Alternatives to hospitalisation

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Alternatives to hospitalisation
Dr Chris Brook Executive Director Rural
Regional Health Aged Care Department of Human
Services - Victoria Current issues, priorities
and future directions primary and community
health services in NSW 8 September 2005
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Victorian government health policy directions

• A Third Wave of National
• Reform
• A Fairer Victoria

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The Victorian Health System

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Providing alternatives to hospitalisation through
integrated services

• What are the challenges we face?
• What have we done?
• What are the results?

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What are the Challenges?

• Changing profile of the population
• ageing, longevity
• Shifting burden of disease
• 40 growth in hospital admissions for ambulatory
  care sensitive conditions
• Fragmented human services sector
• ICT capability
• Cost of patient services

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DHS Policy response

• Improving integration of acute and community
  services

Ambulatory Care
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HealthSMART

• Whole-of-Health Information and Communication
  Strategy (ICT) across
• public health system
• aims
• to improve patient care
• reduce the administrative burden on health care
  professionals
• ease costs associated with updating technical
  infrastructure through a standardised approach to
  information systems.

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Hospital Demand

• HARP demonstrated a successful
• model now being mainstreamed
• through health system as VCCCP
• VCCCP objectives include improved patient
  outcomes, seamless care across hospital
  community sectors, reducing avoidable hospital
  admissions, equitable access
• Targets those with chronic complex conditions
• Multi level interventions Tertiary, Primary

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Metropolitan and Rural Health Frameworks

• Metropolitan Health Strategy
• 4 Strategic Directions
• increase capacity
• -redistribute and reconfigure capacity
• -service substitution and diversion
• -new service models
• Rural Directions
• ?3 directions
• -promote the health and wellbeing of rural
  Victorians
• -foster a contemporary health system and models
  of care for rural Victoria
• -strengthen and sustain rural health services

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Primary Care Partnerships Strategy

• Key vehicle for DHS change activities
• Significant investment of
• Commonwealth State
• Two key deliverablesService Coordination
  Integrated Health Promotion
• Strategy is about change for consumers
  providers
• Consistent with A Fairer Victoria

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Community Health Policy
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Ambulatory Care Framework

• Ambulatory Care Framework (ACF)
• currently being developed
• Person centred care
• Refocusing the mix of hospital and
• community based ambulatory care services
• Integrating parts of the system along area based
  lines
• supporting flexible service delivery

Ambulatory Care
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System outcomes

• Challenge
• System wide change
• Smarter efficient ICT
• Manage hospital demand
• Restructure metro. rural health systems to meet
  changing needs
• Better manage ambulatory care sensitive
  conditions
• Improve agency service coordination and
  population health approaches
• Focus on clients, carers communities
• Rebalancing the system

• Results
• Whole of system change
• HealthSMART program statewide
• VCCCP early intervention initiatives
• Metro Health Strategy Rural Directions
• ACF in development
• Primary Care Partnerships
• Community Health Services leading health outcomes
  locally

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So what does this tell us?

• System wide change is possible
• All levels of system must be involved
• Takes time
• Partnerships work
• Not easy but worth doing