In response to the constant changes in the demand and supply of healthcare, a variety of new healthcare delivery models have been implemented in Australia over the past decade. As a result, there has also been a parallel increase in the number of evaluations of such models. In a new scoping review for the Australian Health Review, Jacqueline Roseleur, Andrew Partington and PCHSS lead investigator Professor Jonathan Karnon show the importance of systematically reviewing such evaluations.
In “Scoping review of Australian evaluations of healthcare delivery models: are we making the most of the evidence?”, the authors describe their review of 636 studies of healthcare delivery models. While noting that evaluations of such models from abroad can help guide Australian health policy, their review focused on evaluations in Australia because local context is a key determinant of the effect of a healthcare delivery model.
Of the 636 reviewed studies, the majority (60%) were randomised controlled trials. In all, 18 included in the review. The study found that majority of the evaluations were conducted in metropolitan areas, with three states (Victoria, Queensland, and New South Wales) accounting for nearly 70% of the evaluations reviewed. Overall, the evaluations covered many different clinical settings, and most of the evaluated models involved allied health practitioners and nurses, rather than GPs or specialist GPs.
The review reveals the massive number of evaluations of Australian healthcare delivery models and highlights the need for “a more systematic approach to the use of this evidence base to inform decisions to fund and implement healthcare delivery models.”
While the application of health technologies across the Australian health system has a dedicated national body (the Council of Australian Governments Health Technology Reference Group), the authors note that there is “no equivalent group focusing on healthcare delivery models, despite the abundant evidence base”.
This is a shortcoming that decision-makers in the health system should address. Implementing new healthcare delivery models requires the reallocation of resources. Given the significant impact of that new delivery models can have on costs and quality of healthcare, it is essential that the large and continually growing body of evidence about their effectiveness be systematically incorporated into decision-making processes.