The Medical journal of Australia
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To consider the implications for mental health policy of a recent synthesis of the literature on the effectiveness of different service delivery models for depression in primary care. ⋯ There is a need to support evidence-based models for depression care, including innovative new technologies for facilitating consumer self-management of depression. The ability of practitioner training and guideline implementation to improve consumer outcomes for depression is limited. Policies and incentives are required to facilitate the reorganisation of general practice and, in particular, the implementation of care management as well as enhanced care and guided self-help in these settings.
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Review
Review of evidence to guide primary health care policy and practice to prevent childhood obesity.
To identify key barriers to effective engagement of primary health care (PHC) providers and families in promoting healthy weight among children aged 2-6 years, and to examine promising interventions to identify policy goals to overcome these barriers. ⋯ Engagement of PHC providers in prevention of childhood obesity requires a systematic approach involving practice protocols, assessment tools, client support material and referral pathways, as well as adequate training and sufficient staff for implementation. A more comprehensive approach could be promoted by increased collaboration, agreed role delineation, consistent public health messages and better coordination between PHC providers and other service providers, facilitated at service policy and administration level.
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Multicenter Study Comparative Study
Unplanned admissions to two Sydney public hospitals after naltrexone implants.
To describe hospital presentations related to the use of naltrexone implants, an unlicensed product used in Australia for treating heroin dependence. ⋯ These severe adverse events challenge the notion that naltrexone implants are a safe procedure and suggest a need for careful case selection and clinical management, and for closer regulatory monitoring to protect this marginalised and vulnerable population.
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To examine policy and implementation issues around multidisciplinary care planning (MDP) as a means of improving outcomes for patients with chronic disease and/or complex care needs. ⋯ While MDP improves many functional outcomes, widespread implementation of MDP in standard practice will require complex and targeted strategies. Devising and testing such strategies is a prerequisite for widespread, routine use of MPD in chronic disease management.
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To review the implementation and impact of different funding initiatives across the health systems of three different countries - England, New Zealand and Australia - on the achievement of multidisciplinary primary health care (PHC) and to reflect on policy implications for Australia. ⋯ Individual, patient-level, financial incentives may present significant impediments for population subgroups with complex needs. Alternative funding arrangements, such as capitation and contracting, could be more widely adopted in Australia to enhance access to care for vulnerable population groups without fundamentally changing the overall fee-for-service financing arrangements.