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OECD Reviews of Health Care Quality: Australia 2015

Raising Standards

image of OECD Reviews of Health Care Quality: Australia 2015

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.

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The implementation of National Safety and Quality Standards in Australia's health system

This chapter reviews the recent implementation of the National Safety and Quality Health Service (NSQHS) Standards. The standards form the foundation of a nationally consistent accreditation system, building on a long-standing history of hospital accreditation administered at regional and local levels. The arrangements seek to improve co-ordination and reduce fragmentation and duplication of the standard setting and assessment functions across the health system. While the new system provides for greater feedback of performance for governments, further clarification of roles at different levels of government is still required to streamline hospital performance oversight processes. The standards have been well received across the system, with key stakeholders endorsing the consultative approach to their development, enhanced clinical relevance and alignment with existing national and regional programmes. Broader application of the standards beyond the acute hospital sector will require development of further guidance, along with careful consideration of existing accreditation arrangements in mental health and primary and community care. The standards address important but relatively uncontested safety issues. Follow through on the planned evaluation of the standards is important.

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