Revenue effects of practice nurse-led care for chronic diseases

Objective: To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. Methods: A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urb...

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Main Authors: Iles, R., Eley, D., Hegney, Desley, Patterson, E., Young, J., Del Mar, C., Synnott, R., Scuffham, P.
Format: Journal Article
Published: CSIRO Publishing 2014
Online Access:http://hdl.handle.net/20.500.11937/47894
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author Iles, R.
Eley, D.
Hegney, Desley
Patterson, E.
Young, J.
Del Mar, C.
Synnott, R.
Scuffham, P.
author_facet Iles, R.
Eley, D.
Hegney, Desley
Patterson, E.
Young, J.
Del Mar, C.
Synnott, R.
Scuffham, P.
author_sort Iles, R.
building Curtin Institutional Repository
collection Online Access
description Objective: To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. Methods: A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urban, one regional and one rural. Patients (n =254; >18 years of age) with chronic conditions (type 2 diabetes, hypertension, ischaemic heart disease) but without unstable or major health problems were randomised into usual general practitioner (GP) or PN-led care for management of their condition over a period of 12 months. After the 12-month intervention, total MBS item charges were evaluated for patients managed for their stable chronic condition by usual GP or PN-led care. Zero-skewness log transformation was applied to cost data and log-linear regression analysis was undertaken. Results: There was an estimated A$129 mean increase in total MBS item charges over a 1-year period (controlled for age, self-reported quality of life and geographic location of practice) associated with PN-led care. The frequency of GP and PN visits varied markedly according to the chronic disease. Conclusions: Medicare reimbursements provided sufficient funding for general practices to employ PNs within limits of workloads before the new Practice Nurse Incentive Program was introduced in July 2012.
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spelling curtin-20.500.11937-478942017-09-13T15:57:40Z Revenue effects of practice nurse-led care for chronic diseases Iles, R. Eley, D. Hegney, Desley Patterson, E. Young, J. Del Mar, C. Synnott, R. Scuffham, P. Objective: To determine the economic feasibility in Australian general practices of using a practice nurse (PN)-led care model of chronic disease management. Methods: A cost-analysis of item numbers from the Medicare Benefit Schedule (MBS) was performed in three Australian general practices, one urban, one regional and one rural. Patients (n =254; >18 years of age) with chronic conditions (type 2 diabetes, hypertension, ischaemic heart disease) but without unstable or major health problems were randomised into usual general practitioner (GP) or PN-led care for management of their condition over a period of 12 months. After the 12-month intervention, total MBS item charges were evaluated for patients managed for their stable chronic condition by usual GP or PN-led care. Zero-skewness log transformation was applied to cost data and log-linear regression analysis was undertaken. Results: There was an estimated A$129 mean increase in total MBS item charges over a 1-year period (controlled for age, self-reported quality of life and geographic location of practice) associated with PN-led care. The frequency of GP and PN visits varied markedly according to the chronic disease. Conclusions: Medicare reimbursements provided sufficient funding for general practices to employ PNs within limits of workloads before the new Practice Nurse Incentive Program was introduced in July 2012. 2014 Journal Article http://hdl.handle.net/20.500.11937/47894 10.1071/AH13171 CSIRO Publishing fulltext
spellingShingle Iles, R.
Eley, D.
Hegney, Desley
Patterson, E.
Young, J.
Del Mar, C.
Synnott, R.
Scuffham, P.
Revenue effects of practice nurse-led care for chronic diseases
title Revenue effects of practice nurse-led care for chronic diseases
title_full Revenue effects of practice nurse-led care for chronic diseases
title_fullStr Revenue effects of practice nurse-led care for chronic diseases
title_full_unstemmed Revenue effects of practice nurse-led care for chronic diseases
title_short Revenue effects of practice nurse-led care for chronic diseases
title_sort revenue effects of practice nurse-led care for chronic diseases
url http://hdl.handle.net/20.500.11937/47894