Impact of Enhanced Primary Care on equitable access to and economic efficiency of allied health services: a qualitative investigation Academic Article uri icon


  • Objective.To evaluate new pathways to access allied health services introduced by the Enhanced Primary Care/Chronic Disease Management (EPC/CDM) initiative that may both increase or decrease equity to and efficiency in access. Design.A qualitative study consisting of semi-structured in-depth interviews with a purposively selected group of allied health practitioners. Participants and setting.Allied health practitioners in private practice in Queensland, Australia, from physiotherapy, occupational therapy, speech pathology, and exercise physiology backgrounds (nā€‰=ā€‰15). Main outcome measures.Interviews focused upon several issues including how referrals are made under the EPC/CDM initiative and what happens for patients once their five allotted sessions are expended. Results.The EPC/CDM initiative appeared to address two key barriers of access to allied health services ā€“ costs to patient of access and patient awareness of benefits. However, gap payments may still be deterring economically disadvantaged patients from attending. Discussion.The EPC/CDM initiative is increasing access to allied health services for people with chronic diseases. However, it is evident that this initiative may still not be meeting the needs of those most disadvantaged economically, and may lead to duplication of efforts by allied health practitioners when patients move between private and public health care sectors. What is known about the topic?Publicly funded subsidy of allied health services for people with chronic disease is a relatively new policy initiative in Australia. The success of such policy hinges on several factors, notably, its ability to improve equity of access to appropriate health care, generate improved health outcomes, and to do so efficiently. What does this paper add?This paper demonstrates how health professionals and patients are actually using the Enhanced Primary Care/Chronic Disease Management initiative to access allied health services. The strengths and weaknesses of current policy identified will inform future policy development and funding decisions. What are the implications for practitioners?Equitable access to allied health services for people with economic disadvantage is still limited due to gap payments. This initiative has facilitated patient exposure to the benefits of allied health services first hand, prompting some to continue paying for these services privately once the annual number of sessions permitted are exhausted.


  • Haines, Terry P
  • Foster, Michele M
  • Cornwell, Petrea
  • Fleming, Jennifer
  • Tweedy, Sean
  • Hart, Alison
  • Mitchell, Geoffrey

publication date

  • 2010