Chronic disease burden grows as primary care funds fall: AIHW

Hospitals account for an ever-larger slice of healthcare funding, while preventable conditions still comprise more than a third of the burden of disease, a wide-ranging Australian Institute of Health and Welfare (AIHW) report has found.
 
The findings are in the AIHW’s Australia health 2026 analysis, the latest edition of its flagship biennial report summarising up-to-date health insights.
 
Released on Thursday, it confirms hospitals accounted for the country’s largest portion of healthcare spending at $113.8 billion in 2023–24, which was 42% of the total.
 
That increased the gap between the hospital sector and primary health care, with the latter standing at $89.1 billion when including public health spending – around a third of the $270.5 billion total funding directed at healthcare.
 
The AIHW also indicated around 36% of the country’s disease burden could be avoided or reduced by modifying risk and environmental factors, a slight drop from previous figures, with overweight and obesity overtaking tobacco as the leading risk factor in 2022–24.
 
RACGP President Dr Michael Wright particularly notes an emphasis on chronic conditions, described in the report as sitting ‘at the centre of Australia’s health story’.
 
‘More than 60% of people have at least one chronic health condition and nearly 40% of people have two or more,’ he told newsGP.
 
‘It is showing that multimorbidity is increasingly the norm within Australia, which means the protocols which focus just on one single condition really aren’t fit for purpose.
 
‘That’s what we’re seeing in general practice.
 
‘And that skill of balancing multiple conditions and treating people holistically rather than just a single disease is at the core of what we do.’
 
Dr Wright also expressed concern about the growing gap between hospital funding and general practice.
 
‘It’s really showing that we need to be investing more in primary care to keep people well, rather than throwing more money at hospital services,’ he said.
 
Meanwhile, the new report confirms dementia as the most common underlying cause of death, as well as a growing incidence of mental health conditions, shown by an almost 9% rise in the rate of people receiving Medicare-subsidised mental health services.
 
AIHW Chief Executive Dr Zoran Bolevich notes that while Australia’s life expectancy has risen, ‘the gains have slowed’, with chronic conditions now ‘responsible for the majority of deaths and disease burden’.
 
He also notes several ‘substantial public health gains’, including a rise in cancer survival rates, a fall in deaths from cardiovascular disease and the decline in the rates of tobacco smoking, high blood pressure and high cholesterol.
 
The AIHW also reports the burden of disease among Aboriginal and Torres Strait Islander people fell by 6.3% between 2011 and 2022, a trend driven by a decline in premature deaths from cardiovascular diseases.
 
However, the AIHW notes that while the disease burden gap has narrowed compared to non-Indigenous Australians, it is still 2.1 times as high.
 
Dr Wright notes the figures suggesting one in four patients delayed their GP visit in 2024–25, but points towards a decrease in that trend shown in the latest figures, which pre-date the introduction of the expanded bulk-billing incentive last year.
 
‘Although general practice access to GP care is very high, we have seen people delaying care due to cost or access,’ he said.
 
‘We know that this data is from before the latest incentives were introduced, which will likely have had an impact.’
 
The report also highlights a lack of data for primary care.
 
‘General practice and other community based primary care services account for the majority of healthcare encounters in Australia, yet historically have not been included in comprehensive, nationally consistent data sets,’ its authors wrote.
 
‘This has limited our ability to understand patterns of access, quality, outcomes, and unmet needs outside hospital settings.’
 
It outlines a move to address the gap with nationally consistent approaches, including ongoing work on its National Primary Health Care Data Collection project.
 
It is a familiar theme for Dr Wright.
 
‘Since the defunding of the BEACH trial over a decade ago, we’ve really struggled to find clear data about what happens in general practice, and there remains a large gap both in the research and in the understanding of what we do,’ he said.
 
He said the college will continue to call for more funding to support analysis of general practice services and ensure data ‘is able to be used by the profession to understand the quality of the care we’re providing’.
 
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