Chronically ill Australians poorly served

4 August 2010

Australian health policy needs to better reflect the fact most chronically ill Australians suffer from multiple illnesses, a team of researchers led by Dr Clive Aspin at the University of Sydney has found.

About a quarter of Australians live with multi-morbid (more than one) chronic illnesses, including heart disease, diabetes and osteoarthritis, and this number is growing. Analysis published in the latest Australian and New Zealand Journal of Public Health finds those multi-morbid chronic illnesses tend to have each condition treated in isolation.

"An uncoordinated approach to dealing with chronic diseases doesn't account for one disease contraindicating treatment of another and this can lead to serious complications," says Dr Aspin from the University's Menzies Centre for Health Policy. "A lack of policy specifically addressing multi-morbidity, affecting the majority of people with chronic illness, also suggests an inefficient use of health funds.

"For chronically ill patients, a lack of coordinated care can add to their confusion and anxiety.

"Already chronic illnesses are responsible for almost 80 percent of illness and injury experienced by Australians. Increases in longevity, type-two diabetes among young people and average blood pressure among children point to chronic illness rising further. Obviously an increased burden on health systems will ensue.

"In order to meet these challenges it is imperative that health policy be designed to provide guidance for the effective prevention and management of multi-morbid chronic illness.

"Health care workers need guidelines about how to care for people with multiple chronic illnesses so they can treat them in combination. At the policy end, policy makers need to work with clinicians and patients to develop appropriate guidelines for the treatment of multi-morbid chronic illness."

In the paper Health policy responses to rising rates of multi-morbid chronic illness in Australia and New Zealand, Dr Aspin and colleagues analysed health policy documents on both sides of the Tasman. The New Zealand findings were similar although Dr Aspin says development of Primary Health Networks in New Zealand has had a positive impact on managing chronic illness. The provision of funding, policy and service delivery across different levels of government in Australia further inhibits coordination, he says.

Of the documents examined in Australia only one, the 2005 National Chronic Disease Strategy made mention of multi-morbidity issues and this reference was indirect.

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