Report reveals glaring holes in Australia’s health system

Report reveals that Australia’s health system works well for those who are well.

Report reveals glaring holes in Australia’s health system

Australia’ healthcare system is working well for those who are well, but has a long way to go to catch up to the changing needs of everyday Australians, says a new report.

The Australian Institute of Health and Welfare (AIHW) report found that the majority of patients are receiving enough information about their healthcare and have well-informed providers. However, those who need it most are the ones who experience the greatest barriers to coordinated care, said Consumers Health Forum (CHF) chief Leanne Wells.

“With almost half of the Australian population now living with chronic disease, it’s time for our health system to catch up with the way our healthcare needs are changing,” said Ms Wells.

“The AIHW report finds that of patients who rated their health as poor, one in five reported not receiving enough information about their care and treatment, compared to one in 25 who rate their health as excellent.

"Consumers with poor self-assessed health status are more likely to need coordinated care across multiple health providers and are most likely to experience poor outcomes when information is not properly shared.

“If you are well, then the system works as it should, but for those with multiple chronic or complex conditions, it is harder to get the care needed in a coordinated way,” said Ms Wells.

The report shows that language and distance are additional barriers to ensuring consumers experience coordinated care and are given the information they need to manage their condition.

“The report highlights the intractable problems that emerge when people move between care systems,” said Ms Wells. “Almost one in four patients who visited a hospital emergency department reported that there was inadequate sharing of information back to their usual GP or place of care.

“Of patients who were admitted to hospital, 14 per cent reported that their usual GP or place of care was not informed of their follow-up needs, and for those who required services after their hospital admission, one in five reported that arrangements were not made by the hospital.

“For the most part, Australian have access to high-quality healthcare services, although the further you are from a major centre the less this is the case. The issue we have is that services are clearly not as linked up and person-centred as they should be.”

Transitions of care, poor discharge planning and medication misadventure were just some of the shortfalls exposed by the report, which coincides with a special four-part series, Health Divide, on the ABC’s 7.30.

“We know from our own recent CHF research of Australians with two or more chronic conditions that those with higher levels of activation – knowledge, skills and confidence to manage their own health – have higher self-reported outcomes and experiences in the healthcare system,” said Ms Wells.

“The key enablers to ensuring patients can achieve better outcomes include timely health information and, for those with complex needs, assistance to navigate available services.

“Health is more than hospitals and access to medicines and current Medicare arrangements are rapidly becoming outmoded. We need additional investment in fit-for-purpose primary care arrangements that take an integrated approach to care and prevention of chronic illness.”

To fix these issues, CHF proposes a person-centred system with new and different models of funding and delivering coordinated care. This would include digital innovations that support patients to actively manage their health.

"We need to tip the scales to a greater focus on prevention and early intervention in primary care. By supporting consumers to self-manage their own healthcare, we can reduce pressure on primary care, reduce avoidable hospitalisations and, most importantly, improve health and wellbeing outcomes for the community," said Ms Wells.

How was your last experience with the healthcare system? Were you satisfied with the outcome? Do you feel you could have been given more information to reduce your reliance on health professionals?

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    8th Jul 2019
    Just when much greater resources need to be ploughed into health care, the federal government, on behalf of the top end of town, has given up billions of dollars in revenue through tax cuts. So many Australians, and not just the elderly, are living lives of quiet desperation with complex illnesses. The coordination of different caregivers is poorly done. More people are fleeing private care and straining the grossly underfunded public hospitals. GPs are not remunerated enough and in many vases are not present in sufficient numbers to give the time required to manage complicated patients. There is no national strategic plan addressing how health care will be delivered in future years: an absolute disgrace.
    9th Jul 2019
    I agree that the federal government, on behalf of the top end of town, has given up billions of dollars in revenue through tax cuts - when there are so many other priorities, including healthcare, where money should have been directed. However, I hope you noted that Labor also did not try hard enough to stop it, and also DID NOT promise to reverse the 3rd stage tax cuts which they "claimed" that they were against (as every greedy MP will get the $11,640 tax cuts - was too hard to pass up!).

    In fact, the first thing should have been to reverse the nasty 2017 Asset Test changes for Age Pensions given that they were done on the excuse of a Budget Emergency - which never existed and now is again proved to be a lie as they have excess money (surpluses) to hand out as tax cuts (noting I am only against the 3rd stage tax cuts from 2024 which will give those on $200K+ $11,640 tax cuts).

    8th Jul 2019
    DUHHH! Just telling us something we know and have experienced for years!
    8th Jul 2019
    I do agree with the article that we need preventative measures and early intervention in primary care.

    Since I have retired since 2002, I have started a regime of exercise and dietary requirements to reduce my weight, my blood pressure, and my thalassemia condition. With an empty nester, looking after myself on my own has been very difficult in the first ten years. Luckily I found my current partner, who is a fit athlete. I was given a proper induction to take care of my welbeing through a proper exercise routine and a regular diet with the near elimination of red meat and comfort food. I reduced my weight by 9 kilos in the first year.

    Since 2016 I had nine operations for my appendicitis and aneurysms. During my stay in the hospital, I contracted two types of staphs, because of which I had a blood clot in my left leg. I couldn't walk and I lost a lot of weight due to loss of appetite. My doctor and nurse told me, if I wasn't so fit in the first place, I wouldn't survive my health battle in the last three years. I have continued with my daily routine of gym exercise, walking, and swimming. However, I wish there are care programs to manage my life after surgery.

    This scenario is repeated when my partner was declared with cancer on the upper arm muscle, which was skillfully removed by the surgeon. My partner was told that the surrounding muscles were so dense due to constant exercise, cancer couldn't metastasize to the lymph gland. My partner hasn't stopped exercising every day since.

    I come to the conclusion if we look after ourselves, physically, mentally, and maybe spiritually, our health and well being will not only give us a happier lifestyle but will also save the government a lot for our healthcare. This may be an answer for the health insurance industry at their current crisises.
    9th Jul 2019
    Well done for taking your health in to your own hands, we all have to take more responsibility for our health by preventative measures as you mention. Unfortunately there are many that just don't get the connection of the poison that is being sold as "food" in supermarkets and lack of exercise to the increase of obesity and chronic health problems.
    8th Jul 2019
    I waited almost two years for foot surgery. The surgery was good, but the assistance on leaving hospital was almost nonexistent. As I live alone, I had tried to organise help at home before I went in, but was unable to do so, being told that the hospital would organise it post surgery. At 75, having had bone surgery on both feet, I went home almost unable to walk, the only assistance was someone to help me shower 3 x weekly. No help with household duties, shopping, transport etc, I organised Meals on Wheels for myself or I would have starved. The system is broken, and complicated to organise any assistance. No doubt if I were a private patient everything would have been laid on. Not good enough
    8th Jul 2019
    My care was first rate but that was due to having private h health insurance. The care was good. My Health Care Fund gave me private nursing for a week and physiotherapy for 8 days. I do need see a heart specialist but have elected to see a public one due to the fact that they attend my local hospital which is a long wait Doctors do need to gibe patients with complex health issues extra time which does not happen and should.
    8th Jul 2019
    Health system overloaded with patients.

    Hospitals not able to stick to schedules, chopping and changing all the time.

    Training hospitals too busy for training.

    New emergencies impact on regular services, as emergency department doesn't appear to have its own doctors and equipment
    9th Jul 2019
    There has been many efforts to educate people on preventative measures to keep good health but as long as they are tempted by advertising, what crap is sold in the supermarket and too much entertainment that involves sitting around the health system will become more overloaded. More money has to be spent in preventative measures and more access to fresh wholefoods for those in low income brackets at prices they can afford.
    9th Jul 2019
    This reminds me of an old episode of 'Yes Prime Minister'... when they gloated about how well their brand new hospital was operating. But needless to say that was BEFORE they admitted any patients !

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