Patient-centred care approaches, such as encouraging regular contact, developing individualised care plans and involving patients in decisions about their care are particularly effective for improving the health outcomes of patients with chronic conditions. The experiences and interactions that patients with chronic conditions have with their doctors and other members of the care team play an important role in whether they stay in contact with the health system and manage their conditions effectively.
Successful patient-centred care approaches are underpinned by good communication: having respectful, two-way conversations and spending adequate time with patients to address their issues and needs. With around 1 in 2 Australians reporting having a chronic condition, improving their health outcomes will have important flow-on effects for the health system and for the population more broadly. However, improving the health outcomes of people with chronic conditions requires an understanding of their current experiences in the health system and where those experiences could be improved.
To date there has been limited national information in Australia on how patients with chronic health conditions experience health care. This report uses data from the Patient Experience Survey 2017–18 to explore patient experiences of communicating with GPs and other specialists for people reporting one or multiple chronic conditions, and for people specifically reporting a mental health condition.
Overall, most people with chronic conditions are having positive experiences with their GPs and other specialists
Most patients (around 4 in 5) felt that their GPs and specialists always listened carefully, showed respect for what they had to say and spent enough time with them. While patients reported similar experiences of GP care regardless of how many chronic conditions they had, there were small differences for specialist care depending on the number of chronic conditions reported.
Patients with mental health conditions report different experiences of care when compared with other patients
Patients who had a mental health condition reported less positive experiences with their GPs and specialists than those with no chronic health conditions. Patients with mental health conditions were particularly less likely than those with no conditions to feel that their GPs and specialists always listened carefully to them (66% compared with 76% for GPs, and 70% compared with 84% for specialists).
Younger patients aren’t reporting the same experiences of GP or specialist care as older patients, particularly those with multiple conditions
Patients aged between 15 and 39 reported less positive experiences than those aged 65 and over. The difference becomes even larger when patients have multiple chronic health conditions – for example, younger patients with multiple chronic conditions were much less likely than older patients to feel that their GPs always listened carefully (56% compared with 81%). For those with no chronic conditions the difference was smaller, but still notable
(72% compared with 87%).
Positive GP and specialist experiences are associated with better self-reported health, especially for patients with chronic conditions
Excellent self-assessed health is associated with better experiences with both GPs and specialists. Patients having the most positive experiences were those who reported being in excellent health despite having multiple chronic conditions, with around 9 in 10 reporting that their practitioners always listened carefully to them, showed respect for what they had to say and spent enough time with them.
Living in a disadvantaged area is associated with less positive GP experiences for patients with multiple chronic health conditions
Patients with multiple chronic health conditions who live in the most disadvantaged areas reported less positive experiences with their GPs than those in the least disadvantaged areas. For example, 79% of patients with multiple chronic conditions from the least disadvantaged areas felt that their GPs always spent enough time with them, compared with 70% of patients from the most disadvantaged areas. This socioeconomic disparity was not apparent for specialists.
The results suggest that the right ingredients for successful condition management and good health are present for many – but not all – vulnerable people in Australia
These findings point to a greater need to understand how being chronically ill impacts patient experiences within the health system, particularly for patients who are young and/or in poor health. In the short term, further work should be done to better understand which of the factors explored in this report most influence experiences of care for vulnerable patients, as well as patients more broadly. Longer-term work should focus on building a better understanding of how the experiences patients have with their medical providers impact on patients’ engagement with the health system more broadly and translate into health outcomes.