Older Australians with disability missing out on key health supports, new survey finds

Older Australians with disability or complex needs are falling behind in health outcomes despite Australia ranking near the top internationally for primary care quality, according to the latest OECD PaRIS 2025 report.

While the report shows Australia performing strongly overall in patient-centred care and coordination, the data also reveal a troubling gap for those with chronic and complex conditions, many of whom rely on disability supports or NDIS-funded services.

“The survey shows just how much the quality of health care depends on who you are and where you live,” says theOECD PaRIS Australian National Report 2025. 

“People with lower education or income, who live in regional areas or have three or more chronic conditions, reported the worst outcomes.”

Australia’s primary care: High ranking, mixed reality

The OECD Patient-Reported Indicator Surveys (PaRIS) measure health outcomes and care experiences for people aged 45 and over with chronic conditions. In the 2025 national report:

• 94% of Australians surveyed rated their care quality as positive, well above the OECD average of 87%
  
• 74% reported good coordination of care (vs. 59% across the OECD)

Australia ranked 3rd for coordination and 4th for person-centred care among 19 participating countries.

But for Australians with disability, mental illness, or multiple chronic conditions, outcomes were consistently worse.

Complex needs, poorer outcomes

People with three or more chronic conditions reported:

• Lower levels of trust in their providers
  
• Reduced confidence in managing their own health
  
• Significantly poorer health and wellbeing outcomes

People with mental health, neurological, or liver conditions — conditions frequently linked to disability — also scored lower across nearly all experience and outcome measures.

“You can have great GPs and still not meet the needs of someone with complex disability,” says the report. “The system is not yet delivering consistently integrated care for people with multiple long-term conditions.”

Who’s missing out?

The people most at risk of poor outcomes included those who:

• Lived in regional or remote areas
  
• Had lower education or income
  
• Were under 65 and living with complex illness or disability
  

According to the report:

• 18% of respondents skipped care due to access issues
  
• 17% cut back on medications due to cost
• 11% struggled to pay health-related bills

“We talk a lot about ‘choice and control’ in the NDIS,” a consumer advocate is quoted as saying in the report, “but how can people choose quality care when they can’t afford to get there or don’t know what’s available?” 

Mental health still a gap

Despite Australia’s strengths in physical health care, the country ranked:

• 11th for mental health outcomes
  
• 12th for social functioning
  
• 13th for wellbeing among the 19 countries

These figures are especially concerning for people with psychosocial disability, who frequently rely on NDIS supports and face barriers to mental health care integration.

Digital divide widens health gaps

The survey also revealed a gap in digital health access:

• 60% of GP practices offer telehealth, but just 40% of patients knew it was available
  
• Only 8% could access medical records online
  
• Just 22% used digital services to request repeat prescriptions

“Digital access isn’t a luxury,” the report warns. “For some people with disability, it’s the only way to manage their health safely and independently.” 

What needs to change?

The report calls for better support for people with complex needs, particularly:

• Continuity of care through stable GP relationships
  
• Stronger integration between NDIS supports and primary care
  
• Clear communication and planning tools (e.g. shared care plans)
• Accessible and inclusive digital services that don’t leave anyone behind