Over-65s weigh heaviest on the health system
A new report from the University of Sydney finds that people aged 65 and older are using twice as many GP resources as the population average, as lead investigator Helena Britt explains.
People aged 65 and older are using twice as many GP resources as the population average, according to a report that quantifies the strain on the health system posed by the older generation and the looming challenge for Medicare.
Older Australians are spending more time with their GPs and seeing them more frequently, for more health problems, according to a report by the University of Sydney’s BEACH research program.
In turn, they are being prescribed more medication and undergoing more tests.
Over-65s are using GP services twice as much as other age groups. Photo: Greg Newington
Lead investigator Helena Britt said the figures demonstrated the need for more investment in primary care, to prevent those patients from needing more expensive care.
Given that the federal government had encouraged older Australians to visit their GPs through polices such as “well checks”, the figures should not be surprising, she said.
“If you have people living longer, you have more and more problems to be managed and therefore you must use up more resources,” Associate Professor Britt said.
“General practice is one of the cheapest parts of Medicare. Perhaps if we gave general practice more power as a gatekeeper, we may prevent some of the far more expensive services from building up.”
While over-65s grew by 18 per cent as a proportion of the population between 2000-2001 and 2014-2015, their use of GP services grew by 22 per cent in terms of GP-patient encounters, 30 per cent in terms of problems managed in general practice and 20 per cent of GP clinical time.
Nearly all of them had one or more chronic diseases and 60 per cent had at least three.
Other groups of the population were visiting their GP less often, possibly as a result of infectious diseases being better controlled with vaccinations.
“There’s nothing to suggest that another age group is suffering as a result of increased utilisation by over-65s,” Associate Professor Britt said.
Life expectancy in Australia has grown by 12 years since 1947, with a child born in 2013 expected to live until 83 years of age – higher than the United Kingdom, New Zealand, Canada or the United States.
At the same time, total health expenditure as a proportion of the gross domestic product is only 9 per cent, the equal lowest among those countries along with the United Kingdom, and almost half as much as the 17 per cent spent by the USA.
The federal government’s chief advisor on primary health care, Steve Hambleton, said acute care episodes were threatening the sustainability of Medicare rather than primary care, but general practice had a role in ensuring that patients with chronic conditions did not deteriorate.
“General practice costs are not the problem,” Dr Hambleton said.
“It’s when people go to hospital and consume all the acute resources. How do we stop people going from two diseases to five diseases?”
The Primary Health Care Advisory Group, chaired by Dr Hambleton, is exploring how general practice could be funded to take into account the growing number of patients with chronic conditions.
The Royal Australian College of General Practitioners has proposed that general practices be given extra funding for patients with complex care needs.
Other groups have proposed blending fee-for-service with a capitation model, whereby patients are enrolled in practices and GPs are given bulk funding according to the type of patients they have on their books.