The prevalence of chronic conditions and multimorbidity is increasing in Australia, with half of people aged 65 and over having two or more chronic conditions and almost one in three having at least one.
The most common chronic conditions found in Australia include high blood pressure, arthritis or other ongoing joint and back pain, mental and behavioural conditions such as depression or anxiety, breathing conditions and cardiovascular conditions.
Findings from the Organisation for Economic Co-operation and Development Patient-Reported Indicator Surveys initiative indicate Australia is managing chronic conditions well compared to other participating OECD countries, scoring highly in general health and physical health.
The inaugural PaRIS survey – conducted in 2023 – included 19 OECD countries, making it the first time there has been standardised data to conduct cross-country comparisons on how people engage with and are impacted by primary health care. It is also the first time the patient perspective has been included in an international survey.
Australia’s participation was implemented by the Australian Commission on Safety and Quality in Health Care with ORIMA Research on behalf of the Department of Health, Disability and Ageing.
Survey participants were aged over 45 and had a primary care consultation within the six months prior to participating.
Of the total 107,011 questionnaire participants and 1,816 general practitices, 2,392 were Australian patients and 54 were Australian GP practices.
The OECD released country notes in February and the Australian Commission on Safety and Quality in Health Care released its analysis of the findings in a localised report published this week.
Australia ranked in the top five for quality of care, coordination of care, person-centred care and physical health.
Dr Liz Marles (supplied by the Australian Commission on Safety and Quality in Health Care)
Overall, Australia is doing “extremely well,” said Associate Professor Liz Marles, the Australian Commission on Safety and Quality in Health Care’s clinical director and a practising GP. Australia’s results for person-centred care and quality of care are “very affirming,” she told Australian Ageing Agenda.
“It’s something that you feel intuitively. When you have a patient that you know and you understand their background and you know what sort of things might be happening in their lives and what sort of things they’ve had to deal with in the past, you don’t have to go over that information every time. But it’s all there, you can take it into account, and you can provide good, tailored advice and also much more effective diagnosis,” Dr Marles told AAA.
“There are a lot of reasons for why continuity of care works, and it’s really great to now have this evidence to demonstrate clearly that those people who have that ongoing doctor-patient relationship are actually having better patient experiences and outcomes.”
Room for improvement in mental health
Australia failed to reach the top 10 in patient-reported outcome measures for mental health – with 81 per cent reporting good or excellent mental health – but was close behind the OECD average of 83 per cent. Positive ratings for social functioning saw similar results, with Australia recording 80 per cent to the OECD’s average of 83 per cent.
“We have more work to do to improve our social functioning, mental health and wellbeing which are close to the OECD average, so we need to better support patients in their activities and responsibilities at home, work and in the community,” said Dr Marles.
She also acknowledged that patients from a regional or rural area and patients with lower levels of education and income reported having worse experiences and outcomes.
Specific chronic conditions like depression or anxiety, neurological conditions and chronic liver disease also reported higher rates of dissatisfaction with the primary healthcare experience.
Australia’s scorecard (source: Australian Commission on Safety and Quality in Health Care)
Dr Marles told AAA the survey insights are helpful at a policy level, to see how well Australia is performing and what elements work well. But the insights are also helpful for GPs and patients.
“For the GPs who participated, they got a report on their own patients and they were able to see how well they’re performing and what areas they could improve in. And for individual patients… we’ve got a lot of insights now into what parts of the system work well for them and what doesn’t work well and the groups we need to pay particular attention to in the future who may be missing out,” Dr Marles told AAA.
Retired 83-year-old senior public servant Nick van Weelden took part in the study to ensure the patient voice was heard.
From his time as a policymaker, Mr van Weelden said he knew that robust data was needed to make policy decisions based on factual data. The survey results will help policymakers understand what people need and where their focus should be for service delivery, he said.
While acknowledging the gaps for people with chronic disease living in rural and remote areas, Mr van Weelden said he saw his GP every six months for a check-up and was happy overall with the health services he used.
He is also proactive in self-managing his health. This includes going to the gym at his retirement living complex, doing weight training, regularly engaging in relaxation and meditation and teaching Tai-Chi to fellow residents. Mr van Weelden also follows a mostly Mediterranean diet, does puzzles every morning and maintains a strong social network.
Dr Marles added that chronic conditions don’t just impact the individual but also family members and involving those families and carers in the decisions resulted in better person-centred care outcomes.
“We want to make sure that we include all the people who may be involved in the care of a person.”
The full report can be accessed here.
The other countries included in the survey are:
Italy
Slovenia
Iceland
Switzerland
Portugal
Norway
Greece
Belgium
Romania
Canada
Spain
France
Luxembourg
The Netherlands
Czechia
Wales, United Kingdom
Saudi Arabia
United States of America
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