Spectrum of care

The third key component of the HealthOne NSW Model of Care is the provision of coordinated and integrated primary health care services that encompasses:

• Health promotion and illness prevention
• Early detection and intervention
• Continuing care for people with chronic and complex conditions
• Multidisciplinary planned care for those who need it

Health promotion and illness prevention are also known as primary prevention. The goal of primary prevention is to "limit the incidence of disease and disability in the population by measures that eliminate or reduce causes or determinants of departures from good health, control exposure to risk, and promote factors that are protective of health" (NPHP 2006, p3)

Early detection and intervention is also known as secondary prevention. Secondary prevention has been described as strategies which aim to "reduce progression of disease through early detection, usually by screening at an asymptomatic stage, and early intervention" (NPHP 2006, p3).

Continuing care for people with chronic conditions, or chronic disease management, has been described as "an intervention designed to manage or prevent a chronic condition using a systematic approach to care and potentially employing multiple treatment modalities" (Weingarten et al 2002 p925).

The prevention aspect of chronic disease management, also known as tertiary prevention, aims to minimise the impact of established disease and improve function through effective treatment and rehabilitation. Elements of chronic disease management that have been found to most frequently impact on health, function and quality of life are self management support (in particular development of self efficacy) and multidisciplinary team care with practice nurses and allied health (Zwar et al 2006).

Prevention was the subject of a presentation (link) and discussion group (link) at the 2008 Statewide HealthOne NSW workshop. It also featured in a Learning Forum teleconference (link) with a presentation by Dr John Wiggers, Director Population Health, Hunter New England Health.

Australian Institute of Health and Welfare (2004).  Australia's Health 2004.  Canberra, AIHW Cat. No. AUS 44.

National Public Health Partnership (2006). The Language of Prevention. Melbourne: NPHP. Link to article

Weingarten SR, Henning JM, Badamgarav E, Knight K, Hasselblad V, Gano A, Jr, et al (2002). Interventions used in disease management programmes for patients with chronic illness - which ones work? Meta-analysis of published reports. BMJ, 325(7370):925-928.