An inaugural report for Australia that compares health data from 107,000 patients with chronic conditions and 1800 practices across 19 countries has shown Australian GPs are performing well in keeping patients healthy, but comes with a warning according to the Royal Australian College of GPs (RACGP).
The Patient-Reported Indicator Surveys (PaRIS) by the Organization for Economic Co-operation and Development (OECD) compares patient-reported experience and outcomes for chronic disease between 19 of the 38 OECD countries.
The Australian report, from the Australian Commission on Safety and Quality in Health Care, found GP–patient relationships were key to several important outcomes for patients with chronic conditions:
- 97% of patients who saw the same GP over three–five years rated their healthcare positively, compared to 79% among patients who do not have a usual GP
- 80% of patients who saw the same GP for more than one year reported positive experiences of coordination of care (whether their healthcare was coordinated and organised to work for them), compared to only 29% among patients without a usual GP
- 62% of patients who saw the same GP for most of their healthcare needs said they trust the healthcare system, compared to 43% of patients who did not
- 95% of patients who saw their GP for more than a year rated their care as good to excellent and 87% said they trust their GP.
Around 61% of Australians live with at least one chronic health condition. Chronic conditions are more common as people age, ranging from 28% for children aged 14 and under to 94% for people aged 85 and over.
RACGP President Dr Michael Wright said while the report reinforces what GPs and patients who see the same GP generally know, it's strong evidence for investment to ensure all Australians can see a GP who knows them.
"Patients living with chronic conditions, like all patients, get the best care from a GP who knows them and their medical history" he said.
"Around three in five Australians now live with at least one chronic condition, whether that be high blood pressure, back or joint pain, or mental health conditions like depression and anxiety.
"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.
"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.
"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.
"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.
"GPs are the experts in providing long-term, whole-person, safe, and comprehensive care, and we need to make sure that that's supported by our health system."
Patients with lower levels of income reported both worse experiences and worse outcomes, as did those living in regional or remote areas compared to patients in cities.
"It's critical that the care a specialist GP provides is both affordable and accessible for everyone, no matter where they live," Dr Wright said.
"It's concerning to see, once again, those outside major cities experiencing worse health outcomes.
"In rural and remote Australia, GPs are often the only medical specialist in or near your town. It's vital rural patients are supported to see them, and rural general practices are sustainable and can attract the GPs their communities need."
Overall, the length of a GP–patient relationship and the frequency of consults correlated with positive experiences of coordination of care.
Dr Wright said the lesson is clear.
"What we know works is exactly what patients are calling for – a system that supports them to see a GP who knows them, when they need to and without cost being a burden," he said.
"That's the heart of what we call continuity of care. Having care that's well-coordinated between everyone treating you. That means we need more GPs, and for Medicare to fund the kind of care patients need.
"Keeping people well reduces the strain on our hospitals systems, and more importantly, allows our patients to live long, happy, and healthy lives."
