Australian Healthcare System: Improving Chronic Disease Prevention – Policy Review And Recommendations

Chronic Diseases in Australia

The Australian health care system is contributed by both the State and the federal government funding and is the solely responsible for the healthcare sector. Thus, making it difficult for the patients to navigate in between. Even though there are complexities, the universal healthcare system of Australia achieves a comparatively good result in an efficient way. As per the OECD average, the healthcare spending is Australia is about 8.8 percent of the GDP. The Life expectancy ranks sixth among all the OECD counties and it is 83 years. However, there are challenges in the rising chronic diseases and the Australian Healthcare system must act to improve through a balanced coordination with the patient care. There is a growing burden of rising from the chronic diseases (Oecd.org, 2018). The study will emphasize on the policy review related to the prevention of the chronic diseases and recommendations on the best option. This study will be aimed towards the governmental policy makers and the others that are willing to formulate and influence policy.

Chronic diseases have the persistent effects and long-lasting conditions. The economic and the social conditions have the consequences that can impact the quality of life of the patients. It is important to highlight that the chronic conditions are gaining priority in the healthcare sector and is a major priority for action. Australian Institute of Health and Welfare reported 8 major groups of chronic diseases and it includes the mental health conditions, diabetes, chronic obstructive pulmonary disease, cardiovascular disease, cancer, back pain, asthma and arthritis. The highlighting facts are as follows:

• In the year 2013-2014, 39 percent and above of the preventable diseases are due to the chronic diseases that are preventable.
• About 30 percent of the problems that are managed in the general practice in the year 2014-2015 is actually associated with the 8 chronic diseases.
• In the year 2014-2015, more than 11 million of the Australians (which is 50 percent of the Australians) have reported to be having 1 out of the 8 chronic diseases.
• The people that are aged 65 years (87%) and above have reported to be suffering from 1 out of the 8 chronic diseases in the year 2014-2015 in comparison to the 35 percent of the people that are aged between 0 to 44 years of age.
• 73 percent of the deaths that have occurred in the year 2013 is due to the 8 chronic diseases (aihw.gov.au, 2018).

Chronic disease conditions are the rising causes of death, disability and illness among the Australians. The main issue is that the chronic disease conditions and the causes of the diseases are the biggest challenges for the Australian healthcare system. Along with the aged population, the rising cost of treatments and pharmaceuticals from the rising chronic disease conditions have led to an unprecedented strain within the Australian Healthcare system (Health.gov.au, 2018a).

Framework: the framework used here is a Policy triangle analysis. The triangle is a simplified representation of the complex set of inter-relationships and the 4 factors are considered separately. The four major factors here are: context, process, content, and Actors (organizations, groups and individuals) (Buse, Mays & Walt, 2012).

• Actors- actors are the one that make and influence the policy. Similarly, the Australian Health department, Australian Government are the major actors here.
• Context- The contextual factors that affect the policy and such factors include the international, national, regional, local, social, economic and political factors that will affect the health policy. The several factors that have contributed to the rising conditions of the chronic disease are the feelings of disengagement, frustration and disempowerment; difficulties in accessing the services like the remoteness barriers, financial barriers, language barriers, transport and mobility barriers; low uptake of the digital health and other technology provided by the healthcare providers; delayed, absent and service duplication; uncoordinated care; and fragmented system with the services and providers working in isolation (Health.gov.au, 2018a).
• Process- It involves the processes that through which policies are framed. In order to prevent the chronic diseases like, Type 2 diabetes, lung disease, chronic kidney disease, stroke and heart failure and heart disease, the Australian government put forwards several strategies and policies that include the National Chronic Disease strategy (NCDS) (Wutzke et al., 2017).

Issues with the existing policy- The major problems identified with the National Chronic Disease strategy (NCDS) is the lacked the implementation plans, infrastructure commitments and the funding commitments. Whereas the other major items that lacked is the lack of partnerships among the governments, national alignment to the strategies, and proper leadership and coordination (Health.gov.au, 2018b).

Policy Triangle Analysis

The key stakeholders in the involved problem- patients and their care givers along with the family members, patients with the chronic conditions, community members, consumer representatives, industry, researchers, academics, health professionals, clinical experts. Non-governmental organizations, peak bodies, territory and state governments (Health.gov.au, 2018b).

An alternative policy option will be called National Strategic Framework for Chronic conditions. This policy will be based on the principles of equity, collaboration, partnerships, access to high standards of healthcare, evidence-based care, person centered approaches, sustainability of the strategic planning process, transparency and accountability regarding decisions and responsibilities, shared responsibilities among all the parties involved (Health.gov.au, 2018c).

Enablers: The role of the enablers is identified and it will assist in achieving the targets and the vision of the policy. The enablers will take necessary actions and steps towards the risk of development of chronic diseases. The enablers will comprise of resources, technology, research, health literacy, health workforce, governance and leadership.

Objectives: The three major objectives that are identified here are: 1) targeting the priority populations, 2) provide appropriate, effective and efficient care in order to support the people that are suffering from the chronic conditions and it will lead to optimize the quality of life, 3) focus on the prevention strategies that will lead to healthier Australia.

Strategic priority areas: The strategic priority areas identified for this policy are as follows:

Objective 1 will focus on the prevention of health risks and focus on healthier Australia.

• Appropriate detection and timely intervention plan
• Special emphasis on the life stages that are critical.
• Reduction of risks and promotion of the health (Health.gov.au, 2018c).

Objective 2 will focus on providing the appropriate, effective, efficient care to support people that are suffering from chronic conditions.

• Supportive systems
• Information sharing
• Health services made accessible
• Active engagement
• Continuity of care

Objective 3 will focus on the targeted populations

• Empowerment and speedy action
• Health of Aboriginal and Torres strait islander (Health.gov.au, 2018c)

• Health promotion in a coordinated and consistent way will positively make an impact on the behavioral choices.
• Targeted education and health messages so that the policy can meet the policy needs.
• The health workforce must be equipped adequately so that it can deliver the healthcare in a holistic way so that health risks can be managed and prevented in a chronic condition (Vogelmeier et al., 2017).
• For the effective preventive measures related to health, the researchers will play a major role in building the evidence.
• Partners must collaborate together to build on a common goal of creating a environment that will promote health.
• Clearer governance and clearer leadership will both be responsible and support the decision-making process that will be existing within the partners (Bauer et al., 2014).

The effectiveness of the policy will can be assessed by analyzing the following indicators:

• Reduction in the screening rates of the bowel, cervical and breast cancer.
• The eligible persons are receiving the counselling and drug therapy to prevent stroke and heart attacks.
• The rates of immunization will increase among the children.
• Reduced prevalence of the chronic respiratory diseases, diabetes, cancers, cardiovascular diseases by the age group (Ichiho & Aitaoto, 2013).
• People with the mental illness, diabetes and asthma are integrated with the care plan.
• Reduced mortality between the age group of 30 to 70 years from the chronic respiratory diseases, diabetes, cancer, and cardiovascular diseases.
• Reduced rates of alcohol related mortality and morbidity among the adults and the adolescents (Lim et al., 2012).

Conclusion

From the above discussion it can be concluded that the Chronic diseases have the persistent effects and long-lasting conditions. The economic and the social conditions have the consequences that can impact the quality of life of the patients. Australian Institute of Health and Welfare reported 8 major groups of chronic diseases and it includes the mental health conditions, diabetes, chronic obstructive pulmonary disease, cardiovascular disease, cancer, back pain, asthma and arthritis. The new policy will provide three major objectives that are identified here are targeting the priority populations; provide appropriate, effective and efficient care in order to support the people that are suffering from the chronic conditions and it will lead to optimize the quality of life; focus on the prevention strategies that will lead to healthier Australia.

References

aihw.gov.au (2018). Chronic disease Overview – Australian Institute of Health and Welfare. [online] Australian Institute of Health and Welfare. Available at:

Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. The Lancet, 384(9937), 45-52.

Buse, K., Mays, N., & Walt, G. (2012). Making health policy. McGraw-Hill Education (UK).

Health.gov.au. (2018a). Department of Health | National Strategic Framework for Chronic Conditions. Retrieved

Health.gov.au. (2018b). Department of Health | Historical documents. Retrieved from

Health.gov.au. (2018c). National Strategic Framework for Chronic Conditions. Retrieved from /National%20Strategic%20Framework%20for%20Chronic%20Conditions.pdf

Ichiho, H. M., & Aitaoto, N. (2013). Assessing the system of services for chronic diseases prevention and control in the US-affiliated Pacific Islands: Introduction and methods. Hawai’i Journal of Medicine & Public Health, 72(5 Suppl 1), 5.

Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., … & Aryee, M. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet, 380(9859), 2224-2260.

Oecd.org. (2018). OECD Health overview policy: Health policy in Australia. Retrieved from https://www.oecd.org/australia/Health-Policy-in-Australia-December-2015.pdf

Vogelmeier, C. F., Criner, G. J., Martinez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., … & Frith, P. (2017). Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. American journal of respiratory and critical care medicine, 195(5), 557-582.

Wutzke, S., Morrice, E., Benton, M., & Wilson, A. (2017). What will it take to improve prevention of chronic diseases in Australia? A case study of two national approaches. Australian Health Review, 41(2), 176-181.