It has become progressively apparent that in our current healthcare climate, that even first world status countries possessing equivalent status healthcare systems are under intense pressure to meet the changes in healthcare needs present as increased demand and healthcare cost, inequities, complex health conditions and a need to improve outcomes.
Despite being recognised as one of the best in the Organisation for Economic Co-operation and Development (OECD), the Australian healthcare system, much like other healthcare systems in many other industrialised countries, are facing the same challenges in dealing with the changing needs of patients, inefficacies and workforce shortages, greater expectation for transparency in reporting the availability of needed services, clinical indicators and patient-reported outcomes, and adopting new technological advancements to ensure informed and efficacious decision-making by patients and their carers.
Further to this, these complex and fragmented systems where funding and responsibilities are shared between federal, state and territory governments, as well as private health insurance often result in funding models and informational asymmetry between patients and health service providers which compound the difficulty in coordinating patient care.
As such, there has been a push for policymakers to address care coordination, patients’ needs, patients’ engagement in healthcare delivery and redesign funding mechanisms to more closely complement these goals.
In a recent population health study, which enrolled 10,186 participants into a preventative healthcare program, it was found that a primary care model based on an enhanced physician-patient relationship, focused on quality and personalized preventive care it was possible to achieve positive health care expenditure outcomes and improved health management within a 3-year time frame.
Using a multivariate model to control for demographics, socioeconomics, supply of health care services, and health status, it was determined that health care utilization and expenditure trends for the 10,186 individuals enrolled, compared to a randomly selected, matched non-enrolled control group, from the pre period prior to enrolment for a period of up to 3 years post enrolment, showed that enrolled individuals experienced reduced utilization of emergency room and urgent care services compared to non-enrolees. The program savings ranges indicated that, over time, increasing percentages of members achieved cost savings compared to non-enrolees. Older age groups were more likely to realize savings in the early years with preventive activities indicating condition management, and younger age groups were most likely to achieve savings by the third year after enrolment.