Glaring holes in the 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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Written by Leon Della Bosca

Leon Della Bosca has worked in publishing and media in one form or another for around 25 years. He's a voracious reader, word spinner and art, writing, design, painting, drawing, travel and photography enthusiast. You'll often find him roaming through galleries or exploring the streets of his beloved Melbourne and surrounding suburbs, sketchpad or notebook in hand, smiling.
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