The COAG Reform Council has delivered its final report evaluating the impact of the national health reform agreement, Healthcare in Australia 2012–13: Five years of performance.

The report examines progress in four of the seven areas to be tracked under the agreement. As the images below show, there have been some notable improvements but many challenges remain.

It seems likely that the wide-ranging cuts to health in the Federal Budget will make it very difficult to address some of the problem areas highlighted.

It also seems likely that the wider budget cuts will increase the reach of disadvantage in Australia, which this report makes clear is associated with both poorer health outcomes and poorer access to care.

Some quick grabs:

• People who live in urban areas have longer life expectancies—in 2010–2012, men lived 2.3 years and women 1.4 years longer. Women continue to outlive men by more than four years but the gender gap is closing—on average life expectancy for women increased by two months per year over the last decade, for men it was three months.

• Costs of dental care remain an issue for many, particularly Indigenous Australians. In 2012–13, more than two out of five (43.9%) Indigenous people aged 15 years and over delayed or did not go to a dental professional due to cost. Dental and prescription medicine costs were a bigger problem in the most disadvantaged areas.

 • From 2007 to 2011, the rate of heart attack for Indigenous people fell from 1208.2 heart attacks per 100 000 people to 1076.9 heart attacks, a reduction of about 10%. The rate for other Australians fell by about 20%.

• Overall one in five Australians delayed or did not see a dental professional due to cost. This was more than three times the rate of those delaying or not seeing a GP for cost (5.8%) and more than double the rate of delay or not filling a prescription (8.5%) or for seeing a specialist (8.8%). In the most disadvantaged areas, 25.1% of people delayed or did not see a dental professional due to cost— more than double the rate in the least disadvantaged areas (12.0%).

• One in twelve delayed or did not fill a prescription from their GP because of cost. In 2012–13, 8.5% of people given a prescription by their GP delayed or did not fill it due to cost. In the most disadvantaged areas, 12.4% delayed or did not fill a prescription; this was twice the rate found in the least disadvantaged areas (6.0%).

• WA and NT lag the other jurisdictions in ensuring patients receive community follow up after discharge from psychiatric treatment.

• In the five years to 2011–12, the overall rate of potentially preventable hospitalisations fell by 3.4% from 2485.9 to 2401.5 hospitalisations per 100 000 people. But the rates of potentially preventable hospitalisations due to acute conditions and vaccine preventable conditions increased.

• Patients living in disadvantaged areas have longer waiting times for elective surgery, as do Indigenous Australians and people living in the most disadvantaged areas.

• Two-thirds of deaths of people aged under 75 years were potentially avoidable. 

(Click on images below to see larger version)

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