Are current health policies failing people with chronic disease as they
approach the end of their life?
1 1 2
Teresa Burgess Professor Annette Braunack Mayer Associate Professor Gregory Crawford and
3
Professor Justin Beilby
1
School of Population Health and Clinical Practice, University of Adelaide
2
School of Medicine, University of Adelaide
3
Faculty of Health Sciences, University of Adelaide
Objective
To identify the extent to which current Australian health policies for chronic disease management and
palliative care address the care needs of people with end-stage chronic disease.
Methods
Four chronic conditions were used as exemplars to identify the care needs of people with end-stage
chronic disease. Key national and state policies, strategies and programs in both palliative care and
chronic disease management were identified and analysed to assess the degree to which they
consider and fund appropriate services to address the care needs of people with these four conditions
as they approach the end of life.
Lessons Learned
Whilst the National Palliative Care Strategy (2010) emphasises the importance of palliative care being
available to all Australians based on need, chronic disease management policies and strategies focus
on early intervention in, and ongoing management of, chronic disease. There is little clarity around
what services should be provided at the end stage of chronic disease and who should fund and
provide the care required.
Implications
Chronic disease management programs can improve the quality of care for people with chronic
disease, but they will not stop an eventual progression to end stage. There is a mismatch between the
rhetoric at both a state and federal level about the importance of improving end of life care and
policies and funding mechanisms to support people with chronic disease as they move towards the
end of their life. Neither palliative care nor chronic disease management programs are currently
configured and funded to address the needs of these people.