Model for integrated care for chronic disease in the Australian context: Western Sydney Integrated Care Program
N. Wah Cheung A B H , Michael Crampton C D , Victoria Nesire C , Tien-Ming Hng E F , Clara K. Chow B G and On behalf of the Western Sydney Integrated Care Program Investigators*A Department of Diabetes and Endocrinology, Westmead Hospital, Western Sydney Local Health District, Hawkesbury Road, Westmead, NSW 2145, Australia.
B Faculty of Medicine and Health, University of Sydney, City Road, University of Sydney, NSW 2006, Australia. Email: clara.chow@sydney.edu.au
C Integrated and Community Health, Western Sydney Local Health District, 18 Blacktown Road, Blacktown, NSW 2148, Australia. Email: michael.crampton@wentwest.com.au; victoria.nesire@health.nsw.gov.au
D Western Sydney Primary Health Network, Level 1, 85 Flushcombe Road, Blacktown, NSW 2148, Australia.
E Department of Diabetes and Endocrinology, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, 18 Blacktown Road, Blacktown, NSW 2148, Australia. Email: tien-ming.Hng@health.nsw.gov.au
F Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
G Department of Cardiology, Westmead Hospital, Western Sydney Local Health District, Hawkesbury Road, Westmead, NSW 2145, Australia.
H Corresponding author. Email: wah.cheung@sydney.edu.au
Australian Health Review 43(5) 565-571 https://doi.org/10.1071/AH18152
Submitted: 23 May 2018 Accepted: 11 October 2018 Published: 13 March 2019
Journal Compilation © AHHA 2019 Open Access CC BY-NC-ND
Abstract
Objective To describe the implementation of a model of integrated care for chronic disease in Western Sydney. This model was established on the basis of a partnership between the Local Health District and the Primary Health Network.
Methods The Western Sydney Integrated Care Program (WSICP) focuses on people with type 2 diabetes, chronic obstructive pulmonary disease and coronary artery disease or congestive cardiac failure. We describe the design of the program, the processes involved and some of the challenges and barriers to integration.
Results Early data indicate a high uptake of services, with some evidence of a reduction in hospital admissions and presentations to the emergency department.
Conclusion A model of integrated care has been successfully implemented and embedded into local practices. Preliminary data suggest that this is having an impact on the utilisation of hospital services.
What is known about the topic? There is evidence that integrated models can improve cost-effectiveness and the quality of clinical care for people with chronic disease. However, most integrated models are small scale, focus on very specific populations and generally do not engage both primary care and acute hospitals.
What does this paper add? This paper describes an effective partnership between state-funded hospital services in the WSLHD and the federally funded local Primary Health Network (PHN) of general practitioners. The paper outlines the design of the program and the structural, governance and clinical steps taken to embed integrated care into everyday clinical practice. In addition, preliminary results indicate a reduction in the use of hospital services by people who have received integrated care services.
What are the implications for practitioners? Involvement of both primary care and the public hospital system is important for a successful and sustainable integrated care program. This is a long and challenging process, but it can lead to positive effects not just for individuals, but also for the health system as a whole.
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