Abstract
Background
Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is to have primary care more formally involved in delivering CR and secondary prevention. Our solution is a structured business model and value proposition to primary care providers to implement CR and achieve Heart Health for Life.
Methods
• Investigated operational practicalities in the primary care setting
• Interrogated the Australian Medicare items to identify what additional support and underutilised items are available for use in primary care based CR
• Interviewed rural general practitioners (GPs) and practice nurses
• Presented the model to rural GPs community of practice through face-to-face and online workshops
Results
The model utilises the Chronic Disease Care Planning Medicare items to incorporate CR in the primary care context. GPs complete 4 clinical assessments at 1-2 weeks, 8-12 weeks, six-months and 12 months post-discharge. Implementing this model accrues a net benefit of between $797.15–11,476.55 per patient plus improved health outcomes and a more holistic care experience. Uptake was demonstrated by an increase in the number of rural GPs providing CR in partnership with CATCH through the GP hybrid model to 28 by the end of 2022. The biggest limitation to uptake was access to allied health services. Although catered for in the Medicare schedule, the timely availability of allied health services in rural areas is challenging.
Conclusion
We present a Medicare-approved and financially viable model to deliver CR and secondary prevention in primary care using item numbers that are currently underutilised.
Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is to have primary care more formally involved in delivering CR and secondary prevention. Our solution is a structured business model and value proposition to primary care providers to implement CR and achieve Heart Health for Life.
Methods
• Investigated operational practicalities in the primary care setting
• Interrogated the Australian Medicare items to identify what additional support and underutilised items are available for use in primary care based CR
• Interviewed rural general practitioners (GPs) and practice nurses
• Presented the model to rural GPs community of practice through face-to-face and online workshops
Results
The model utilises the Chronic Disease Care Planning Medicare items to incorporate CR in the primary care context. GPs complete 4 clinical assessments at 1-2 weeks, 8-12 weeks, six-months and 12 months post-discharge. Implementing this model accrues a net benefit of between $797.15–11,476.55 per patient plus improved health outcomes and a more holistic care experience. Uptake was demonstrated by an increase in the number of rural GPs providing CR in partnership with CATCH through the GP hybrid model to 28 by the end of 2022. The biggest limitation to uptake was access to allied health services. Although catered for in the Medicare schedule, the timely availability of allied health services in rural areas is challenging.
Conclusion
We present a Medicare-approved and financially viable model to deliver CR and secondary prevention in primary care using item numbers that are currently underutilised.
Original language | English |
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Article number | 519 |
Pages (from-to) | S347 |
Number of pages | 1 |
Journal | Heart, Lung and Circulation |
Volume | 32 |
Issue number | Supplement 3 |
DOIs | |
Publication status | Published - Jul 2023 |
Keywords
- cardiac rehabilitation
- primary care
- health care delivery