Healthcare system ‘complex and fragmented’: experts

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When compared with other countries, our healthcare system stacks up well in terms of access and affordability. But … many Australians find the system difficult to navigate, fragmented and complex.

Consumers Health Forum CEO Leanne Wells says patients who need to access multiple services find the system difficult to understand without expert help.

She was writing in the latest edition of the Australian medical e-journal Health Voices, which reviewed the concept of ‘patient navigation’.

Ms Wells says the difficulties are the result of the mix of state and federal funding, private health insurance and self-funded individuals. This creates a complex system that patients need to navigate to access their care and treatment, she says.

Read: Medicare fraud costing taxpayers $7 billion per year

According to Ms Wells, the ‘navigability’ of Australia’s health system does not stack up when measured against most other OECD countries.

“The healthcare system in Australia is more complicated and difficult to access than many other OECD countries with comparative development and standards of living,” she says. “With the focus on funding, and not outcomes, health consumers are not offered holistic care and services that best suit their needs.”

Writing in the same journal, health researchers Associate Professor Yvonne Zurynski, Dr Louise Ellis and Professor Jeffrey Braithwaite argue that the problem is not new, pointing out that in 2015 the OECD Health Care Quality Review of Australia concluded our “health system is too complex for patients”.

Read: Doctors seek halt to Medicare cuts that threaten telehealth

The reasons, they say, are fragmentation and poor coordination. They argue that our electronic health records, when available, are hosted on separate data platforms making information-sharing difficult.

Another issue, according to the trio, is that the Medicare rebate system de-incentivises long consultations with proportionately lower rebates for long consultations.

“Although the complexity of people’s medical problems and their multi-morbidities are increasing, the length of the average GP consultation has remained at approximately 15 minutes for over 20 years,” they write. “A quarter of an hour is often not enough to fully engage and understand patient needs and preferences, nor to establish shared care plans and coordinate interdisciplinary care.”

Read: Why isn’t dental included in Medicare?

They say the cost of healthcare is another associated issue. Although most people are confident of getting quality care if they become seriously ill, more than 40 per cent of people with chronic conditions surveyed in 2018 were not confident they could afford that care.

“Improving health system navigation, no matter how sophisticated, will mean little if people who need it most can’t afford to access it,” they say. “We urge Australian health consumers to continue their strong advocacy for a more integrated, affordable, accessible and equitable healthcare system.”

Ms Wells believes that getting consumers involved in the design of the nation’s health system is the key. “Overseas research continues to reinforce the idea that consumer co-design in health system design improves health outcomes and can reduce costs for government funders,” she says.

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