Chronic Disease Outcomes and Enhanced Primary Care in Seniors: A Cross-Jurisdictional Linkage Project

该项目将提供证据，说明如何最好地利用澳大利亚全科医生的努力，为患有糖尿病、心脏病和高血压、哮喘和肺气肿、癫痫发作和胃病等慢性疾病的65岁以上患者获得更好的结果。它还将研究全科医生访问可以促进所有75岁以上老年人健康老龄化的最佳方式。对于每种疾病和老年人，该研究将能够检测以下哪些因素对改善患者健康最重要：（i）看GP更多次，（ii）以更均匀的间隔看GP，（iii）看同一个GP，或（iv）看一个在慢性病方面有很多经验的GP。将对住在宿舍和疗养院的老年人进行单独调查，因为他们的需要可能不同。这项研究还将评估1999年医疗保险发生的重大变化的好处，当时全科医生被支付进行健康评估和为患有慢性健康问题的患者准备健康计划（与其他卫生工作者一起）。结果将使这一重要举措得到进一步改进。这项研究将使用一个独特的新的澳大利亚研究设施，该设施汇集了来自州和联邦两级的西澳大利亚州全体人口的健康数据，包括医疗保险使用、药品、住院和死亡的信息。该设施的工作方式是保护病人和全科医生的隐私。这项研究的一个重要特点是，参加全科医生诊所的澳大利亚老年患者的代表性和自愿性团体以及全科医生本身的参与程度，为研究人员提供关于消费者和全科医生重要性的建议。

This project will provide evidence on how best to use the efforts of Australian GPs to obtain better outcomes in patients aged 65+ years who suffer from chronic diseases such as diabetes, heart disease and high blood pressure, asthma and emphysema, seizures and stomach disorders. It will also examine the best way that GP visits can promote healthier ageing in all older seniors, aged 75+ years. For each disease and in older seniors, the study will be able to detect which of the following factors are the most important for better patient health: (i) seeing a GP more times, (ii) seeing a GP at more even intervals, (iii) seeing the same GP, or (iv) seeing a GP with a lot of experience in chronic diseases. Separate investigations will be made in older people living in hostels and nursing homes, because their needs may be different. The study will also evaluate the benefits of a major change that occurred to Medicare in 1999, when GPs were paid to perform health assessments and to prepare health plans (with other health workers) for patients with chronic health problems. The results will enable this important initiative to be further improved. The study will use a unique and new Australian research facility, which has brought together health data on the entire population of WA from both the State and Commonwealth levels, including information on Medicare use, pharmaceuticals, hospital stays and deaths. The facility works in such a way as to preserve patient and GP privacy. A strong feature of this research will be the degree of involvement of a representative and voluntary group of older Australian patients who attend GP clinics, and the GPs themselves, in advising the researchers on what's important to consumers and GPs.