Abstract
BackgroundIncreasing demand for services and rising health care costs create pressures within the Australian health care system and result in higher health insurance premiums and out-of-pocket costs for consumers.ObjectiveTo measure changes in consumer views on the quality of the Australian health care system, contributors to rising costs and attitudes towards managing these costs.MethodsTwo computer-assisted telephone interviews were conducted in 2006 (533 respondents) and 2015 (1318 respondents) and results compared.ResultsMore respondents in 2015 rated the Australian health care system ‘very adequate’ than in 2006 (22.3% vs 8.3%; Odds Ratio OR 3.2, 99% CI 2.1, 5.1) with fewer ‘concerned’ or ‘fairly concerned’ about the health care costs (69.0% vs 85.7%; OR 0.37, 99% CI 0.25, 0.53). The 2015 respondents were more likely to identify new treatments for cancer (77% vs 65.7%; OR 1.75, 99% CI 1.30, 2.35) and community expectations for access to the latest technologies (73.8% vs 67%; OR 1.39, 99% CI 1.04, 1.86) as contributors to rising health care costs. While more 2015 respondents agreed that patients should pay a greater part of the health care costs, this remained a minority view (37.9% vs 31.7%; OR 1.32, 99% CI 0.99, 1.76). They were less likely to agree that doctors should offer medical treatments regardless of the cost and chance of benefit (63.6% vs 82.9%; OR 0.36, 99% CI 0.25, 0.50).ConclusionsSatisfaction with the Australian health care system has increased over time. Consumers recognise the cost pressures and have lower expectations that all services should be provided regardless of their costs and potential benefit. Public consultation on the allocation of health care resources and involvement in health care decision-making remains important. There should be community consultation about the principles and values that should guide resource allocation decisions.
Highlights
Ageing populations, longer life expectancy, and increased rates of chronic diseases and cancers are creating increasing demand for health care services and contributing to rising health care costs worldwide
More respondents in 2015 rated the Australian health care system ‘very adequate’ than in 2006 (22.3% vs 8.3%; Odds Ratio odds ratios (OR) 3.2, 99% CI 2.1, 5.1) with fewer ‘concerned’ or ‘fairly concerned’ about the health care costs (69.0% vs 85.7%; OR 0.37, 99% CI 0.25, 0.53)
The 2015 respondents were more likely to identify new treatments for cancer (77% vs 65.7%; OR 1.75, 99% CI 1.30, 2.35) and community expectations for access to the latest technologies (73.8% vs 67%; OR 1.39, 99% CI 1.04, 1.86) as contributors to rising health care costs
Summary
Longer life expectancy, and increased rates of chronic diseases and cancers are creating increasing demand for health care services and contributing to rising health care costs worldwide. In Australia, governments struggle to meet demands for access to new and expensive medicines, health technologies, surgical interventions and hospital care, with regular claims that the increases in health care costs are unsustainable [1,2]. Patients variably contribute to the cost of medical and hospital services through additional co-payments depending on their socio-economic circumstances, the willingness of their health care providers to accept scheduled fees as the basis of their billing, and their use of private health care services. Increasing demand for services and rising health care costs create pressures within the Australian health care system and result in higher health insurance premiums and out-ofpocket costs for consumers.
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