title: 'The onus is on me': primary care patient views of Medicare-funded team care in chronic disease management in Australia.
abstract: OBJECTIVE
  This study investigated the views of primary care patients in receipt of Medicare-funded team care for chronic disease management (CDM) in Australia.
  
  
  METHODS
  A qualitative study using a repeat in-depth interview design.
  
  
  METHODS
  Twenty-three patients (17 female), aged 32-89, were recruited over a six-month period from two purposively selected general practices: one urban and one regional practice in Queensland, Australia.
  Semi-structured interviews were conducted with participants 6 months apart. An interview guide was used to ensure consistency of topics explored. Interviews were recorded and transcribed, and a thematic analysis was conducted.
  
  
  RESULTS
  Patients in this study viewed the combined contributions of a GP and other health professionals in team care as thorough and reassuring. In this case of Medicare-funded team care, patients also saw obligations within the structured care routine which cultivated a personal ethics of CDM. This was further influenced by how patients viewed their role in the health-care relationship. Aside from personal obligations, Medicare funding got patients engaged in team care by providing financial incentives. Indeed, this was a defining factor in seeing allied health professionals. However, team care was also preferential due to patients' valuations of costs and benefits.
  
  
  CONCLUSIONS
  Patients are likely to engage with a structured team care approach to CDM if there is a sense of personal obligation and sufficient financial incentive. The level of engagement in team care is likely to be optimized if patient expectations and preferences are considered in decisions.
authors.affiliation: School of Social Work and Human Services, The University of Queensland, Brisbane, St Lucia, Australia.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Foster
authors.affiliation: Centre for Primary Healthcare Research, The University of Queensland, Brisbane, St Lucia, Australia.
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001315:Australia; D002908:Chronic Disease / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D010348:Patient Care Team; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods*; D036301:Qualitative Research
keywords: Australia; allied health services; chronic disease management; patient experience; primary care; team care