Initiatives in health are found to be unequally spread

The recent `Innovations in care for chronic health conditions’ report highlights the discrepancy in services available to people depending on where they live.

“There are many simple and inexpensive innovations that help people avoid hospital and enjoy a better quality of life,” says Productivity Commissioner, Stephen King.

“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 says.

The report highlights examples of services that successfully manage chronic health conditions.

They include initiatives that send friendly SMS reminders to people to monitor their symptoms and make healthy choices, and programs that rearrange health service workflows so they can offer better support.

“While the health system works well for most people, most of the time, its weaknesses are exposed when it comes to chronic health conditions,” says Productivity Commissioner Richard Spencer.

“For example, health services in one part of the country may not know what is happening in other areas, so great ideas are only partly adopted,” he says.

Half of all hospital admissions are related to chronic health conditions. One of the programs the report looked at lowered admissions by 25%, by keeping in touch with patients and helping them address problems before they needed hospitalisation.

With relatively small investments, such innovations could be expanded, benefitting more people. Governments have an appetite for change and are making progress but diffusion of new ideas could be much more effective.

“Health system reform is often slow and piecemeal. Our report provides examples of services that found ways to improve care within the system we have now – they offer valuable and practical lessons for other parts of the health system,” says Mr King.

“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”.

Key points:

  • Innovative approaches to managing chronic health conditions are present in all types of health services and in all jurisdictions.
    • These innovations improve people’s wellbeing and reduce the need for intensive forms of health care, such as hospital admissions. They achieve this 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 case studies of innovation included in this report show that there are practical ways to overcome long‑standing barriers to health reform. 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.
  • There are substantial barriers to the development and broader diffusion of healthcare innovations.
    • Innovation often relies on the commitment of dedicated individuals and the support of local health service executives. But unless there are strong incentives for change, entrenched organisational and clinical cultures tend to maintain the status quo.
    • Existing funding structures, which are largely based on the volume of healthcare services delivered, do not encourage investment in quality improvement. Some trials of innovative approaches are only funded for short periods, making it difficult to achieve outcomes and dampening the willingness of clinicians to participate.
    • There are few structured mechanisms to encourage the diffusion of innovation. Health services often try to solve problems that have been overcome in other places or other parts of the system.
  • Implementing innovative interventions on a larger scale depends on effective diffusion mechanisms and funding reform.
    • 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.
    • 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 Productivity Commission’s report on Innovations in care for chronic health conditions can be found at: https://www.pc.gov.au/chronic-care-innovations

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