Report Reveals Health Cost Burden Hot Spots

A new report points to the nations ‘hot spots’ where Australians have delayed seeing a dentist or doctor or filled a medication prescription due to the cost burden.

The report points to 14 local areas around Australia where 25% or more of residents have delayed or avoided seeing a dentist in the past year due to cost, and a further 32 areas where at least one in 10 residents have put off either seeing a doctor or filling a prescription, or both.

The latest report from the National Health Performance Authority finds there were 20 Medicare Local catchments where 10% or more of residents delayed or avoided filling a prescription due to cost, followed by 17 areas where 10% or more of residents put off seeing a medical specialist due to cost, and 11 areas where 10% or more delayed or avoided seeing a GP.

Yet the report – described as the first comprehensive national attempt to examine how well local populations' access to health services aligns with health needs – has found the average health of local populations has little bearing on access to these or other services.

The report, Healthy Communities: Australians’ experiences with access to health care in 2011–12, is accompanied by the launch of a new national website – www.myhealthycommunities.gov.au – that allows the public to see health information for their local area, and compare it with other similar areas across the country.

“The report finds health experiences vary greatly across local populations and that no one area does consistently well or poorly. Instead, the findings create a unique 'health signature' for each local population covered by the new 61 Medicare Locals set up around Australia,” according to Authority CEO Dr Diane Watson.

Across Medicare Local catchments in 2011–12, the report finds:

• The percentage of adults who were referred to a medical specialist, who felt they waited longer than acceptable for their specialist appointment ranged from 16% to 35%
• The percentage of GP attendances bulk-billed ranged from 50% to 96%
• Medicare Locals with poorer average health were no more or less likely to have a higher percentage of GP attendances bulk-billed
• Adults who saw a dentist ranged from 29% to 66%, and those who reported cost barriers to seeing a dentist ranged from 11% to 34%
• Adults who saw a medical specialist ranged from 22% to 42%, and those who reported cost barriers to seeing a specialist ranged from 3% to 14%
• Adults who delayed or avoided filling a prescription because of cost ranged from 5% to 15%
• Adults who had been to a hospital emergency department in the period ranged from 8% to 29%. Across metropolitan Medicare Local catchments, visits to EDs ranged from 8% to 15%.

Dr Watson said the percentage of adults with long-term health conditions varied from 34% to 60%, which suggested that Medicare Locals faced different challenges in ensuring health care is responsive to the needs of people in their local areas.

"For each of these measures, the local populations in parts of the country where people have the poorest health were no more likely to have seen a doctor or dentist in the past year," Dr Watson said.

"Parts of the country where people have the poorest health are no more likely to face reduced waiting times for medical specialists or lower cost barriers to visit a GP, dentist or specialist.

"We must remember, the report has a large focus on GP, dental and specialist attendances, which are part of the picture. There may be other groups, such as community nurses, meeting patient needs that are not covered by this report.

"This is an early report from the National Health Performance Authority, which charts experiences before Medicare Locals were established. It does not reflect their performance to date, but is instead a starting point to inform their early work in these 61 communities."

The report is based on Medicare statistics as well as survey data from almost 27,000 Australian adults in 2011–12.

"Our new website allows interactive comparisons across Medicare Local catchments, and is a starting point to inform the public, and to make it easier for health leaders to see where improvements can be most effectively targeted in different parts of Australia," Dr Watson said.

"MyHealthyCommunities charts Australians' experiences with health care in a way never before seen in this country, enabling comparisons and local information across a range of measures, including service access, immunisation rates and cost."

The National Health Performance Authority was established under the National Health Reform Act 2011 as an independent agency that reports regularly on the comparable performance of health care organisations.

The Performance Authority bases its reports on 48 indicators agreed by the Council of Australian Governments (COAG).