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Centre for Primary Health Care & Equity update

Over the past eleven years, our research has evolved to reflect the changes in the Australian health care system. Primary health care research is less exclusively focused on general practice or community health, and issues of integration tend to deal with practical issues of coordination across system boundaries rather than large scale system redesign. While we continue to work in areas such as unemployment and health and information systems for chronic disease care, the emphasis has shifted to emerging issues such as interventions in early childhood, health impact assessment and urban health.

One rapidly developing area is risk factor management and chronic disease prevention. Our first major program was a study of enhancing the management of SNAP risk factors through Divisions of General Practice, beginning in 2002. This highlighted some of the practical and organisational issues involved in having risk factors addressed in general practice, and the lessons were applied in the development of Life Scripts. This has been followed by a parallel study of incorporating risk factor management in community health, which is informing work under the Australian Better Health Initiative. We have since completed a study of the feasibility of addressing pre-diabetes through general practice and this has lead to a trial which is about to commence on the prevention of chronic vascular disease in general practice. We are currently studying the management of risk factor management as part of the new MBS funded health check for people 45-9 years old. We are also investigating the effectiveness of absolute cardiovascular risk assessment in general practice.

These trials not only test the efficacy of preventive care they also address questions about the capacity of primary health care to provide preventive care for particular patient groups. More broadly they raise questions about the capacity of the primary health care workforce and the systems which support preventive care both within services (such as IT systems) and across the whole system (such as linkage of patients with practices, the responsibility of PHC for populations and the availability and integration of referral services and programs to support prevention).

For further information contact:
Gawaine Powell Davies
Ph: 02 9385-1506
E: g.powell-davies@unsw.edu.au
Web: www.cphce.unsw.edu.au/