OECD Reviews of Health Care Quality: Australia 2015

Raising Standards

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Australia’s health system functions remarkably well, despite operating under a complex set of institutions that make coordinating patient care difficult. Complications arising from a split in federal and state government funding and responsibilities are central to these challenges. This fragmented health care system can disrupt the continuity of patient care, lead to a duplication of services and leave gaps in care provision. Supervision of these health services by different levels of government can manifest in avoidable impediments such as the poor transfer of health information, and pose difficulties for patients navigating the health system. Adding to the Australian system’s complexity is a mix of services delivered through both the public and private sectors. To ease health system fragmentation and promote more integrated services, Australia should adopt a national approach to quality and performance through an enhanced federal government role in steering policy, funding and priority setting. The states, in turn, should take on a strengthened role as health service providers, with responsibility for primary care devolved to the states to better align it with hospital services and community care. A more strategic role for the centre should also leave room for the strategic development of health services at the regional level, encouraging innovation that is responsive to local population need, particularly in rural and remote areas.



Strengthening primary health care in Australia

Australia has a fragmented set of primary and community health services that can be difficult for patients to navigate. Attempts at planning across governments and facilities are limited, making it difficult to design robust patient pathways from primary care to hospital, and back into the community. As the evidence suggests that the number of people suffering from one or more chronic diseases will increase, it will be critical for primary health care services to adapt to models of health care delivery that require co-ordination across several health professionals. Alongside this, efforts to improve the ability of patients to be more proactive about managing their health and avoiding serious health conditions could be implemented. To achieve such a transformation to higher quality primary health care services, reform will be needed to the blunt mechanisms by which doctors are paid today. Accompanying this ought to be the collection of wellselected data that allows general practitioners to be benchmarked against their peers, to assess the quality of the services they provide.


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