The ultimate goal of any health system is to optimize health, both in the present through curative and rehabilitative care and in future measures such as preventative care and the research of new medicines. Measures of the benefits and challenges that impede this goal continue to be important. Furthermore, efforts to assess and assure the quality of the contexts of health care delivery are necessary when improving the accountability of health services.
Primary Care: Benefits and Challenges
Primary Healthcare (PHC) is the foundation of a strong and functional health system that ensures positive health and wellbeing outcomes and health equality. The World Health Organisation defines primary health care as curative treatment provided by first contact providers along with promotional, preventive and rehabilitative services administered by multi-disciplinary teams of health care professionals such as general practitioners, practice nurses, psychologists, physiotherapists, community health workers and pharmacists (WHO, 2008). PHC is universally accessible and socially appropriate first level care, generally provided in a community based setting, it is supported by integrated referral systems that prioritises those most in need whilst developing community and individual self-reliance and participation (Australian Medical Association, 2010). Increasingly, both in Australia and overseas, it is recognized that improving the way that PHC is provided is vital in defining how well a health system responds to current and emerging pressures. Research shows that the benefits of health systems with sound primary care include increased efficiency, reduced health care costs and expenditure, lower hospitalization rates, fewer health inequalities, better health outcomes including reduced rates of morbidity and mortality, and better health outcomes generally (Atun, 2004). This helps patients better manage their conditions in the community and results in fewer people relying on secondary and tertiary services, thus freeing up hospital beds and emergency departments for those who need hospital based care. Starfield et, al. note that there are several mechanisms that explain the beneficial outcomes: (1) wider access to health services; (2) improved quality of care; (3) emphasizing prevention; (4) the identification and early management of conditions; (5) the combined effect of the various characteristics of primary care systems; (6) reduction in unnecessary care by secondary and tertiary specialists (Starfield et, al., 2005).
However, despite the near global agreement that PHC is a critical component of any health care system, there lies an imbalance between primary and specialty health care services. A difficulty in recruiting health professionals is a major challenge to the sustainability of PHC, the problem particularly acute outside of Australia’s major cites. The numbers of General Practitioner’s (GP) per 100,000 people varies from under 60 in remote regions to...