title: The future of community-centred health services in Australia - an alternative view.
abstract: Community-centred healthcare works in conjunction with hospital-centred healthcare. Both have strengths and limitations. Community-centred healthcare has been demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care at best in a limited fashion. If hospital-centred services dominate healthcare services in Australia, as argued previously in this journal, then this has not extended to maintenance of inpatient bed provision. The author, as a hospital-based emergency specialist, has observed case load and models of care in hospitals and emergency departments for 30 years and is sceptical of promises to substantially further decrease emergency department demand and acute bed requirements. The real benefits of community, primary and preventive care should not be over sold.
authors.affiliation: Emergency Department, Ryde Hospital, Denistone Rd, Eastwood, NSW 2122, Australia. pcunning@nsccahs.health.nsw.gov.au
authors.forename: Paul A
authors.initials: PA
authors.lastname: Cunningham
mesh_terms: D003151:Community Health Centers / Q000639:trends*; D003156:Community Mental Health Services / Q000639:trends*