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Nation’s cut-price health system ‘performs well’: OECD

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Australia’s health system has been given a big tick by the Organisation for Economic Co-operation and Development for delivering world-class life expectancy and cancer survival rates despite below-average funding.

In its latest Health at a Glance report, the OECD reported that Australia’s average life expectancy of 82.2 years was the sixth highest among the world’s richest countries, and its record on breast and colorectal cancer survival was “among the best”.

Significantly, given the Federal Government’s claims of unsustainable growth in health spending, the Organisation reported that Australia’s expenditure was 8.8 per cent of gross domestic product, below the OECD average of 8.9 per cent.

“Australia performs well in terms of overall population health status,” the OECD said. “[It] achieves good outcomes relatively efficiently.”

But, echoing AMA arguments for increased investment in general practice, the Organisation said the country could cost-effectively achieve even better outcomes if it cut down on the number of patients with chronic health problems who end up in hospital.

It found that Australia had among the highest rates of avoidable hospitalisations for patients with asthma and chronic obstructive pulmonary disease among its member countries, and recommended a greater emphasis on treatment by family doctors.

“Effective treatment for these conditions can be delivered at a primary care level, negating the need for hospital admissions that are not in the best interests of patients, and are more costly for the health system,” the OECD said. “A well-organised primary health care system emphasises health promotion and prevention, and educating patients about self-management of chronic disease.”

Its comments are in line with AMA calls for greater support for GPs in managing patients with chronic conditions and providing health promotion and preventive care, and came a day after the release of a major report showing there has been a blow-out in the demands faced by GPs from an aging population with increasingly complex health needs.

The Bettering the Evaluation and Care of Health (BEACH) report from Sydney University’s Family Medicine Research Centre found that older patients were seeing their GP more often, and with a wider array of health problems.

Because of this, doctors are having to spend more time with each patient – on average, a little less than 15 minutes – heightening the financial strain caused by the increasingly inadequate Medicare rebate, which has been frozen by the Federal Government until mid-2018.

The BEACH researchers said GPs were playing a crucial ‘gatekeeper’ role in preventing duplication and ensuring the coordination and continuity of care patients receive from hospitals, specialists, allied health professionals and other providers, and recommended greater support for them in carrying out the role.

With the incidence of patients with multiple complex and chronic health complaints set to increase as the population ages, AMA President Professor Brian Olwer said the Government needed to lift its investment in general practice.

Out-of-pocket costs among highest

AMA concerns that the Government is increasingly abrogating its health responsibilities and dumping more of the cost of care on to patients, the OECD found that Australians face above average out-of-pocket costs.

It reported that 20 per cent of health spending comes directly from the pockets of patients – much more than is faced by patients in other countries with Government-funded health systems like the United Kingdom, Canada and New Zealand – and jumped by 1 percentage point between 2008 and 2012.

The OECD warned that in such an environment, there was a heightened risk that increasing the barriers to access to care could “unduly affect” the sickest and most vulnerable.

In conclusions that that endorse the AMA’s successful campaign last year and early this year against Coalition Government proposals for an up-front patient charge to see their GP, the OECD said that “co-payments remain a blunt policy instrument that can have many unintended consequences, particularly when the prevailing economic conditions are simultaneously reducing incomes for many citizens”.

“The risk remains that citizens forego needed care that can have long-term adverse health outcomes,” it said.

“Given the current level of out-of-pocket payments in Australia, there is a need to ensure that policy options aimed at improving the appropriate use of care do not unduly affect the most vulnerable, and the overall burden of out-of-pocket payment I the community more generally.”

The OECD report can be viewed at: http://www.oecd.org/health/health-at-a-glance-19991312.htm

An interactive chart comparing Australian and OECD helath spending can be viewed at the folling link: 

Adrian Rollins