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Table 1 Aged care systems and policies in Australia and Sweden

From: Factors influencing deprescribing for residents in Advanced Care Facilities: insights from General Practitioners in Australia and Sweden

  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].
  1. ACF aged care facility, GP general practitioner, GPwSI ACF GPs with special interest in aged care facilities, LGPT longitudinal general practice team