Health gains but access to right care in right place challenging
Health in NSW is improving with a drop in deaths from heart disease, stroke and common cancers over a decade but people do not always have affordable access to the right care in the right place.
The Bureau of Health Information“s second annual report Healthcare in Focus 2011: How well does NSW perform? compares the state to Australia and 10 countries to identify achievements and opportunities for improving healthcare for sicker adults* – people most likely to have recent, first-hand experience with care.
Just over half of NSW sicker adults (52%) report having a 'medical home' where four key aspects of care are all met:
- a regular doctor or GP practice
- who knows them
- is accessible and
- helps coordinate care.
NSW was outperformed by three countries on providing a 'medical home' for sicker adults.
“The Bureau's report shows that sicker adults in NSW who have a 'medical home' are more likely to be able to get care in the evening, weekends or holidays without going to the emergency department,” Bureau chief executive Dr Diane Watson said.
“Providing the right care in the right place reduces avoidable visits to emergency departments and hospitals,” Dr Watson said.
“We've found 15% of NSW sicker adults with a chronic condition are hospitalised or visit an emergency department, which is twice as high as France. In NSW, hospitalisation rates for chronic conditions such as diabetes and respiratory disease are high relative to most countries.
“Internationally, we can see some countries have taken opportunities to be less reliant on hospitals. In 2011 one quarter of adults in NSW (24%) and Australia (24%) reported they were hospitalised in the past two years which is much higher than Canada (14%) and the UK (15%),” Dr Watson said.
The Bureau's report shows health investment in NSW from all sources is about the same or lower than other surveyed countries but none has lower spending and better health.
“NSW gets value for its health dollar but when people are sick out-of-pocket costs for care can be high,” Dr Watson said. “Only the US had a higher percentage of sicker adults who reported cost as a barrier to accessing doctors, medicines, tests and treatments.”
While no public patient in NSW incurs out-of-pocket costs for hospitalisation, 42% of NSW sicker adults reported that they and their family had spent more than $1,000 out-of-pocket on medical care – a higher percentage than in nine countries.