Chronic Disease Management

Chronic disease refers to illness that persists, rather than those conditions that resolve after a single episode. It includes many common conditions such as asthma, diabetes, heart disease, emphysema and kidney disease to name a few. Often management of these important conditions can be complex, but good management can make a big difference to you in reducing the risk of complications and maintaining good health.

Care planning
Pioneer Health makes use of care planning to facilitate the best possible management of chronic disease. Care plans or GP management plans involve a detailed assessment of your current symptoms and treatment followed by identifying ways to improve, based on best practice guidelines. You and your GP decide together on important goals for your treatment and a plan of action to enable you to achieve them. Care plans are usually undertaken 6 monthly or annually depending on the severity of your chronic disease. Completing a care plan usually involves a 30 minute appointment with your usual GP, followed by a 15 minute appointment with the practice nurse. We believe that all patients with chronic medical problems should make use of this comprehensive approach and we routinely bulk bill all care plan appointments. 

Team care
Best care for many of these conditions is usually delivered by a team of health care providers including specialists, pharmacists and allied health professionals. Your GP plays a pivotal role in coordinating this care to ensure the best possible outcome for you. If your GP completes a "team care arrangement" you may be eligible for up to 5 subsidized visits to allied health professionals each year (such as a physio, podiatrist, exercise physiologist, etc). 

 

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