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Cost concerns lead to patient care skipping as healthcare system falls

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The latest Australian Healthcare Index June 2023 report, with support from Healthengine and the Australian Patients Association, reveals that the healthcare system is facing ongoing strain.

The fifth Australian Healthcare Index June 2023, a bi-annual survey by Healthengine and the Australian Patients Association, reports a continuing decline in satisfaction with Australia’s healthcare system.

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

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 healthcare system 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 eighteen,” Dr Tan added.

Cost concerns impacting care for 18-34-year-olds

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 concerningly, 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 18-34-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 18-34-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 major concern for this group, with 1 in 3 (33%) of 18-34-year-olds seeking mental healthcare 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 18-34-year-olds saying they had to skip scripts compared to 27% of respondents across the board. 

The cycle of emergency department overuse for non-emergencies

The long-term issue of emergency department misuse appears to be continuing, with 49% of people who went to the ED saying 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 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.

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