Serena Yu, Kees van Gool, Karen Edwards, Sue Kirby, Karen Gardner, Louise Robinson, Tricia Linehan, Mark Harris and Jane Hall
The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general…
Abstract
Purpose
The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general practices, and examine the feasibility of implementing an ICS, within a predominantly fee-for-service delivery model.
Design/methodology/approach
Mixed methods were used to analyse the implementation of the ICS, including practice-level patient data on changes in service provision. This includes unit-record data on 130 enroled patients across three rural sites, as well as qualitative data collection from providers.
Findings
There were significant increases in both revenue-generating and non-revenue-generating activities (primarily care coordination activities) associated with implementing the ICS. Each occasion of service involved greater contact time with practice staff other than GPs, as well as greater administration time. There is evidence that ICS activities such as case conferencing and team care planning substitute for traditional GP consultations. Overall, the study found that a significant investment of resources – namely staff time devoted to a range of activities – was required to support the implementation of the ICS. Such an investment was supported both externally and through revenue-generating practice-level activities.
Research limitations/implications
The data collection and evaluation project is ongoing, with analysis based on the first wave of data from three sites.
Practical implications
At the practice level, a substantial commitment of resources is required to invest in, and sustain, a new model of integrated care (IC). This commitment can currently be supported both through higher revenue generation at the practice level, and externally by health system stakeholders, but changes in financial settings could impact on financial viability.
Originality/value
This paper provides evidence on the role of blended payment mechanisms in facilitating the implementation of IC in a rural setting where there are medical workforce constraints.
Details
Keywords
Farley Ishaak, Ron van Schie, Jan de Haan and Hilde Remøy
Commercial real estate (CRE) indicators typically include asset deals and exclude share deals. This study aims to explore the phenomenon of real estate share deals and assess…
Abstract
Purpose
Commercial real estate (CRE) indicators typically include asset deals and exclude share deals. This study aims to explore the phenomenon of real estate share deals and assess whether omitting these transactions results in indicators that do not accurately reflect the market.
Design/methodology/approach
Various registers in the Netherlands were used to estimate transaction volumes, total values and price developments of both share and asset deals. Share deals are company transfers and its transactions cover more than real estate. To estimate the contribution of real estate in share deals, valuations were used.
Findings
In the Netherlands, share deals are most prominent for rental dwellings. Adding share deals to volume and value indicators seems required. In price development estimates, significant differences were found for dwellings between share and asset deals. Price indices should, therefore, also include share deals, but in practice this is difficult and has little impact on the outcomes due to the low weight of share deals.
Research limitations/implications
Legislation has a major impact on choosing a share or asset deal. The significance of share deals is expected to vary amongst countries. Performing similar research in other countries will contribute in harmonising real estate indicators.
Practical implications
Statistical agencies face many challenges in the construction of CRE indicators. This study provides statisticians knowledge that can be used to evaluate possible data gaps.
Originality/value
This is the first study to estimate indicators of real estate share deals and compare these to asset deal indicators.