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    Raymond Bange

    One of the goals of health reform should be to improve access to primary care within a patient-friendly environment at appropriate times.
    The increasing focus on primary care has highlighted the importance of access to an appropriate primary health care team for medical problems that arise outside normal business hours and on weekends and holidays.
    Studies in the US (2010 Health Tracking Household Survey) have found that one in five people who attempted after-hours contact with their primary care provider reported it was “very difficult” or “somewhat difficult” to reach a clinician. Those who reported less difficulty contacting a clinician after hours had significantly fewer emergency department visits and lower rates of unmet medical need than people who experienced more difficulty. Not surprisingly, these findings indicate that increasing support to offer or coordinate after-hours care may help reduce rates of emergency department use and unmet medical need.
    Equally important is that many issues can be resolved in the home or within the patient environment by using the advanced skills of health and allied health practitioners such as paramedics and the delivery of care by various innovative means – by phone, by internet, in person or through some combination of inter-professional practice, depending on the patient’s needs.

    As Mark has noted, Australia has a wonderful opportunity to explore the options and innovate in health care delivery by utilising the advanced skills of paramedic professionals and other members of the health care team in out-of-hospital care. I look forward to the results of the current studies replicating the beneficial outcomes experienced with several well-documented studies overseas.

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