Health care quality & performance

The Coordination of Health Care Study was developed by the AIHW to fill a national data gap and provide information on patients’ experiences of coordination of care across Australia.

What is coordination of health care?

Health systems can be difficult to navigate, especially for people with multiple conditions or complex, long-term health care needs. Coordinating health care so relevant information is transferred between providers (for example, a GP and a specialist) and settings (for example, emergency department and primary health care) is crucial if a patient is to receive consistent, cohesive care. The goal of coordinated care is to ensure that all providers and organisations involved in a patient’s care have the information they need to provide the right type of care, at the right time. This is achieved through establishing cooperative, ongoing relationships between a patient and their health care providers.

The following reports were released as part of this study:

What does the Coordination of Health Care Study involve?

The study focuses on patients’ experiences with health care providers. Measuring coordination of care from a patient’s perspective is a crucial step in identifying common themes, areas for improvement and monitoring the impact of change. Patients’ experiences also provide insights for the development of new health care performance indicators.

The study was designed so that coordination of health care can be explored nationally, and at smaller geographic areas, including Primary Health Network (PHN) areas. The study has 2 components:

1. The 2016 Survey of Health Care, which sampled people aged 45 and over who saw a GP in the previous 12 months
2. Looking at participants’ responses and their use of health services and pharmaceuticals 12–24 months before and after the survey (through data linkage), drawn from Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and hospital records.  

The study design was approved by an independent Human Research Ethics Committee.

2016 Survey of Health Care

The study started with the 2016 Survey of Health Care. The survey was conducted by the Australian Bureau of Statistics (ABS) between April and June 2016.

Participants gave information about their:

• health
• health service use
• experiences with access
• continuity and coordination of care, and
• demographic characteristics.

The survey is the first in Australia to record whether people had a usual GP or usual place of care, as well as their experiences with:

• information sharing between their usual GP/usual place of care and other health care providers they may have seen
• health professionals for their physical health
• health professionals for their emotional and psychological health.

The survey was designed to provide robust samples from each of the 31 PHN areas in Australia, being sent to almost 125,000 people across metropolitan, rural, regional and remote locations—about 3,500 people in each PHN area. 

The survey sampled people aged 45 and over who had at least one GP visit in a 1-year period (November 2014 to November 2015).

Half of the people who were sent surveys had seen a GP 12 or more times in that year. This group was a specific focus for the survey, as they are more likely to have complex and chronic conditions, and to have experiences with multiple health care providers, including hospitals, specialists and allied health professionals.

More than 35,000 survey responses were received (a 29% response rate), allowing results to be reported for all of the PHN areas.   

The survey results are confidential and all data are securely stored. Strict data suppression rules are in place to ensure individuals cannot be identified.

Data linkage

Survey participants were asked for their consent to link their responses to information about health services they received between 1 January 2014 and 30 June 2018, recorded in the national MBS and PBS data sets, and from data provided by states and territories on emergency department (ED) visits and hospital admissions.  

Analysing participants’ experiences in conjunction with their health service use for the period before and after the survey will provide insights into service use, and possible predictors of health care use and outcomes.

What does the study aim to achieve?

The study’s objectives were:  

• to fill an information gap relating to patients’ experiences with, continuity and coordination of care
• to provide contextual and locally relevant information to PHNs to support the development of health improvements at the PHN area-level, including:
• better patient experiences with coordination of care
• GPs being better placed to provide care to patients subsidised through the MBS and PBS
• fewer patients going to EDs or being admitted to hospital for conditions that could effectively be managed outside hospitals.

The data will enable analyses and reporting of:

• indicators of health care performance in local areas, including on themes related to access to care, patient-centred care and information sharing among a patient’s health care providers
• experiences of coordination of care among particular population groups, such as people with chronic conditions or who have been admitted to hospital.

The study supports linking participants’ survey responses with their health service use before and after the survey, recorded in MBS, PBS and hospital data sets. Linking these data will create a comprehensive picture of a patient’s experiences of, interactions with, and pathways through, the health care system, and will tell a much richer story than any one data set could on its own.

For the first time at the local level right across Australia, it will be possible to look at how a person’s self-reported health status (such as self-assessed health and chronic conditions) and their experiences with health care providers (such as accessibility of care and information sharing among their providers) align with their actual health service use (as detailed in the MBS, PBS and hospital data sets).

It will provide an opportunity to assess if there is an association between higher or lower coordination of care and:

• concurrent and future use of GPs, medical specialists, pathology or imaging funded under the MBS
• PBS medication use
• hospitalisations (including potentially preventable hospitalisations and re-admissions to hospital) and ED attendances.

Further, linkage will enable the components of care coordination that are more important than others in preventing use of EDs or hospitals (for example, the impact of improvements in information flow compared with continuity in relationships) to be identified.

All data linkage will be approved by the relevant ethics committees, and follow strict confidentiality procedures to ensure participants’ personal information is properly handled and no individuals can be identified.  

Other reports on patient experiences of care in Australia: