title: Practice nurse involvement in general practice clinical care: policy and funding issues need resolution.
abstract: In Australia, primary care-based funding initiatives have been implemented to encourage general practices to employ practice nurses. The aim of this paper is to discuss limitations of the current funding and policy arrangements in enhancing the clinical role of practice nurses in the management of chronic conditions. This paper draws on the results of a real-world economic evaluation, the Primary Care Services Improvement Project (PCSIP). The PCSIP linked routinely collected clinical and resource use data to undertake a risk-adjusted cost-effectiveness analysis of increased practice nurse involvement in clinical-based activities for the management of diabetes and obesity. The findings of the PCSIP suggested that the active involvement of practice nurses in collaborative clinical-based activities is cost-effective, as well as addressing general practice workforce issues. Although primary healthcare organisations (e.g. Medicare Locals) can play a key role in supporting enhanced practice nurse roles, improvements to practice nurse funding models could further encourage more efficient use of an important resource.
authors.affiliation: Department of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email: ; ; ;
authors.forename: Hossein Haji Ali
authors.initials: HH
authors.lastname: Afzali
authors.affiliation: Department of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email: ; ; ;
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karnon
authors.affiliation: Faculty of Health Sciences, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email:
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
authors.affiliation: Department of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email: ; ; ;
authors.forename: Jodi
authors.initials: J
authors.lastname: Gray
authors.affiliation: Department of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email: ; ; ;
authors.forename: Christine
authors.initials: C
authors.lastname: Holton
authors.affiliation: Department of Public Health, The University of Adelaide, 178 North Terrace, Adelaide, SA 5000, Australia. Email: ; ; ;
authors.forename: David
authors.initials: D
authors.lastname: Banham
mesh_terms: D001315:Australia; D002908:Chronic Disease / Q000628:therapy; D003362:Cost-Benefit Analysis; D005380:Financing, Government; D058006:General Practice; D006291:Health Policy; D006801:Humans; D024802:Nurse's Role