Integrated GP and allied health care for patients with type 2 diabetes

BACKGROUND: Integrated general practitioner and allied health chronic disease management (CDM) has been supported by Australian Government Medicare initiatives since 2005. Practical ways of implementing CDM have been slow to develop. METHODS: An integrated CDM program for patients with type 2 diabetes was piloted in 2006 by Central Northern Adelaide Health Service (South Australia), in conjunction with four divisions of general practice. Health providers included GPs, practice nurses, credentialed diabetes educators, dieticians and podiatrists. Eligible patients with Medicare approved Team Care Arrangements (TCAs) received allied health care for the Medicare Plus rebate only. This article reports on GP and staff perspectives of the processes, and the effectiveness and sustainability of the pilot. RESULTS: Chronic disease management improved with integrated health care, reflected by appropriate allied health referrals and better quality TCAs, interprofessional communication, and patient satisfaction. DISCUSSION: There are benefits for interested GPs, their staff, co-located allied health providers and diabetic patients if integrated multidisciplinary care is provided in the manner of this Enhanced Primary Care CDM model. (author abstract)