Australia | Sweden | |
---|---|---|
Population ≥65 years | 15 % [21] | 20 % [22] |
Population ≥65 in ACF | 7.8 % [23] | 5 % [22] |
Number of medications per ACF resident | 7–10 [3, 4, 24] | 7–10 [25, 26] (>70 % have one or more PIM) |
ACF providers | • Private not-for-profit [27] • Private for-profit [27] | • Municipality (responsible) • Private (paid by municipality) [28] |
General practice structure | • Single/multiple GP private practices [29] • Small − medium business model [29] | • Team-based primary care facilities • Most public (owned by the county councils) • Few private (mostly owned by companies or cooperatives) [30] |
GPs in ACF | • Continuity model: GP follows long-term patient to ACF [31] • ACF panel model: GP provides care for >2 patients in nearby ACF [31] • GPwSI ACF model: GP provides regular scheduled service to large number of ACF residents [31] • LGPT model: GP part of team-based care [31] • ACF-based model: Single GP partners with single ACF [31] | • County councils responsible for residents’ medical care; generally weekly visit to ACF by one GP from the local primary care unit [28] |
Funding for primary health care | • Government funded (both state-, territory- and local-) • Fee-for-service paid directly by patients and clients • Private health insurers • Private charities [32] | • Funded through national and local taxation [30]. |
GP funding structure | • Fee-for-service paid directly by patients, and/or • Reimbursement by Government Medicare Benefits Schedule [29] | Different funding in the 20 different county councils [33]. In Skåne where interviewed GPs worked [34]: • Based on capitation for registered patients. • Complemented with estimated ‘illness burden’ indexation • Performance-based payments |
Medication reviews for ACF residents | • Pharmaceutical review outsourced by ACF to private company or local pharmacist. • Compulsory biennially as part of ACF accreditation process [35]. • GP may request local pharmacist to undertake medication review at any time [35]. • Funded by Government Medicare Benefits Schedule; maximum 1 review in 12 month period. | • Undertaken by county council employed pharmacists undertaken at any time, at least once a year, aiming to increase quality of medications and reduce PIMS [36]. |