Patients skip medical care, scripts due to cost concerns: report

The Australian Healthcare Index June 2023 report, supported by Healthengine and the Australian Patients Association, shows a continuing decline in patient satisfaction with the health system as it continues to be stretched.

Findings from the survey of more than 10,000 respondents suggest that this can primarily be attributed to dissatisfaction about the decline in bulk billing offered at clinics (71% of respondents), Medicare not covering a wide enough range of care (67% of respondents), and long wait times (66% of respondents).

Australian Patients Association CEO Stephen Mason said, “The results show a health system continuing to be under considerable stress, with patients struggling to get the services they need. The recent federal budget is the first step to helping more GP clinics bulk bill their most vulnerable patients from November this year. However, with significant numbers of patients from all walks of life making financial choices to skip care, we still have a long way to go.”

CEO and Founder of Healthengine Dr Marcus Tan said, “The government’s recent bulk-billing incentives and rebate rise will ease the financial burden of accessing primary health care for those with concession cards and children. However, there is work to be done in other areas as people with health concerns who do not fit into this category will continue to avoid visiting a doctor due to cost concerns, especially Millennials without a concession card and Gen Zs who are over the age of 18.”

Skipping scripts

One in two (51%) patients aged 18–34 — a group that includes both Gen Z and Millennials — now go less often to the GP because of out-of-pocket costs.

In general, there is a decline in GPs being the first point of care and advice from 58% in November 2022 to 52% across all age groups. More concerning, in the 18–34 age cohort, only 43% visit their GP first for care and advice. This age group is the most likely to make “Dr Google” their first stop for health advice, with 1 in 4 (25%) turning to the internet first.

The 18- to 34-year-old cohort is the least likely age group to have a regular GP or dentist. 23% do not have a regular GP, compared to 12% of the general patient population without one. 51% of 18- to 34-year-olds do not have a regular dentist, compared to 42% of respondents across all age cohorts who do not visit a regular dentist.

Mental health is also a big concern for this group, with 1 in 3 (33%) of 18- to 34-year-olds seeking mental health care in the past six months, compared to 1 in 4 across all age groups (25%). Also, this figure is higher for women and people who live in regional areas.

They are also the most likely age cohort to have gone without prescription medication due to cost concerns, with 42% of 18- to 34-year-olds saying they had to skip scripts compared to 27% of respondents across the board.

Emergency department overuse for non-emergencies

The long-term issue of emergency department misuse appears to be continuing. 49% of people who went to the ED said later that they thought their care could have been provided by a GP or urgent care clinic instead.

CEO of the Australian Patients Association Stephen Mason said that this matches the APA experience with healthcare users. “We’re continuing to hear of patients all around Australia going to the emergency department for non-emergency care to avoid out-of-pocket costs instead of visiting a doctor. This is impacted by the initial problems of cost of basic care — patients who skip primary care check-ups because of cost concerns are increasing their chances of ending up in a hospital with a far more serious condition or forcing them to visit the emergency department with a non-urgent condition, contributing to a cycle of ED overuse, ambulance ramping and strain on medical resources and staff.”

Further findings in the Australian Healthcare Index June 2023 include statistics on aged care, ambulance services, dental, emergency departments, elective surgery, general practice, Medicare, mental health, healthcare workers, pharmacy, private health insurance, private hospitals, public hospitals, rural/remote care and telehealth.

Key highlights include:

• Patient satisfaction with the healthcare system in Australia has declined to 7.0 out of 10 in June 2023, down from 7.8 out of 10 in March 2021.
• 35% of all respondents are skipping medical diagnostic tests due to associated out-of-pocket costs, with potential barriers to timely diagnosis.
• 43% of patients consider out-of-pocket costs to see a doctor or GP a top healthcare challenge, up 10% since November 2022.
• Wait times are still among the top three challenges patients face when using Australian health care since November 2022, with 43% concerned about GP, nurse and healthcare worker shortages and 40% worried about emergency department wait times.
• 49% of people who went to the emergency department (ED) said they thought their care could have been provided by a GP or Urgent Care clinic instead, suggesting EDs are being inappropriately used because other services are unavailable or unaffordable.
   

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