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Health care homes: lessons from the Diabetes Care Project

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Better care coordination, e-health tools and funding systems are essential for chronic disease management

One of the biggest health care challenges in Australia is ensuring that people with chronic diseases receive the care they need in a high quality and sustainable way. Today, one-third of the population — about 7 million people — have one or more chronic conditions, accounting for 85% of the total burden of disease, 90% of all deaths, 40% of general practitioner visits and 60% of disease-allocated health expenditure.1,2 As the National Health and Hospital Reform Commission noted in 2009, these patients often have great difficulty accessing appropriate care and “end up literally ricocheting between multiple specialists and hospitals, not getting access to community support services, and having endless diagnostic tests as each health professional works on a particular ‘body part,’ rather than treating the whole person”.3

In response to this challenge, and drawing on local and international experience,46 the commission recommended the concept of a health care home. The proposal was that people with chronic and complex health problems who chose to enrol with a single primary health…