There are a number of innovations that policymakers can implement to support the wellbeing of people living with chronic health conditions, improve the healthcare system, and reduce hospital use, according to the Productivity Commission.
The commission’s new productivity reform case study, released on Wednesday, outlines initiatives that could prevent people’s chronic health conditions from deteriorating, or improve their management.
The innovations could provide major benefits through improved responsiveness to consumer preferences, greater recognition of the skills of health professionals, effective collaborative practices, better use of data for decision making by clinicians and governments, and new funding models that create incentives for better management or prevention of disease, the report said.
“They enable quality care for people with chronic health conditions and are backed by evidence of better outcomes and greater efficiency. Implementing them more widely, with adaptation to local needs where required, would deliver benefits to consumers, practitioners and governments,” it said.
Nearly 10 million Australians currently live with chronic health conditions, yet successful innovative programs in healthcare only benefit a small fraction, according to productivity commissioner Stephen King.
“There are many simple and inexpensive innovations that help people avoid hospital and enjoy a better quality of life. But these innovations are localised — limited to one state or even one town. People only get access if they live in the right place,” he said in a statement.
The new PC report offers examples of services and initiatives that successfully manage chronic health conditions, such as SMS reminders that prompt people to monitor their symptoms, and programs that rearrange health service workflows so they can offer better support.
One program the report looked at lowered hospital admissions by 25% by keeping in touch with patients and helping them address problems before they needed hospitalisation.
There are “substantial” barriers to the development and broader diffusion of healthcare innovations, the report said. For example, the current design and allocation of health funding is “problematic”, and weakens incentives for interventions in primary care that improve chronic disease management and avoid hospital use.
“The commonwealth-state funding divide — whereby the Australian government is broadly responsible for primary care and both the Australian and the state and territory governments fund hospitals — can reduce the attractiveness of investments in primary care where the benefits are primarily realised as reductions in hospital costs,” the report said.
The PC noted that effective diffusion mechanisms and funding reform would be needed to implement innovative interventions on a larger scale.
“There are existing institutions in the health system that could contribute to the diffusion of evidence on quality improvement and support better care for people with chronic conditions,” it said.
“Trials of blended payment models and pooled funding — supported by data and models that ensure interventions assist the people who face the highest risks of avoidable hospitalisation — offer a path towards funding reform.”
The report has argued that there are mutual benefits from funding reforms, and so “the costs should be borne by both levels of government”.
Innovations could be expanded with relatively small investments, the report said. King noted that while health system reform is often “slow and piecemeal”, the PC has given examples of services that have improved care within the current system.
“If all of the good ideas identified by the report — and some of them were breathtakingly simple — were adopted across Australia, they could benefit millions of Australians,” he said.
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