title: Australian general practice and pandemic influenza: models of clinical practice in an established pandemic.
abstract: To minimise the health impact of pandemic influenza, general practice will need to provide influenza-related and non-influenza primary health care, as well as contribute to the public health goal of disease control. Through interviews and workshops with general practitioners, nurses and policy leaders between March and July 2006, and literature analysis, we identified potential models of general practice in an established pandemic, and assessed their strengths and weaknesses. Three possible clinical models were identified: a default model of no change to service delivery; a streamed services model, where general practices reorganise themselves to take on either influenza-specific care or other clinical services; and a staff-determined mixed model, where staff move between different types of services. No single model or set of strategies meets the needs of all general practices to deliver and sustain the essential functions of primary health care during an established pandemic. Governments, general practice and the relevant peak professional bodies should decide before a pandemic on the suite of measures needed to support the models most suitable in their regions. Effective participation by general practice in a pandemic requires supplementary infrastructure support, changes to financial and staffing patterns, a review of legislation on medicolegal implications during an emergency, and intensive collaboration between general practices.
authors.affiliation: College of Medicine and Health Sciences, Australian National University, Canberra, ACT, Australia. christine.phillips@anu.edu.au
authors.forename: Christine B
authors.initials: CB
authors.lastname: Phillips
authors.forename: Mahomed S
authors.initials: MS
authors.lastname: Patel
authors.forename: Nicholas
authors.initials: N
authors.lastname: Glasgow
authors.forename: Christopher
authors.initials: C
authors.lastname: Pearce
authors.forename: Paul
authors.initials: P
authors.lastname: Dugdale
authors.forename: Alison
authors.initials: A
authors.lastname: Davies
authors.forename: Sally
authors.initials: S
authors.lastname: Hall
authors.forename: Marjan
authors.initials: M
authors.lastname: Kljakovic
mesh_terms: D001315:Australia / Q000453:epidemiology; D003695:Delivery of Health Care; D004189:Disaster Planning; D004196:Disease Outbreaks / Q000517:prevention & control*; D005194:Family Practice / Q000458:organization & administration; D006284:Health Plan Implementation; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D017053:Infection Control; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008962:Models, Theoretical; D010356:Patient Isolation; D010561:Personnel Staffing and Scheduling; D011320:Primary Health Care; D016730:Program Development; D011634:Public Health; D012051:Reimbursement Mechanisms; D000078329:Workforce