AUSTRALIA’S doctors have been given a fail mark by a new review which finds they aren’t measuring patient’s blood sugar, blood pressure, weight or cholesterol.
This is despite them being given more than $1 billion a year in payments to write and manage chronic disease plans and carry out health assessments.
And their failure to deliver clinical best practice is the reason there are $2 billion worth of avoidable admissions to hospital each year.
A Grattan Institute review of chronic illness is calling for an overhaul of general practice that would see doctors’ Medicare rebate income frozen.
Instead, they would be given a $40,000 a year incentive only if they met disease management targets.
The review found just 15 per cent of diabetes patients had their blood glucose, weight and blood pressure measured by their doctor each year.
Only 30 per cent of patients attending GPs had their cholesterol adequately managed even though 40,000 people die from heart disease each year.
Less than 20 per cent of people with high cholesterol who see a general practitioner reached recommended cholesterol levels.
Less than 30 per cent with high blood pressure who saw a GP had it adequately controlled.
Less than a third of those with mental illness received some form of intervention.
The Grattan Institute analysis of 11,103 patients with asthma found only 4.1 per cent had spirometry measures testing how well they could breathe.
The institute looked at 2013-2014 data from 162 general practices using the Medical Director patient management system.
They analysed outcomes for treatment of diabetes, asthma, Chronic Obstructive Pulmonary Disease (COPD) and hypertension.
Review author Hal Swerissen says the problem is our Medicare system was designed to pay for acute episodes of care rather than continuing chronic illness.
Three quarters of people over the age of 65 now have one or more chronic diseases and 90 per cent of Australians die from chronic disease.
Mr Swerissen says the government should look at permanently freezing the Medicare rebate at current levels and instead pay doctors lump sum incentive payments if they meet test targets, improve patient health and keep them out of hospital.
“In 2013-14 the Commonwealth spent about $1 billion on managing chronic disease through the Practice Incentives Program, Service Incentive Payments, Health Assessments and chronic disease and mental health management,” the report says.
“These payments could be combined into an annual practice payment to encourage high quality of care for people with chronic disease. This would give practices much greater flexibility in the way they provide care and support for these people.,” the report says.
Annual practice payments could be made for the number of patients with an agreed set of chronic and mental health conditions registered at an accredited practice where they normally get their care.