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A framework for bridging the gap in the care of familial hypercholesterolaemia in the community: pragmatic and economic perspectives

Purchase, Sharon1; Vickery, Alistair2; Garton-Smith, Jacquie3; O’Leary, Peter4,5,6; Sullivan, David7; Slattery, Mark10; Playford, David8; Watts, Gerald9

International Journal of Evidence-Based Healthcare: December 2014 - Volume 12 - Issue 4 - p 244–254
doi: 10.1097/XEB.0000000000000019
DISCUSSION PAPER

Objective: To analyze various business models for improving the diagnosis and treatment of familial hypercholesterolaemia.

Methods: Five different strategies were analyzed and data were collected through documentary analysis and structured interviews. Interviewees included professionals from universities, Western Australia Department of Health, private medical practitioners and not-for-profit organizations.

Results: Two business models are recommended: alliance with general practitioners and primary health care organizations and a joint venture model between private cardiology clinics and lipid disorder clinics in the public sector. Primary care providers are in a good position to co-ordinate across the multi-disciplinary health services required to treat familial hypercholesterolaemia within the population.

Conclusions: Devolution of knowledge on treatment of familial hypercholesterolaemia from centralized specialist hospital clinics to primary care services is required to improve the rate of detection of this condition in the community. An International Classification of Disease (ICD)-10 and/or a Diagnosis-Related Group (DRG) code is required to codify, catalogue and document new cases and treatment, as well as to facilitate research and re-imbursement strategies. Primary Health Care Organizations can usefully facilitate the transfer of knowledge on best standard of care to general practice, but the best model of care will require close integration of care with specialist and academic centres.

1UWA Business School, University of Western Australia

2Primary Health Care – General Practice, SPARHC, Faculty of Medicine, Dentistry and Health Service, University of Western Australia

3Clinical Lead, Cardiovascular Health Network, DoHWA and Hospital Liaison GP, Royal Perth Hospital, Australia

4Centre for Population Health Research, Faculty of Health Sciences, Curtin University

5School of Pathology and Laboratory Medicine, University of Western Australia

6School of Women's and Infants’ Health, The University of Western Australia

7Department of Biochemistry, Royal Prince Alfred Hospital, University of Sydney, New South Wales, Australia

8Faculty of Medicine, University of Notre Dame, Western Australia; Armadale Health Service, Western Australia

9Lipid Disorders Clinic, Metabolic Research Centre and Cardiovascular Medicine, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia

10Department of Health, Western Australia

Correspondence: Sharon Purchase, BE (Civil), MBA, PhD, University of Western Australia, Perth, Western Australia, Australia. E-mail: sharon.purchase@uwa.edu.au

International Journal of Evidence-Based Healthcare © 2014 The Joanna Briggs Institute
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