Australia’s health system is more transparent than most other countries – but more needs to be done to turn this into meaningful information for patients and users.
A new report by KPMG International Through the looking glass assesses 32 systems worldwide and puts Australia in the second tier of transparency of health systems, alongside the UK and New Zealand, but behind the Scandinavian countries, based on a framework covering six areas: quality of healthcare; patient experience; finance; governance; personal healthcare data and communication of healthcare data.
The report notes that, internationally, there is good evidence that public reporting stimulates quality improvement activities, particularly at hospital level. For example, hospitals were found significantly more likely to report quality improvement initiatives in response to publication of mortality rates.
Yet it also found publication of sub-standard data can lead to worse outcomes if wrong conclusions are drawn and even high-performing countries have faced difficult questions about the value created for all their effort.
KPMG Australia Healthcare Partner Dan Harradine said: “It is often said that sunlight is the best disinfectant – overall this report shows that disclosure of healthcare data can make substantial, positive improvements in patient outcomes and drive better value for health systems. By being open about performance – whether clinical outcomes, financial performance, long-term treatment trends or other information that is pertinent to decision-making – patients can make more informed choices about their care, and health systems can learn valuable lessons about the efficacy and sustainability of services”.
The KPMG report finds that Australian healthcare systems are doing relatively well in terms of transparency. On finance, its shares top ranking with other countries. Ii relation to ‘Governance’, Australia is one of only a small minority of countries to score a bonus point for routinely publishing health service procurement prices and contracts as well as information about health service procurement processes.
But there are still areas where significant improvements in Australia can be made – for example, in relation to transparency of ‘Quality of Healthcare’ through more standardised public reporting of risk-adjusted mortality/survival rates, re-admission rates, adverse events, and hospital-acquired infections. But encouragingly, average waiting times for emergency care are published by hospital providers.
Similarly, there is room for improvement on transparency of ‘Patient Experience’ with a particular need for measurement and publication of patient reported outcomes and patient approval ratings.
Dan Harradine said: “Like all health systems, growth in the amount of data that is collected about Australian hospitals and healthcare services has grown exponentially over recent years. However, accessing that data – both within healthcare organisations and for patients seeking to information about performance of their hospital or indeed even their clinician – can be difficult,” Harradine said.
“This is particularly important, given the strength of emerging evidence that informed and engaged patients can improve outcomes and reduce costs associated with healthcare service delivery,” Harradine said.
“In healthcare, like in all industries, we tend to see that organisations deliver results in line with the indicators they measure,” he said. “If we measure financial outcomes in detail, we improve financial performance. The same is true of clinical outcomes. For that reason, transparency across a broad range of domains is important for health systems.”
In relation to ‘Personal Healthcare Data’, the report notes that it is encouraging to note that patient data privacy and safeguarding is a legal obligation in the country, and that the MyHealth Record is driving outcomes in the right direction for patients to be able to access their own information in a way that outperforms many other international jurisdictions.
Senior Communications Manager, KPMG
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