1. Overcoming silos in health care systems through meso-level organisations – a case study of health reforms in New South Wales, Australia
- Author
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David Peiris, Anne-Marie Feyer, Justine Barnard, Laurent Billot, Tristan Bouckley, Anna Campain, Damien Cordery, Alexandra de Souza, Laura Downey, Adam G. Elshaug, Belinda Ford, Hannah Hanfy, Lynelle Hales, Behnoosh Hosseinloui Khalaj, Carmen Huckel Schneider, James Inglis, Stephen Jan, Louisa Jorm, Bruce Landon, Sanja Lujic, John Mulley, Sallie-Anne Pearson, Gill Schierhout, Prithivi Sivaprakash, Cynthia Stanton, Anna Stephens, and Deborah Willcox
- Subjects
Care coordination ,Health system reform ,Integrated care ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Fragmented care delivery is a barrier to improving health system performance worldwide. Investment in meso-level organisations is a potential strategy to improve health system integration, however, its effectiveness remains unclear. In this paper, we provide an overview of key international and Australian integrated care policies. We then describe Collaborative Commissioning - a novel health reform policy to integrate primary and hospital care sectors in New South Wales (NSW), Australia and provide a case study of a model focussed on older person's care. The policy is theorised to achieve greater integration through improved governance (local stakeholders identifying as part of one health system), service delivery (communities perceive new services as preferable to status quo) and incentives (efficiency gains are reinvested locally with progressively higher value care achieved). If effectively implemented at scale, Collaborative Commissioning has potential to improve health system performance in Australia and will be of relevance to similar reform initiatives in other countries.
- Published
- 2024
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