Appendix A: Coordination of Health Care Study
The Coordination of Health Care Study was developed by the AIHW to fill a national data gap and to 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 that relevant information is transferred between providers (for example, between a GP and a specialist) and settings (for example, between an 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.
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 and areas for improvement and monitoring the impact of change. Patients’ experiences also provide insights for developing 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 PHN areas. The study has two components:
- the 2016 Survey of Health Care, which sampled people aged 45 and over who saw a GP in the previous 12 months
- 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.
An independent Human Research Ethics Committee approved the study design.
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 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
- 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 emergency departments 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 emergency department attendances.
Further, linkage will enable components of care coordination to be identified that are more important than others in preventing use of emergency departments or hospitals (for example, the impact of improvements in information flow compared with continuity in relationships).
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.