Chronic failure in primary care

by Hal Swerissen and Stephen Duckett

Ineffective management of heart disease, asthma, diabetes and other chronic diseases costs the Australian health system more than $320 million each year in avoidable hospital admissions.

At best, our primary care system provides only half the recommended care for many chronic conditions. Only a quarter of the nearly one million Australians diagnosed with type 2 diabetes get the monitoring and treatment recommended for their condition.

Each year there are more than a quarter of a million admissions to hospital for health problems that potentially could have been prevented. Yet each year the government spends at least $1 billion on planning, coordinating and reviewing chronic disease management and encouraging good practice in primary care.

Three quarters of Australians over the age of 65 have at least one chronic condition that puts them at risk of serious complications and premature death. Social, economic and environmental changes are the best way to prevent these diseases. But there are much better outcomes where good quality primary care services are in place.

Our primary care system is not working anywhere near as well as it should because the way we pay for and organise services goes against what we know works.

The role of GPs is vital, but the focus must move away from fee-for-service payments for one-off visits. A broader payment for integrated treatment would help to focus care on patients and long-term outcomes.

Primary Health Networks should be given more responsibility for local primary care services. The evidence shows that a consistent, coordinated approach to specific diseases helps primary care more effectively prevent and manage chronic conditions. In regional areas, clear targets and well-designed incentives for disease prevention are vital.

Simple reforms can reduce the burden on Australian hospitals, and make patients healthier for longer.

Read the media release

Download Report