criteria, including 12 specific to primary mental health care. Twenty-six levers were identified. Conclusion: Referral management, contracts and tendering processes, and health information systems were identified as useful levers for implementing stepped care approaches. Location, enrolment, capitation and health information systems were identified as useful in implementing a health care homes approach. Other levers were relevant to overall health system functioning. Further work is needed in order to develop a robust evidence-base for systems levers. PHNs can play an active role in this by documenting and evaluating the levers that they deploy and making their findings available to researchers and other commissioning bodies.
PY17030 Accepted 23 September 2017
© La Trobe University 2017