Primary care failing people with diabetes: Expert

10 Mar 2016

Only a quarter of the million Australians diagnosed with type 2 diabetes get the monitoring and treatment recommended for their disease, a scathing report on the primary care system has found.

The statistic is just part of a new Grattan Institute report that has branded primary care in Australia a “chronic failure”.

The 50-page report is scathing in its assessment of the primary care system, claiming “that at best our primary care system provides only half the recommended care for many chronic conditions.”

The report paid close attention to diabetes, citing its role in the major underlying cause of death from circulatory and heart disease, as well as undiagnosed kidney disease, which is also common in people with diabetes.

“Around 40 per cent of people with type 2 diabetes have kidney disease and they have a 23 per cent higher risk of dying over 10 years than people without diabetes,” the researchers wrote.

“Yet, the available research indicates that less than half of people with diabetes seeing Australian general practitioners had recommended levels of blood pressure, blood sugar and cholesterol, which are important risk factors for kidney and heart disease.

“A study of the quality of care for diabetes and heart disease in general practice found that only half had good control of blood sugar levels, just a quarter reached recommended blood pressure levels and less than 20 per cent achieved adequate management of their cholesterol levels.”

Co-author Dr Stephen Duckett, health program director at the Grattan Institute, said diabetes had been used as an example of how the system is failing patients, and was by no means a suggestion it was the only problem area.

“Diabetes is a big problem, and we used it as an example in our data extraction,” he told the limbic. “We are really concerned about what’s happening across the whole primary care system as it relates to all chronic disease management, not just diabetes.”

The report calls for an urgent overhaul of the current model of health service delivery for patients with chronic disease.

This would include a “broader payment for integrated team care” to help to focus care on patients and long-term outcomes. Primary Health Networks should be given responsibility for coordinating local primary care services, and in regional areas, clear targets and well-designed incentives for disease prevention were vital.

“There are a whole lot of systems in place but they are not working so we have to do something,” he said.

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