GP and patient

Rising tide of chronic disease swamps GP services

1 September 2016

New research by the University of Sydney's BEACH research program reveals an increasing load on GP-delivered services as they respond to a rising tide of chronic disease in ageing Australia.

Amid the ongoing freeze to Medicare payments for GP services, two new reports reveal that GPs managed 67 million more problems at patient encounters in 2015–16 than they did in 2006–07.

Compared to 2006-07, GPs provided:

  • 31 million more prescriptions
  • 25 million more clinical treatments (eg,  advice and counselling)
  • 10 million more procedures
  • 5 million more referrals to medical specialists
  • 5 million more to allied health services
  • 24 million more pathology tests/test battery orders
  • 6 million more imaging tests

The federal government’s Health Care Homes initiative proposes targeting people with two or more diagnosed chronic conditions to improve the coordination of health care.

To date, most discussion has centred on the care of older people aged 65 plus with complex chronic health issues. However, the new BEACH reports suggest a need to focus on middle-aged Australians as well.

In 2015-16, middle-aged people aged 45-64 years had many more tests, referrals, medications and GP encounters than the average person. Specifically, they had:

  • 9 per cent more encounters with GPs
  • 14 per cent more clinical face-to-face time with GPs
  • 16 per cent more problems managed
  • 16 per cent more medications
  • 31 per cent more tests ordered
  • 20 per cent more referrals

“The reports indicate that the 1.2 million middle-age Australians aged 45 to 64 who have three or more chronic conditions could benefit from the government’s proposed ‘Health Care Home’ environment,” said Professor Helena Britt, lead investigator of the two reports.

The reports reveal that 60 per cent of middle-age Australians (about 3.5 million) have at least one diagnosed chronic condition, 37 per cent have two (about 2.2 million), and one-in-five (about 1.2 million) have three or more chronic conditions.

A comparison of middle-aged (45-64 years) and older Australians (65 years plus) reveals 300,000 more middle aged people (3.54 million) have one or more diagnosed chronic conditions compared to older people (3.24 million).

Since people with diagnosed chronic conditions visit healthcare providers more often than an average person, the findings have implications for future rates of consultation to GPs, specialists and allied health professionals – and associated costs to Medicare.

However, this extra spending should improve patients’ overall health and potentially reduce avoidable hospitalisations, which incur much bigger costs than the extra care provided in general practice.

Access the new BEACH reports here.

Dan Gaffney

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