How should we fund integrated primary care for children in Australia? A resource allocation study

IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Australian and New Zealand Journal of Public Health Pub Date : 2024-10-25 DOI:10.1016/j.anzjph.2024.100196
Cate Bailey , Suzy Honisett , Jacinta Dermentzis , Janelle Devereux , Jo-Anne Manski-Nankervis , Kim Dalziel , Harriet Hiscock
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Abstract

Objectives

Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia.

Methods

We conducted a resource allocation survey to value funding models for integrated care. Participants were purposively sampled experts in primary health, social care and mental health care. Six funding types were included in the study. Outcome measures included ranking of funding model preferences and qualitative analysis from open-ended questions.

Results

Block-funding, alternative-payment-methods and incentive-payments were preferred models for integrated care individually and within a blended model. Fee-for-service, capitation and pay-for-performance were the least preferred models. There was agreement Fee-for-service may hinder integrating care.

Conclusions

A blended model, including alternative-payment-methods, incentive-payments and block-funding, were preferred models to best integrate care for child outcomes.

Implications for Public Health

Determining how best to fund integrated primary care for children is a priority for decision-making in Australia, as fee-for-service is no longer considered appropriate.
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我们应该如何资助澳大利亚儿童综合初级保健?资源分配研究。
目标:综合初级保健提供健康和社会保健服务,以便及早干预并支持儿童和家庭。综合医疗的资金是提供医疗服务的一个障碍,但关于哪种资助模式最合适的证据却很有限。我们的研究旨在提供专家判断,哪种资助模式或模式组合最有可能有效地整合澳大利亚 0-12 岁儿童家庭的初级保健:我们进行了一项资源分配调查,以评估整合护理的资助模式。参与者是有目的地抽取的初级医疗、社会医疗和心理医疗专家。研究包括六种资助类型。结果测量包括筹资模式偏好排名和开放式问题的定性分析:结果:整笔供资、替代支付方法和奖励支付是单独和混合模式中首选的综合医疗模式。收费服务、按人头付费和按绩效付费是最不受欢迎的模式。大家一致认为,收费服务可能会阻碍整合护理:结论:混合模式,包括替代性支付方法、激励性支付和整笔供资,是最有利于整合医疗服务以促进儿童健康的首选模式:对公共卫生的影响:在澳大利亚,由于收费服务不再被认为是合适的,因此确定如何为儿童综合初级保健提供最佳资金是决策的当务之急。
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来源期刊
Australian and New Zealand Journal of Public Health
Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.20
自引率
5.70%
发文量
121
审稿时长
6-12 weeks
期刊介绍: The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.
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