With healthcare spending projected to rise to over 40% of the state budget by 2050, it is critical that the Queensland public health system delivers care differently.
This project conducted a comprehensive systems analysis to identify the successes, gaps and opportunities in chronic disease prevention across the Queensland public health system.
Making prevention a health system priority – systems analysis projectProject title
What is the issue?
Queenslanders are living longer, yet many people experience more years of poor health due to preventable chronic diseases. Almost one in two people in Queensland have one or more chronic diseases.1
As the population ages, the high burden of chronic disease will continue to grow, reducing people’s wellbeing and quality of life, and increasing pressure on the health system. With healthcare spending projected to rise to over 40% of the state budget by 2050,2 it is critical that the Queensland public health system delivers care differently.
Effective chronic disease prevention improves quality of care, reduces health inequity, and delays or prevents people moving into higher-risk categories for disease. It also supports improved health system efficiency, creating capacity to meet increasing service demands.
There are many unseen and unknown opportunities to strengthen and integrate prevention as part of routine clinical care in the Queensland public health system. Thousands of Queenslanders connect with the healthcare system every day, providing many opportunities for enhanced prevention, such as screening and referral to appropriate support services. (Download Figure 1 for a diagram showing the spectrum of prevention activities and key organisations in Queensland.)
In the context of this project, prevention largely refers to efforts to prevent the progression of cardiovascular diseases, type 2 diabetes, some cancers, chronic kidney disease and chronic respiratory diseases.
This project, predominantly funded by the Commonwealth Government, aligns with national long-term health reforms that recognise the importance of prevention to reduce the burden of chronic conditions and build sustainability in the health system.
How did the project address the issue?
Queensland Health’s Prevention Division led a comprehensive systems analysis to identify the successes, gaps and opportunities in chronic disease prevention across the Queensland public health system.
The Prevention Centre provided systems science expertise to guide the analysis.
Using a co-design approach with stakeholders across the Queensland Health system, the project:
- Gathered information about current prevention activities
- Increased understanding around prevention gaps, opportunities and barriers
- Built a shared understanding of prevention
- Identified existing best practice prevention activities
- Identified feasible mechanisms to better embed, integrate and target prevention efforts across healthcare pathways.
The co-design approach helped determine solutions that allowed for greater flexibility at the local level.
The team used a variety of methods to engage with stakeholders, including broad communication with the Queensland Health workforce, crowdsourcing, focus groups, participatory workshops and in-depth interviews.
The project used systems thinking methods to identify prevention opportunities and solutions that might otherwise remain invisible or unnoticed.
It focused on how prevention efforts reach those with the greatest need, including Aboriginal and Torres Strait Islander people and rural and remote Queenslanders.
What is the relevance for policy and practice?
The project’s findings will be used to identify implementation options for potential system redesign and determine how prevention could be better supported and integrated with treatment services and care delivered across Queensland.
What are the outcomes?
The key outcome was the identification of high-value opportunities to help expand and sustainably embed chronic disease prevention as a core function of quality clinical care in the Queensland public health system.
The project also:
- Created stewardship and support for prevention
- Built capacity to use systems methods
- Began to generate change in the system.
For more information, email the Queensland Health team leading the project.
1. Australian Bureau of Statistics. National Health Survey: First Results, 2017-18. Canberra: ABS; 2018. Catalogue No. 4364.0.55.001. Available from: https://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Overweight%20and%20obesity~90.
2. Deloitte Access Economics, An IGR for the States: health and aged care expenditure Final Report, 23 January 2012 in State Infrastructure Plan Part A: Strategy, Department of Infrastructure, Local Government and Planning, Queensland Government. March 2016. https://www.dsdmip.qld.gov.au/__data/assets/pdf_file/0020/31727/sip-part-a.pdf