RESUMEN
BACKGROUND: Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business model for primary care providers to implement CR using current Medicare items. DISCUSSION: Using the chronic disease management plan, general practitioners (GPs) complete four clinical assessments at 1-2 weeks, 8-12 weeks, and 6 and 12 months after discharge. The net benefit of applying this model, compared with claiming the most used standard consultation Item 23, in Phase II CR is up to $505 per patient and $543 in Phase III CR. The number of rural GPs providing CR in partnership with the Country Access To Cardiac Health (CATCH) through the GP hybrid model has increased from 28 in 2021 to 32 in 2022. This increase might be attributed to this value proposition. The biggest limitation is access to allied health services in the rural areas.
Asunto(s)
Rehabilitación Cardiaca , Atención Primaria de Salud , Humanos , Rehabilitación Cardiaca/métodos , Rehabilitación Cardiaca/economía , Rehabilitación Cardiaca/estadística & datos numéricos , Australia , Medicare/economíaRESUMEN
BACKGROUND: General practices need to consider a number of practical issues when becoming a teaching practice. OBJECTIVE: This article describes the key aspects of patient and financial management when trainees are present in the practice and suggests solutions to potential issues. DISCUSSION: Managing a practice where trainees are present adds additional organisational workloads and responsibilities. One aspect is the management of patients when trainees are present. This includes ensuring patients understand the requirements of a teaching practice and obtaining informed consent from patients, particularly for more junior training levels. It also requires the appropriate management of appointments to allow for teaching and supervision and a process for managing complaints and follow up. Another aspect for a teaching practice is financial management. Staff have additional roles which can impact on their service roles and a number of factors can impact on the income generated by a trainee. Teaching practices need to be aware of these issues and establish systems to enable them to manage a practice effectively when trainees are present.