Australia’s health system is too complex for patients


16/11/2015 - Australia should improve the integration of care across the patient pathway to prepare for a rise in chronic disease and make the health system less complex for patients, according to a new OECD report.

The OECD Health Care Quality Review of Australia says the Australian health system is too complicated for patients to navigate, and this is amplified by a split in funding and responsibilities between the federal and state and territory governments.

However, with an ageing population and the anticipated rise in chronic disease, Australia needs to strengthen primary health care to better co-ordinate the care of patients. Poor co-ordination of care increases the risk of medical errors that are unacceptable to patients and costly for the health system.

Evidence of Australia’s need to strengthen primary health care can be seen from the hospitalisation rates for respiratory disease such as asthma and chronic obstructive pulmonary disease which are considerably higher than the OECD average.

One option to ease the fragmentation of the system is to devolve responsibility for delivering primary care to the states and territories, to better align it with hospital and community services. In turn, the federal government’s role in steering the health system should be enhanced.

Australia should also emphasise the role of general practitioners (GPs) as care co-ordinators for patients with chronic conditions, and promote a system that enables patients to receive care from a multidisciplinary team of health professionals.

Head of the OECD Health Division, Francesca Colombo, said adopting a national approach to quality and performance could ease some of the system’s complexity.

“This could include an enhanced federal government role in steering policy, funding, co-ordination and performance monitoring. The states and territories in turn could take on a strengthened role as health service providers, developing innovation responsive to local population need” she said.

Despite these challenges, Australia compares favourably to its OECD peers on many indicators of health. At 82.2 years, life expectancy is the sixth highest in the OECD. Australia has the fourth lowest smoking rate in the OECD of 12.8%, and the heart disease mortality rate is well below the OECD average. The country’s breast cancer five-year survival rate of 88% is behind that of only Sweden, the United States, Norway and Finland.

Australia achieves good health outcomes relatively efficiently, with health expenditure at 8.8% of GDP, about the same as the OECD average. However, Australia is the fifth most obese country in the OECD, with 28.3% of Australians aged 15 and over obese, considerably higher than the OECD average of 19%. To improve the quality of its health care system, Australia should also:

  • Build on the Practice Incentives Programme with a more robust blended payment system comprising more indicators of quality and outcomes, to provide GPs with financial incentives to improve the quality of care and patient outcomes;

  • Require GPs to begin reporting data on a wide range of indicators linked to quality and patient outcomes and publish more indicators of quality online, including hospital-level data for adverse events and the results of patient experience surveys for public and private hospitals; 

  • Expand the scope and alignment of the National Safety and Quality Health Service Standards not only in hospitals, but also across primary health care, long-term care and mental health services;

  • Improve the quality of rural and remote health care by extending Australia’s basic information set on health service needs, service use and outcomes to rural and remote settings.

Journalists can access the report’s main findings and recommendations as well as the full report here.

For further information please contact Ian Forde (tel + 33 1 45 24 81 24) or Francesca Colombo (tel + 33 1 45 24 93 60).

OECD Reviews of Health Care Quality examine what works and what doesn’t in countries, benchmarking their efforts and providing advice on reforms to improve quality of health care. The country reviews will be followed by a final summary report on the lessons and good practices relevant to all governments.

Working with over 100 countries, the OECD is a global policy forum that promotes policies to improve the economic and social well-being of people around the world.


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