Providing healthcare for people with chronic illness: the views of Australian GPs.
OBJECTIVE
To explore general practitioners' views on chronic-disease care: the difficulties and rewards, the needs of patients, the impact of government incentive payments, and the changes needed to improve chronic-disease management.


METHODS
Qualitative study, involving semi-structured questions administered to 10 focus groups of GPs, conducted from April to October 2002.


METHODS
54 GPs from both urban and rural practices in New South Wales and South Australia.


RESULTS
Consistent themes emerged about the complex nature of chronic-disease management, the tension between patients' and GPs' goals for care, the time-consuming aspects of care (exacerbated by federal government requirements), and the conflicting pressures that prevent GPs engaging in structured multidisciplinary care (ie, team-based care involving systems for patient monitoring, recall, and care planning).


CONCLUSIONS
Structured multidisciplinary care for people with chronic conditions can be difficult to provide. Barriers include the lack of fit between systems oriented towards acute care and the requirements of chronic-disease care, and between bureaucratic, inflexible structures and the complex, dynamic nature of GP-patient relationships. These problems are exacerbated by administrative pressures associated with federal government initiatives to improve chronic-illness management. Changes are needed in both policies and attitudes to enable GPs to move from episodic care to providing structured long-term care as part of a multidisciplinary team.
Oldroyd
John
J
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
Proudfoot
Judith
J
Infante
Fernando A
FA
Powell Davies
Gawaine
G
Bubner
Tanya
T
Holton
Chris
C
Beilby
Justin J
JJ
Harris
Mark F
MF
D000208:Acute Disease / Q000628:therapy; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006285:Health Planning / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010348:Patient Care Team / Q000458:organization & administration; D010819:Physician's Role; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000706:statistics & numerical data*; D013021:South Australia