A large, international patient survey puts Australia near the top of the pile for chronic healthcare, largely thanks to general practice.
Medicare may not be perfect, but new data shows that Australia outstrips similar high-income countries when it comes to patient-reported quality of care, coordination of care and person-centred care.
The inaugural report from the OECD Patient-Reported Indicator Surveys (PaRIS) initiative, which was released on Thursday, collected data from roughly 107,000 patients at 1800 GP clinics in 19 countries.
In Australia, 2392 patients from 54 GP clinics participated in the 2023 survey.
All patients were aged 45 years or older.
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Across 10 measures, Australia ranked in the top five countries for four – coordination of care, person-centred care, quality of care and physical health – and in the top 10 for another three – confidence to self-manage, trust in the health system and general health.
It came in at 11, 12 and 13 for wellbeing, social functioning and mental health, respectively.
GP and Australian Commission on Safety and Quality in Health Care clinical director Associate Professor Liz Marles said that, overall, the findings spoke to the importance of a trusted, long-standing relationship between patients and GPs.
Of the Australian respondents, 97% of people who had a regular GP rated their care positively, while just 79% of people who did not have a regular GP rated their care positively.
Longer GP-patient relationships also translated to higher levels of trust and improved quality of care.
RACGP president Dr Michael Wright said the data would come as no surprise to GPs.
“What this data shows, and what the college has been saying for a long time, is that there’s no substitute for the care that you get from a GP who knows you, and it’s important that we avoid changes that might fragment care or reduce patients’ ability to get that care from their trusted GP when they need it,” he said.
“We know that long-term GP care is the most efficient use of funding in our health system, and these results show that it also gives the best patient satisfaction.”
Dr Wright called for more Medicare support for longitudinal GP care.
“We’ve been calling for investment in Medicare that supports the kind of care patients with chronic conditions need, particularly the longer consultations that are vital for managing these chronic conditions well,” he said.
“A growing share of our patients depend on support from their GP for mental health care, an area which this report found Australia underperformed in compared to other countries.”
Patient ratings of care improved when their GP provided a tailored care plan, discussed a patient’s specific health goals, provided written care instructions, involved carers and family and recorded self-management goals in medical records.
“Interestingly, GP practices reported they were using care plans for around 50% of all patients with chronic conditions, while only 25-35% of patients reported they had a care plan,” the report said.
Other specific findings included that patients who had multiple chronic conditions rated their care coordination higher but were less confident in managing their own care and trusted the health system less.
The patients who were more likely to have a better subjective experience of chronic disease management were aged 65 or older and located in more metropolitan areas.
The patients who were more likely to have better outcomes had fewer than three chronic conditions, were aged 65 or older, had higher education levels and higher income levels.
Meanwhile, patients with chronic liver disease, neurological conditions and depression and anxiety were more likely to report less favourable experiences across several measures.
On mental health, where Australia ranked 13 out of 19 countries, patients 65 and older were more likely than younger patients to rate their mental health as good.
People were also more likely to rate their mental health as good when they experienced positive coordination of care.
The full PaRIS report covering all 19 countries was released in February of this year.
Across all OECD countries, the most common chronic conditions were high blood pressure, arthritis and joint health, cardiovascular conditions and diabetes.
Compared to the other countries, Australia had slightly higher levels of mental health conditions and breathing conditions, and lower levels of diabetes.
In terms of patient outcomes, the highest-performing countries were Switzerland, the US and Canada.
In terms of patient experiences, though, Australia, Belgium, Switzerland and the US all consistently scored above the OECD average.
