SA HealthPlus, one of nine national Australian coordinated care trials, addressed chronic illness care by testing whether coordinated care would improve health outcomes at the cost of usual care. SA HealthPlus compared a generic model of coordinated care for 3,115 intervention patients with the usual care for 1,488 controls. Service coordinators and the behavioral and care-planning approach were new. The health status (SF-36) in six of eight projects improved, and those patients who had been hospitalized in the year immediately preceding the trial were the most likely to save on costs. A mid-trial review found that health benefits from coordinated care depended more on patients' self-management than the severity of their illness, a factor leading to the Flinders Model of SelfManagement Support.Keywords: Chronic disease, coordinated care, care plan, self-management, health outcomes. In Australia, the coordination of care for patients with multiple service needs may be hampered by mixed funding sources and the lack of integrated systems of care. Each of the commonwealth, state, and territory governments funds public health services: the commonwealth government administers the taxpayer-funded Medicare program to provide universal access to public health services by reimbursing general practitioners (GPs) and specialists on a fee-forservice basis, and the state governments support public hospitals. A mixture of state and commonwealth programs fund community care, including allied health services, and individuals can purchase private health insurance, which provides private hospital care and a range of ancillary services (physiotherapy, psychology, podiatry, etc.).In 1997, Australia's governments began trials of coordinated care to develop and test models of service delivery for chronic conditions (Commonwealth Department of Human Services and Health 1995). The impetus for reform was escalating health care costs driven by an aging population and advances in technology, a shift in emphasis of health care delivery from the tertiary-to the primary-care sector (World Health Organization 2002), and demands by consumers for more patientcentered care.The principal national hypothesis that the trials were asked to test within a two-year time frame was the following: Coordinating the care of people with multiple service needs, who receive their care through individual care plans and funds pooled from existing commonwealth, state, and joint programs, will improve their health and well-being using existing resources. The main purpose of the trials was to "develop and test different service delivery and funding arrangements, and to determine the extent to which the coordinated care model contributes to• Improved client outcomes.

A multiple regression analysis was used with variables relevant to sleeping problems from a large community health survey in South Australia. The variables that were found to be most strongly correlated with sleep problems were, in order of importance, pain, anxiety, age, somatic health and annual household income, all of which accounted for 22% of the variance. Weight problems, depression and sex of the respondent were not so important in this analysis. Arthritis, which often increases with age, appeared to be most strongly associated with pain, explaining in part why sleeping problems increase with age. Anxiety, pain and poor somatic health were most strongly associated with lying awake at night or sleeping badly, and anxiety and pain were most strongly correlated with taking longer to get to sleep. Poor somatic health and anxiety were most strongly associated with waking early, and age and pain were the most important variables in taking tablets to aid sleep.

Background: Primary health care research is under pressure to be accountable to funders in terms of benefits for practice and policy. However, methods to assess the impact of primary health care research must be appropriate to use with the diverse topics, settings and approaches of this sector. This project explored the feasibility of using the Buxton and Hanney Payback Framework to determine the impact of a stratified random sample (n = 4) of competitively funded, primary health care research projects.

The Internet is often consulted for health information, 1 which can be highly valued by patients and caregivers 2,3 despite the concerns of some physicians. 4 Better knowledge of the factors associated with seeking health information on the Internet could improve communication with consumers at an individual level (e.g. physician-patient interactions) and on a large scale (e.g. publicly funded health information initiatives).The primary purpose of this research was to investigate the relationship between self-reported health and searches for online health information, which has not yet been explored in Australia. International research shows that individuals with reported chronic conditions were more likely to search for health information on the Internet 5 yet self-rated 'good' health is also associated with online health information seeking. 2Online health messages may appropriately target a broad range of the population, including those in good health. For example, advertising on search engines has been found to be an effective way of promoting colorectal cancer screening. 6 In Australia, the relationship between health and online health information seeking is further complicated by socioeconomic factors, as

BackgroundFunding for research is under pressure to be accountable in terms of benefits and translation of research findings into practice and policy. Primary health care research has considerable potential to improve health care in a wide range of settings, but little is known about the extent to which these impacts actually occur. This study examines the impact of individual primary health care research projects on policy and practice from the perspective of Chief Investigators (CIs).MethodsThe project used an online survey adapted from the Buxton and Hanney Payback Framework to collect information about the impacts that CIs expected and achieved from primary health care research projects funded by Australian national competitive grants.Results and DiscussionChief Investigators (CIs) provided information about seventeen completed projects. While no CI expected their project to have an impact in every domain of the framework used in the survey, 76% achieved at least half the impacts they expected. Sixteen projects had published and/or presented their work, 10 projects included 11 doctorate awards in their research capacity domain. All CIs expected their research to lead to further research opportunities with 11 achieving this. Ten CIs achieved their expectation of providing information for policy making but only four reported their research had influenced policy making. However 11 CIs achieved their expectation of providing information for organizational decision making and eight reported their research had influenced organizational decision making.ConclusionCIs reported that nationally funded primary health care research projects made an impact on knowledge production, staff development and further research, areas within the realm of influence of the research team and within the scope of awareness of the CIs. Some also made an impact on policy and organizational decision-making, and on localized clinical practice and service delivery. CIs reported few broader economic benefits from their research. Routine use of an instrument of this type would facilitate primary health care research funders' determination of the payback for funding of research in this sector.