On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding.

Consensus is growing that long-term care delivery, regulation, and financing are no longer viable, a concern that will grow more salient as the population ages. To better understand these prevailing challenges, the authors interviewed experts regarding the current state of long-term care in the United States, the attributes of an ideal long-term care system, and potential areas for reform. The findings highlight the problem of maintaining an adequate workforce despite changing demographics. They also identify commonly agreed upon attributes of an ideal system—person centered, professionally rewarding, integrated, affordable, accountable, community based, and consumer directed—in addition to less commonly identified attributes—supportive, comprehensive, dignified, culturally appropriate, innovative, responsible, and safe and secure. Areas for reform include workforce recruitment and retention, financing and insurance, quality improvement and regulation, health information technology, and organizational change and innovation. The challenges facing long-term care must be addressed by both government and private citizens alike if long-term care recipients' lives are to improve and the increased demand for services is to be met.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The aim of the study is to examine the feasibility of comparing hospitals internationally and to highlight some of the barriers. Design/methodology/approach -Comparative analysis of anonymised patient-level data from hospitals in New Zealand and the UK. Findings -Comparisons were made of aggregate statistics. For example, it was found that average length of stay and death rates in New Zealand were lower than in the UK, although average severity was higher. Adverse reactions were higher in the New Zealand sample than in that of the UK. Research limitations/implications -There were data limitations associated with different coding conventions in the two countries. There may also be different coding conventions used when classifying data. The research attempted to correct for this, but some may remain. Originality/value -There are few cross-national comparisons of hospital performance. This paper shows that such analysis is possible. It is hoped that further effort can be put into addressing some of the data issues described above to further refine the results.

Commissioning is set to become a stronger feature in the Australian health system as Primary Health Networks embrace it as a tool for improving population health outcomes. International experience shows that developing into a commissioning organisation is not always easy. Drawing on international experiences of commissioning, as well as those from the Australian hospital sector, will help smooth the path for Primary Health Networks.