Grattan Institute exposes avoidable hospital admissions

The Grattan Institute revealed that poor management of chronic disease costs more than $320 million a year 6 March 2016

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, according to a new Grattan Institute report.

Chronic failure in primary care finds that 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,’ says Grattan Health Program Fellow Hal Swerissen. ‘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 and environmental changes are the best way to prevent these diseases. But Chronic failure in primary care shows that outcomes are much better 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,’ says Professor Swerissen. ‘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 team care would help to focus care on patients and long-term outcomes.

Primary Health Networks should be given more responsibility for coordinating local primary care services, and in regional areas, clear targets and well-designed incentives for disease prevention are vital.

The evidence shows that a consistent approach to specific diseases also helps primary care more effectively prevent and manage chronic conditions.

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

Supporting the Grattan Institute, National Heart Foundation CEO, Professor Garry Jennings AO said today

"Heart disease is the single biggest killer of Australians, yet is largely preventable through simple lifestyle changes such as eating a balanced and healthy diet, not smoking, reducing alcohol, and being more physically active.

Everyone, not just doctors, have a responsibility for heart health, however it is concerning that relatively few GPs are routinely measuring blood pressure, cholesterol and weight in their patients, therefore contributing to the alarming rate of heart disease in Australia.

The Heart Foundation advises that all Australians aged over 45 or 35 for Aboriginal and Torres Strait Islanders ask their GP for an annual heart health check. The best test for cardiovascular disease is an absolute risk assessment – a simple, cheap and accurate way of grading your risk of having a heart attack over the next five years. This assessment looks at factors including blood pressure, cholesterol, weight, gender, family history, smoking status and age.

The Heart Foundation is calling on the Government to develop an ‘integrated health check’ that would be conducted by GPs and include screening for heart disease and stroke, type 2 diabetes and kidney disease. These diseases are often linked and will ensure people at risk of these chronic diseases are diagnosed early, and stay well and out of hospital."