Beyond community-based XXXX management and the COAG coordinated care trial.

@entity1 @entity102 @entity164 @entity6
OBJECTIVE: This article describes the @entity1 management processes developed during the Council of Australian Governments (COAG) coordinated care trial and use of health outcome measures to monitor changes in utilisation patterns and @entity1 well-being over time for a subgroup of 398 @entity1 with @entity164 2 @entity6 . DESIGN: The Eyre component of the South Australian (SA) HealthPlus coordinated care trial was a matched geographically controlled study in which the outcomes for the intervention group of 1350 @entity1 were compared with those of a similar control group of 500 @entity1 in another rural health region in SA. SETTING: The trial was carried out on Eyre Peninsula in SA across populations in rural communities and in the main centres of Whyalla, Port Lincoln and Ceduna. Care planning was organised through general practitioner practices and services negotiated with allied health services and hospitals to meet @entity1 needs. SUBJECTS: The SA HealthPlus trial included 1350 @entity1 with @entity102 . A subset of this group comprising 398 @entity1 with @entity164 2 @entity6 is described in this report. @entity1 recruited into the three-year trial were care planned using a @entity1 centred care planning model through which @entity1 goals were generated along with medical management goals developed by clinicians and primary health care professionals. Relevant health services were scheduled in line with best practice and care plans were reviewed each year. @entity1 service utilisation, progress towards achieving health related goals and @entity1 health outcomes were recorded and assessed to determine improvements in health and well-being along with the cost and profile of the services provided. RESULTS: Significant numbers of @entity1 experienced improved health outcomes as a consequence of their involvement in the trial, and utilisation data showed reductions in hospital and medical expenditure for some @entity1 . These results suggest that methods applied in the SA HealthPlus coordinated care trial have led to improvements in health outcomes for @entity1 with @entity6 and other @entity102 . In addition, the processes associated with the COAG trial motivated significant organisational change in the Regional Health Service as well as providing an opportunity to study the health and well-being outcomes resulting from a major community health intervention. CONCLUSIONS: The importance of the SA HealthPlus trial has been the demonstrated link between a formal research trial and significant developments in the larger health system with the trial not only leading to improvements in clinical outcomes for @entity1 , but also acting as a catalyst for organisational reform. We now need to look beyond the illness focus of health outcome research to develop population based health approaches to improving overall community well-being.
