When you last visited a doctor, did you feel your doctor took the time to understand your medical history? Did you feel listened to and respected? Did you need to repeat yourself when seeing different health professionals? These elements of the patient experience are key to how Australians feel about the quality of the health care services they receive.

Why is patient experience important?

Patient experiences provide a unique perspective on health care that not only contributes to measuring system performance (NHIPPC 2017), but also provides insights into patient journeys and their quality of care. Patient engagement is increasingly recognised around the world as an integral part of quality health care and a critical component of people-centred services (WHO 2016). Taking the time to understand a patient’s needs, preferences, beliefs and attitudes, and adapting care to meet their expectations, is central to an effective patient–doctor relationship (AIHW 2019).

Australia’s health performance framework

The Australian Health Performance Framework is used to guide the reporting of Australia’s health performance, ensuring the needs of different populations and levels of the health system are considered. Identified areas of assessment include ensuring service is person-centred and culturally appropriate, and that patients have autonomy in their care. Outcomes of studies such as the Patient Experience Survey (PEx) and the Coordination of Health Care study can inform the indicators within such frameworks. 

Doctors who engage effectively with both their patients and other health care providers are key to facilitating proper coordination of health care and good patient health outcomes. Patients who are engaged—who are listened to, respected, and included in decisions made about their care—are better able to make informed decisions about their health (WHO 2016).

How are patient experiences measured?

Tools to measure patient experience, such as patient surveys, are internationally recognised as a key marker of quality of care (Raleigh et al. 2015). It is important that monitoring of patient experiences continues so that Australians continue to receive equitable, high-quality health care and any gaps between different populations can be reduced.

The AIHW monitors and reports on patient experiences of health care services in Australia through the Australian Bureau of Statistics’ (ABS) Patient Experience Survey (PEx). PEx data have been reported annually since 2010–11, and results from the PEx 2018–19 are presented below. The AIHW also reports on patient experiences with mental health services specifically, through the Your Experience of Service (YES) survey. For patient experiences with mental health services, see Mental health services.

With patient experience information predominantly obtained through surveys, it is important to note that performance is as reported through the eyes of patients. Differences in patients’ reported experiences are likely to be influenced by a mix of health provider practice and the expectations of the patients themselves.

In collaboration with the ABS, the AIHW is also conducting the Coordination of Health Care (CHC) study. The study was designed to provide information on patients’ experiences of coordination and continuity in care across Australia. The 2016 Survey of Health Care (SHC) was a key component of the CHC study. It focused on Australians aged 45 and over who had at least 1 GP visit in the previous 12 months. Thirty-five thousand people responded on their experiences related to care received during 2015–16. The next part of the CHC study will link results from the SHC to other data sets, including hospital and emergency data.

Patient experiences

Experiences with general practitioners

In general, most people reported positive experiences of health care provided by general practitioners (GPs). Three-quarters felt that their GPs always listened carefully to them (75%) and spent enough time with them in their appointments (76%). A slightly greater proportion of people (81%) felt their GPs always showed respect for what they had to say (Figure 1).

Men were slightly more likely than women to report that their GP always listened carefully, showed respect and spent enough time with them. Similarly those in better health tended to report higher satisfaction than those in poorer health.

Reported patient experiences did not vary greatly between city, regional or remote areas across Australia. There was, however, a slight decline in patients’ experiences with their GPs with increasing socioeconomic disadvantage. For example, 78% of people who were in the highest socioeconomic areas felt they were always listened to by and spent enough time with their GP, compared with 73% of those in the lowest socioeconomic areas.

See Primary health care.

Experiences with medical specialists

In general, people rated their experiences with medical specialists more positively than their experiences with GPs. Overall, 80% of people felt they were always listened to by their medical specialists, while 7.0% felt this happened only sometimes, rarely or never. Similar proportions felt that medical specialists spent enough time with them for their appointments and showed respect.

Similar to experiences with GPs, males tended to rate their experiences with medical specialists more highly than females in general, and those with better self-assessed health were more likely to report that their medical specialist always listened carefully, showed respect and spent enough time with them (Figure 1).

As with GPs, there were no substantial differences between city, regional or remote areas, but those in the lowest socioeconomic areas were slightly less likely than those in the highest socioeconomic areas to feel that their medical specialist always showed them respect. However, these patients were still more satisfied with their specialists than they were with their GPs.

See Specialist, pathology and other diagnostic services.
 

Coordination of health care

Coordination of health care aims to ensure that the patient journey through the health system is smooth. It requires different professionals to collaborate and communicate effectively across different health care settings. The quality of this coordination affects patients’ experience of their health care, as well as treatment and health outcomes. For patients with complex health needs, such as those with multiple chronic conditions, good coordination of health care is especially important.

What is coordination of health care?

Coordination of health care is defined as ‘the deliberate organisation of patient care activities between two or more participants involved in a patient’s care to facilitate the appropriate delivery of health care services’ (Victorian Department of Health and Human Services 2018). Having access to well-coordinated and good-quality health care is essential to enhancing patients’ understanding, control and self-management of their illness (Bywood et al. 2011; Jeon et al. 2010).

Information sharing between health care providers is essential for the provision of safe and high-quality health care. The 2016 Survey of Health Care, part of the Coordination of Health Care study, focused on people aged 45 and over who had seen a GP in the previous 12 months. In 2016, almost all (98%) patients reported their GP was aware of their health care history, with a similar proportion (92%) feeling their health professional understood their health care needs and preferences well, and that they received enough information about their care and treatment (also 92%).

Patients living in Remote and very remote areas were more likely to say their GP was not informed of visits to other providers than people living in Major cities (19% compared with 10% of those living in Major cities). Those with no usual GP were 2–3 times as likely to report poor sharing of information as those with a usual GP. Additionally, of the patients who visited an emergency department, about 1 in 4 (23%) said this information was not shared with their usual GP or place of care.  

Most patients in this study reported positive experiences with GPs for quality of care provided, with better experiences of care reported by patients who were in better health, were better educated, spoke English and lived in cities.

It was also found that:

  • nearly all (98%) patients had a usual GP or place of care
  • those who spoke English at home were more likely to report having a usual GP or place of care than those who spoke another language (98% compared with 94%)
  • almost 9 in 10 (89%) patients felt they were involved in decisions about their care and a similar proportion (93%) felt test results were explained in a way they understood (Figure 2)
  • those aged 75 and over were more likely to feel they received excellent or very good quality care from their usual GP or in their usual place of care than younger patients.
     

Where do I go for more information?

For more information on patient experience of health care, see:

Visit Primary health care for more on this topic.

References

ABS (Australian Bureau of Statistics) 2017. Survey of Health Care, Australia, 2016. ABS cat. no. 4343.0. Canberra: ABS.

ABS 2019. Patient experiences in Australia: summary of findings, 2018–19. ABS cat. no. 4839.0. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2018. Coordination of health care—experiences with GP care among patients aged 45 and over, 2016. Cat. no. CHC 2. Canberra: AIHW.

AIHW 2019. Coordination of health care: experiences of information sharing between providers for patients aged 45 and over, 2016. Cat. no. CHC 3. Canberra: AIHW.

Bywood P, Jackson-Bowers E & Muecke S 2011. Initiatives to integrate primary and acute health care, including ambulatory care services. PHCRIS (Primary Health Care Research & Information Service) policy issue review. Adelaide: PHCRIS.

Jeon Y, Kraus S, Jowsey T & Glasgow N 2010. The experience of living with chronic heart failure: a narrative review of qualitative studies. BMC Health Services Research 10:77.

NHIPPC (National Health Information and Performance Principal Committee) 2017. The Australian Health Performance Framework. Viewed 18 October 2019.

Raleigh V, Thompson J, Jabbal J, Graham C, Sizmur S & Coulter A 2015. Patients’ experience of using hospital services. London: The King’s Fund.

Victorian Department of Health and Human Services 2018. Care coordination. Melbourne: Victorian Department of Health and Human Services. Viewed 24 October 2019.

WHO (World Health Organization) 2016. Patient engagement: technical series on safer primary care. Viewed 23 October.