Patient experience in Australia: How are we doing? And why does it matter?
In this blogpost Emerson Health senior consultant Michelle Thomson discusses the recently released ABS Patient Experience statistics. She considers the key findings of the survey, applies a COVID-19 lens, and shares why patient experience is important to Emerson Health.
At Emerson Health a lot of the work we do is to design policy, operations and improvements that will impact on patient experience across the various components of the health system in Australia. It is therefore important to us to keep a finger on the pulse of how Australians are experiencing health services over time.
The Australian Institute of Health and Welfare (AIHW) monitors and reports on patient experience of healthcare services in Australia through the Australian Bureau of Statistics’ (ABS) Patient Experience Survey.
The AIHW indicates, and we would agree, that collecting patient experience data is important because (1);
“Patient experiences provide a unique perspective on health care that not only
contributes to measuring system performance (2), but also provides insights into
patient journeys and their quality of care.
Patient engagement is increasingly recognised around the world as an integral part
of quality health care and a critical component of people-centred services (3).
Taking the time to understand a patient’s needs, preferences, beliefs and attitudes,
and adapting care to meet their expectations, is central to an effective patient–
doctor relationship (4).”
Simply put, we believe that patient experience informs the best possible design of health services, and that great patient experience is an enabler of the best possible health outcomes for patients and families.
This blog aims to give a high-level overview of the most recent patient experience statistics in Australia, particularly with regard to COVID-19, and explore the importance of understanding and leveraging the personal experiences of Australians in our health services.
ABS' Annual Patient Experience Survey
Every year the ABS collects, analyses and releases findings from the Patient Experience Survey (5), captured through the Multipurpose Household Survey conducted throughout Australia. The findings from the 2020/21 financial year have recently been released, and this allows us to get a true point-in-time sense of patient experiences in our health system.
28,386 respondents contributed to this year’s data set. All respondents are aged 15 years or over, and represent urban, rural, remote and very remote parts of Australia (6). The survey explores patient experience across 14 factors that attempt to encapsulate respondent’s experience of the health system in the past 12 months. The survey spans primary and hospital care, explores wait times, barriers to access, and the influence of long-term health conditions among other experience factors (7). In response to COVID-19 the 2020/21 survey included new questions regarding COVID-19, telehealth and mental health.
What are patients saying about our health system?
The Patient Experience Survey has captured multiple statistics over a number of years, allowing us to make comparisons and identify trends. The recently released data identified an increase in GP wait times, but found patient experiences to be generally more positive in 2020/21 relative to 2019/20.
Health service use decreased for GPs, Dentists, Emergency Departments, and afterhours GPs when compared to 2019/20. For the remainder of services, health service use was similar to 2019/20
The proportion of people who waited 24 hours or more to see a GP for an urgent medical matter increased from 29.8% in 2019/20 to 33.9% in 2020/21
People who saw a health professional in 2020/21 generally reported more positive experiences compared to 2019/20
People reported the most positive experiences with dental professionals and the least positive experiences with hospital ED doctors and specialists.
How has COVID-19 influenced patient experience?
COVID-19 has shifted the behaviours of patients and families, and for the first time the Patient Experience Survey collected data to substantiate this. The survey validates assumptions that some patients have delayed or not accessed services due to COVID-19.
The proportion of people who delayed or did not use health services when needed due to COVID varied across different services; dental professionals (12.2%), GPs (9.8%), after hours GPs (7.3%) and medical specialists (7.3%)
Females were more likely to delay or not use health services due to COVID-19 than males
Those aged under 25 or over 65 were least likely to delay or not use health services due to COVID-19
Those living in major cities were more likely to delay or not use health services when needed due to COVID-19 than those living in outer regional, remote or very remote areas.
Let's talk about mental health
COVID-19 has brought mental health more into the spotlight than ever before. This is the first year that mental health data has been collected in the Patient Experience Survey. Findings indicate that telehealth is supporting the delivery of mental health services, but that there is still unmet need due to cost.
15.8% of people saw at least one health professional for their mental health in 2020/21, and of these, 30.5% did so at least once via telehealth
Females were more likely to see a health professional for their mental health than males (20.0% compared with 11.3%)
17.3% of people reported needing to see a health professional for their mental health, and of these 34.3% delayed or did not see a health professional, with 8.9% of these not accessing a health professional at all when needed
Of all the people who reported needing to see a health professional for their mental health, 12.0% reported that cost was a reason for delaying or not seeing a health professional. This varied across the different types of health professionals required, with psychologists and psychiatrists identified as having the most significant cost barriers.
And what about the rise of telehealth?
COVID-19 has shifted the way that patients and families access health services, and the Patient Experience Survey has captured data reflecting this for the first time in 2020/21. The survey validates assumptions around the uptake of telehealth due to COVID-19, finding a significant number of people have had at least one telehealth consultation in the last 12 months.
28.8% of people had at least one telehealth consultation in the last 12 months
Males were more likely than females to have attended a telehealth consultation (35.0% compared to 22.2%)
Patient experience of telehealth consultations was widely positive, with over 80% of people reporting that telehealth practitioners listen carefully, showed respect, and spent enough time
Of those who had a telehealth consultation, 83.4% reported that they would use telehealth again if it was offered.
Ok, they're interesting statistics, but what's the 'so what'?
Capturing these kinds of statistics allows us, people working to make a positive impact on the health system, to do a couple of things as we consider the experience of patients in Australia.
We are able to identify those things that are most important to patients in Australia when accessing health services. For example; this year’s survey highlights the rise of telehealth and the positive patient experiences associated with this. From this data, we can infer that investing in continued and improved telehealth services will set the foundation for these positive patient experiences to continue.
We are also able to understand barriers to access and begin work to reduce or remove them. For example; a key barrier highlighted by the survey data was cost. This applied particularly to psychologist and psychiatrist services. Identifying this as a barrier allows us to understand the behaviour of our patients, and may contribute to creating the burning platform required to drive change.
Finally, we are able to identify trends and shifts in consumption patterns and experiences over time. For example; the survey identified an upward trend of positive experiences with some health services. Further exploration to understand the drivers for this trend would enable the system to replicate and maintain those drivers across the system, ensuring continued and even increased positive patient experiences.
The key takeaways should be;
that a data-informed understanding of patient experience ensures we focus our energy where it will have the most impact on the way patients and families experience the health system
that health service design informed by patient experience and patient voice is more likely to deliver services, access, and outcomes in ways that meet expectations of patients and families.
While these statistics are captured at a national level, it is equally or even more important and valuable to use patient experience to inform decisions and system design at a state, region, and health service level. At Emerson Health we undertake consultation to capture the candid patient voice, and across our team have vast experience turning that sentiment into meaningful action.
It is important to us that the work we do is making an impact on the experiences of patients and families across Australia’s health system. If you are thinking about ensuring candid patient voices inform the work you’re doing, or are designing systems with an eye to improving patient experience, we’d love to hear from you.
Australian Institute of Health and Welfare. Patient Experience of Health Care. [Online] 2020. https://www.aihw.gov.au/reports/australias-health/patient-experience-of-health-care
National Health Information and Performance Principal Committee. The Australian Health Performance Framework. [Online] 2017. http://www.coaghealthcouncil.gov.au/Portals/0/OOS318_Attachment%201.pdf
World Health Organisation. Patient engagement: technical series on safer primary care. [Online] 2016. https://apps.who.int/iris/bitstream/handle/10665/252269/9789241511629-eng.pdf
Australian Institute of Health and Welfare. Coordination of health care: experiences of information sharing between providers for patients. [Online] 2019. https://www.aihw.gov.au/reports/primary-health-care/coordination-of-health-care-experiences-of-informa/contents/summary
Australian Bureau of Statistics. Patient Experiences in Australia: Summary of Findings. [Online] 2021. https://www.abs.gov.au/statistics/health/health-services/patient-experiences-australia-summary-findings/latest-release#key-statistics
Australian Bureau of Statistics. Patient Experiences in Australia: Summary of Findings methodology. [Online] 2021. https://www.abs.gov.au/methodologies/patient-experiences-australia-summary-findings-methodology/2020-21
Australian Bureau of Statistics. Patient Experience Questionnaire 2020/21. [Online] 2021. https://www.abs.gov.au/statistics/health/health-services/patient-experiences-australia-summary-findings/2020-21/48390_patient_experience_questionnaire_202021.xlsx