Volume 197 - Issue 8
CareTrack: assessing the appropriateness of health care delivery in Australia
Authors: Annemarie Wright and Bruce Bolam
Med J Aust 2012; 197 (8): 442. || doi: 10.5694/mja12.11190
Published online: 15 October 2012
Published online: 15 October 2012
We support the recommendation of Runciman and colleagues for national agreement on clinical standards of health care, and highlight the importance of including routine health promotion activities as a core part of quality care in clinical practice. The indicators used by Runciman et al fail to consider core aspects of preventive care, such as screening and evidence-based behavioural interventions for lifestyle risk ...
To the Editor: We support the recommendation of Runciman and colleagues for national agreement on clinical standards of health care,1 and highlight the importance of including routine health promotion activities as a core part of quality care in clinical practice. The indicators used by Runciman et al fail to consider core aspects of preventive care, such as screening and evidence-based behavioural interventions for lifestyle risk factors including smoking, poor diet, high-risk alcohol consumption and physical inactivity. Failure to include these aspects of preventive care is a missed opportunity for reducing the disease burden and promoting health. Indeed, the “health care encounter”1 presents a unique opportunity for changing health behaviours related to these risk factors, as medical practitioners are the most trusted source of health information.2
Reduction in the prevalence of these factors not only has the potential to significantly reduce the disease burden, provide cost savings through increased work productivity and improve household and leisure time productivity; it can also potentially provide considerable cost savings in terms of health sector offsets, which are the costs of future health care delivery (eg, hospital admissions) that can be avoided by reducing the number of cases of disease.3 The importance of these risk factors has been partially recognised in the prototype United States study,4 which included preventive care indicators such as screening for smoking status and providing smoking cessation advice, but these indicators were excluded from the CareTrack study. Further, models for tackling these disease risk factors in general practice, such as the “SNAP model” (a model for managing four common lifestyle risk factors: smoking, nutrition, alcohol and physical activity),5 could be adapted to meet criteria for the development of standards of practice.1 Health promotion efforts such as these are a vital part of improving clinical standards of care in Australia.
Competing interests
No relevant disclosures.
References
- Runciman WB, Hunt TD, Hannaford NA, et al. CareTrack: assessing the appropriateness of health care delivery in Australia. Med J Aust 2012; 197: 100-105. CHDFJIIF
- Hesse BW, Nelson DE, Kreps GL, et al. Trust and sources of health information: the impact of the internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med 2005; 165: 2618-2624. i1142873
- Cadilhac DA, Magnus A, Cumming T, et al. The health and economic benefits of reducing disease risk factors. Melbourne: VicHealth, 2009. http://www.vichealth.vic.gov.au/Publications/Research/Health-and-economic-benefits-of-reducing-disease-risk-factors.aspx (accessed Sep 2012).
- McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003; 348: 2635-2645. i1142877
- Harris MF, Hobbs C, Powell Davies G, et al. Implementation of a SNAP intervention in two divisions of general practice: a feasibility study. Med J Aust 2005; 183 (10 Suppl): S54-S58. i1142881