4343.0.55.001 - Coordination of Health Care Study: Use of Health Services and Medicines, Australia, 2015-16  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 18/12/2018  First Issue
   Page tools: Print Print Page Print all pages in this productPrint All

EXPERIENCES WITH SPECIALIST SERVICES

Medical specialists play a crucial role in the management and treatment of health conditions for which they have specialist knowledge and skills. Examples of specialists include dermatologists, cardiologists, neurologists and gynaecologists. Visits to specialists require a referral from a GP or other doctors. This chapter presents data on persons aged 45 years and over who had at least one GP visit between November 2014 to November 2015 (the Study cohort) who used MBS subsidised specialist services in 2015-16.

Of the 8.8 million people in the Study cohort, half (4.4 million people, or 50%) saw a specialist at least once in 2015-16.

FREQUENCY OF SPECIALIST USE

Of the 4.4 million people in the Study cohort who saw a specialist in 2015-16:

  • 27% saw a specialist once
  • 43% saw a specialist 2-4 times
  • 30% saw a specialist 5 or more times.

WAITING TIMES

Study participants were asked whether they had waited longer than they felt was acceptable to see a specialist in the last 12 months. The proportion who reported they had waited longer than they felt was acceptable was relatively consistent irrespective of the number of specialist visits people had, ranging between 21% and 22%.

BARRIERS

Waiting times, costs and availability of specialist services may act as barriers to people requiring access to this care, thereby impeding effective health outcomes. Study participants were asked whether there was a time in the last 12 months when they felt they had needed to see a specialist but did not go, and reasons why they did not go.

The proportion who indicated that there was a time in the last 12 months when they felt they needed to see a specialist but did not go was relatively consistent irrespective of the number of specialist visits they had in 2015-16, ranging between 11% (for people who had 5 or more specialist visits) and 12% (for people who had 2-4 specialist visits).

Of those who reported there was a time in the last 12 months when they felt they needed to see a specialist but did not go, the reasons for not doing so were relatively consistent irrespective of the number of specialist visits people had.

EXPERIENCES WITH SPECIALISTS

Study participants who reported they had seen a specialist in the last 12 months were asked about their experiences with specialists, such as whether their specialist had access to their test results, explained treatment choices and involved them in decisions about their health care. These are important components in establishing cooperative ongoing relationships between patients and health care providers such as specialists, which are crucial if patients are to receive consistent, cohesive and appropriate care1.

Whether there was a time when specialist did not have medical information or test results

Having a higher number of specialist visits was associated with a small increase in the proportion of people reporting there was at least one time when their specialist did not have their medical information or test results. Around 10% of people who had 5 or more specialist visits reported their specialist did not have their medical information or test results at least once, compared with 6% for people who had one specialist visit.

Whether specialist explained treatment choices

The proportion of people who reported that, in their most recent visit, their specialist explained treatment choices so that they could be understood was consistent irrespective of the number of specialist visits a person had, at 95%.

How often specialist involved patient in decisions about health care

Involving patients in decisions about their health care is an important component of the quality of that care, and is associated with improved health outcomes2.

The proportion of people who reported that their specialist always involved them in decisions about their health care was relatively consistent irrespective of the number of specialist visits a person had (between 71% and 74%).
Graph of how often specialist involved patient in decisions about own health care, by number of specialist visits in 2015-16


Whether usual GP or others in usual place of care seemed informed about care received from most recent specialist visit

Communication and information sharing between specialists and a patient's usual GP or place of care can result in benefits for the patient3. Participants in the Study who had seen a specialist were asked whether their usual GP or others in their usual place of care seemed informed about the care they received at their most recent visit to a specialist.

Having more specialist visits was associated with a higher proportion of people reporting that their usual GP or others in their usual place of care seemed informed about the care that people received at their most recent specialist visit. Around four in five people (83%) who had 5 or more specialist visits reported that their usual GP or others in their usual place of care seemed informed about the care they received at their most recent specialist visit, compared with around three quarters of people who had one specialist visit (73%) or 2-4 specialist visits (74%).

REFERENCES

1. Australian Institute of Health and Welfare 2018. Healthy Communities: coordination of health care – experiences with GP care among patients aged 45 and over, 2016. Cat. no. CHC 2. Canberra: AIHW.
2. Longtin Y, Sax H, Leape L, Sheridan S, Donaldson L, & Pittet D 2010. Patient participation: current knowledge and applicability to patient safety. Mayo Clinic Proceedings 85(1): 53–62.
3. Sampson R, Barbour R, & Wilson P 2016. The relationship between GPs and hospital consultants and the implications for patient care: a qualitative study. BMC Family Practice 17(45).