AMA Transcript - Chronic disease management – Grattan Institute Report

MICHAEL BRISSENDEN: Australia spends about a billion dollars a year managing chronic health conditions like diabetes and heart disease, but may not be getting the best bang for its buck.
That's the assessment of the Grattan Institute which says GPs aren't properly monitoring and treating chronic conditions.
The Institute is calling for a funding shake-up.

Lucy Carter reports.

LUCY CARTER: Chronic health issues like heart disease, asthma and diabetes are an enormous burden on the Australian health system.
The director of the Health Program at the Grattan Institute, Stephen Duckett, says doctors are spending significant amounts of government money but are treating chronic health conditions ineffectively.

STEPHEN DUCKETT: We analysed general practice records. Very rarely do proper measurements get recorded, and for those who have measurements recorded, the outcomes of achieving goals of care are weak.

LUCY CARTER: However, the Australian Medical Association's (AMA) Chair of the Council for General Practice Dr Brian Morton says the Grattan Institute's assessment is overly pessimistic.

BRIAN MORTON: Chronic disease management can be done better, there's no doubt about that. But the care that is given now actually is top of the OECD list if you actually look at the care for diabetes.

LUCY CARTER: Dr Stephen Duckett says the Grattan Institute is recommending a major change to GP funding that would see doctors rewarded financially for meeting disease management targets rather than just for seeing patients.

STEPHEN DUCKETT: The Government spends about a billion dollars a year through general practice. 

We're saying that the same amount of money should flow into general practice, but the basis of the flow should change, so that rather than getting a particular payment for every item of care, they get an annual payment of roughly $40,000 on average, and that they get it for achieving particular targets, better measurements, better outcomes. 

LUCY CARTER: The AMA's Dr Brian Morton wouldn't support or condemn this proposal.

BRIAN MORTON: I think we need to risk stratify patients, we need to change funding where it's appropriate, and we need to test and pilot the schemes before we actually institute them.

It would bankrupt the country to apply funding models where the care is not needed. We need to target patients and apply appropriate funding for the major chronic and complex patients.
I think the collection of data is crucial. The Grattan Institute report actually acknowledges that there is very little data in the primary care space.
There is very little data as to what actually works in Australia in the primary care space. Yes, we need data, and we need to collect it. And we need not to use it in a punitive way but apply it in a way, to improve health delivery.

MICHAEL BRISSENDEN: The AMA's Dr Brian Morton ending that report from Lucy Carter.

7 March 2016

CONTACT: John Flannery                            02 6270 5477 / 0419 494 761

                     Kirsty Waterford                       02 6270 5464 / 0427 209 753

Follow the AMA Media on Twitter: http://twitter.com/ama_media
Follow the AMA President on Twitter: http://twitter.com/amapresident
Follow Australian Medicine on Twitter:  https://twitter.com/amaausmed
Like the AMA on Facebook https://www.facebook.com/AustralianMedicalAssociation