Consumers are leading health care change movement
DELIVERING care at home is very much a part of the transformation of health care treatment choices for Australians.
Health insurer Medibank is pursuing this approach as a result of its research of similar set-ups overseas. Under the banner of Medibank at Home the insurer has implemented the first of its hospital care services at home and is in the throes of piloting another three, with more likely to come on board over time.
Medibank's chief medical officer Dr Linda Swan said, "My prediction is that you will see this as a fairly rapidly growing space and you'll see more and more care in the home options being offered over the next five to ten years".
"We could see from the international literature that delivering care in the home was in many other countries successful at delivering high quality care with a great experience for patients and at a lower cost."
"What was most encouraging from our pilots is how positively people responded to the option of having some choices about where they receive their care," Dr Swan added. "This is not about us saying people must have care in the home, because it's not for everybody. For some people it's an absolute life-changing option if they can have their care delivered home rather than the hassle and expense of travelling to hospital and being away from your family and home."
Medibank has implemented its hip and knee joint post-surgery rehabilitation program in every State for Medibank customers. There has been 750 people through the program since it started in October 2017. "There is still a lot of growth to happen there," Dr Swan said.
The three services now being piloted are chemotherapy, palliative care and haemodialysis. "All the programs are designed to be clinician led," Dr Swan said. "It depends on the clinician determining that person and that person's treatment is okay to happen in the home setting."
The palliative pilot program is available in Perth, the dialysis program is available in Victoria, New South Wales and Queensland to customers with long-term kidney disease, and the chemotherapy program is available in Victoria, Western Australia and South Australia for customers that need long term intravenous chemotherapy treatment.
The challenge ahead for home care is setting and maintaining high quality delivery standards, ensuring good governance and the availability of sufficient human resources.
"If you look at our renal dialysis program, at the moment it's really limited to one state because, from our efforts to look at providers and ensure we have a high-quality provider, we could at this time only find one," Dr Swan said. "As the market place develops and people realise that payers like us are prepared to fund this type of care, I think there will be more competition in the marketplace and we will see more people branching out to provide services at the home."
Dr Swan sees other in-hospital services that could be done in a community or home setting such as some in-patient psychiatric services.
"It's a consumer led movement," Dr Swan said. "People are saying that they want the flexibility of choice. But, it's really important people understand this is absolutely a matter of choice."