There is growing interest by government, clinicians and the public in the health and economic benefits offered by the comnined use of mainstream and complementary medicine (integrated care) and anecdotal and some documented evidence of examples within Australia.  This interest has been stimulated by concern about our ability to effectively manage chronic disease and escalating health costs in the context of an ageing population.  These issues are facing countries world-wide, as is the consequent attention being given to prevention and health maintenance, reflected in Australia through the establishment and reports of the Health and Hospitals Reform Commission and Preventative Health Care Taskforce.

Notwithstanding these factors, there is no current profile on integrated care initiatives; compendiums of examples and their benefits or information collected on a regularised and agreed basis to enable trends to be monitored and comparisions of health and cost benefits to be made.   Yet this information is required to inform future research choices and priorities as well as clinical practice.  This is increasingly pressing with the known high rate of mixed use, with some 30% of Australians concurrently using complementary and pharmaceutical products in major disease areas and registration of traditional Chinese medicine practitioners in 2012.

Integrated care poses significant policy issues for government and other stakeholders, such as development of clincial guidelines; practitioner and product regulation; rebate schemes and in relation to medicines, pharmaceutical benefits listings.

In its intial phase of work, NICM focused on establishing a baseline of activity and therefore:

• Commissioned a directions paper describing integrated care initiatives and models; and
• Established seed funding to support integrated care projects and associated data collection, to demonstrate safety, clinical efficacy and cost-effectiveness.  Outcomes of the 2009 Integrated Care Research Grants Program funding available here   - click here

Commissioning a directions paper was identified as an important first step to take a stock of models of care; issues and activities.  For example, it is known that a number of mainstream health and support settings have policy guidelines on the use of complementary medicine, but little is known about this content; the extent to which they cover key sectors and the extent to which they are followed.  NICM was not positioned to undertake an exhaustive review, instead focusing on setting the broad landscape, building on available papers and literature reviews describing models of integrated care.

The landscape is rapidly evolving, and there have been a number of developments even in the short space of time when work was commissioned.  However, it is hoped the report and associated resources will both prompt and inform future activity in this important part of our healthcare system.

Updated January 2010