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AMA Victoria proposal for $10 million funding

Victorian Government program to

  1. support at risk patients to receive general practice care,
  2. reduce ED presentations and avoidable hospital admissions, and
  3. provide clarity on the interaction between general practice care and other health services.

 

Background

Powerful evidence links primary care to improved health outcomes, health system efficiency and health equity. Victorians face increasing accessibility challenges for general practice related to cost and accessibility, in the setting of general practice workforce shortages in a chronically under-funded sector that faces post-pandemic uncertainties and threats arising from primary care fragmentation and scope of practice reviews. The benefit of quality GP-led team based care is often ‘invisible’ and has been inadequately studied in terms of its impact on the wider healthcare system.

Victorian data demonstrate that only 50% of patients who are admitted to Victorian hospitals with a cardiac diagnosis are seen by a general practitioner within 12 months of discharge1. NSW data demonstrates that seeing a general practitioner in a timely manner after hospital discharge reduces avoidable hospital re-admissions2. NSW Lumos3 data further demonstrates that patients who attend a high-connectivity practice have a reduced risk of ED attendance and unplanned hospital admissions4. Victorians increasingly have complex and chronic care needs, which benefit from GP led team based care in terms of outcome measures of cost benefit, health service demand and patient health outcomes. There is an undeniable need to improve transfer of care, general practice accessibility and support in Victoria if we are to deliver person-centred, efficient, effective healthcare, close to home.

 

Program proposal

The largest ever Victorian Government program to support at risk patients to receive general practice care that will reduce ED presentations and avoidable hospital admissions, and provide clarity on the interaction between general practice care and other health services. This information will facilitate system design (redesign) to break down healthcare silos and support general practice as an integral part of the Victorian healthcare system to deliver person-centred, efficient, effective healthcare, close to home.

 

Existing DOH projects leveraged

  • Transfer of Care work being conducted by Safer Care Victoria
  • Commonwealth funded Ensuring Data Linkage Strategy
  • Potentially: Victorian Virtual Specialist Consults

 

Aims

  • Improved patient outcomes, initially targeting patients who have been admitted to Victorian health services with cardiac diagnoses, and who are at moderate to high risk of representation
  • Demonstrate general practice care efficiency (cost savings through primary care support)
  • Prevent avoidable hospital ED presentations and readmissions
  • Provide effective care closer to home
  • Clear outcome measures (patient & practitioner satisfaction, reduced hospital bed days, cost savings, benefit in capacity, benefit to cost ratio, increased delivery of general practice care to at risk patients)
  • Improve hospital transfer of care arrangements with general practices

 

Recommended experts to engage in program design consultation

  • Professor Lena Sanci, DOH Chief General Practice Adviser
  • Dr Lance Emerson, DOH Deputy Secretary eHealth
  • Dr Kean-Seng Lim, General Practitioner

 

Additional potential funding sources to explore

  • Medical Research Future Fund – Emerging Priorities and Consumer Driven Research Initiative and Primary Health Care Research Initiative (NHMRC)

 

Organisations to engage in program consultation development

  • AMA Victoria
  • RACGP
  • PCBC
  • AGPA
  • ACRRM
  • RDAV

 

References
 

1 Verbal communication from Dr Lance Emerson, January 2024

2  https://www.health.nsw.gov.au/lumos/Pages/readmissions-to-hospital.aspx

3 Lumos is a NSW statewide linkage programme that integrates general practice data

4  https://www.health.nsw.gov.au/lumos/Pages/lumos-high-connectivity-cba.aspx