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Reports Find Changes in Public Attitudes to Public and Private Hospital Use in Australia

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According to two recent reports, the pattern of hospital use in Australia is shifting, with consumer satisfaction with public hospitals on the increase, as well as concerns about the affordability of care in the private sector. Leanne Wells, CEO of Consumers Health Forum of Australia, writing in Croakey.org outlined the findings and the growing concerns about care affordability.

Two recently-released reports show that Australians’ attitudes to and use of public and private hospitals have undergone significant changes in recent years. The reports reflect two quite different research projects which show, on the one hand, that positive attitudes to public hospitals have risen significantly; and on the other, that formerly strong growth in the use of private hospitals has eased.

The Consumers Health Forum has long argued for more transparency in healthcare to give consumers informed choice. It appears in any event that high out of pocket costs are among the factors pushing people to rethink their hospital choices.

The first report, published in the Health Expectations journal, ‘Changes in public perceptions and experiences of the Australian health‐care system: A decade of change’ reveals that by and large Australians are satisfied with the system, although a significant minority have concerns about aspects including the cost of and access to healthcare, and about the state of aged care. The article reports on the results of a population‐based online survey conducted in 2018, and comparisons with previous Australian population survey data sets from 2008, 2010 and 2012. One of the most striking changes between 2018 and previous years was the sharp improvement in the standing of public hospitals.

The report found increasing concerns about affordability across the decade of surveys concurred with recent reports regarding increasing out‐of‐pocket expenses, increasing private health insurance premiums and less value for money of private health insurance.

Despite increasing costs of healthcare to consumers and government, health outcomes have not improved in Australia over the last 10 years; for example, potentially preventable hospitalisations remained static and adverse events in hospital increased.

The other report explores a separate dimension. ‘Falling growth in the use of private hospitals‘ was compiled by researchers from the Melbourne Institute of Applied Economic & Social Research.

It points out that since mid-2015, the higher growth in out-of-pocket costs relative to the growth in wages began to reduce the affordability of private healthcare and marked the start of the drop in private health insurance coverage.

Using publicly available data, this paper describes the decline in growth in the use of private hospital care before and after 2015.

Growth in the use of elective surgery in private hospitals fell with some indication of increased waiting times in public hospitals, and evidence of doctors spending more of their time in public hospitals rather than in private practice.

In Australia’s mixed public-private health system, the perceptions about hospitals— whether public or private — are a focus of continuing attention and debate for both consumers and policy makers.

These reports come at a time when private health insurance memberships are falling and the weakening position of health funds is prompting industry claims for more government assistance.

For Australian policymakers, this state of affairs raises the issue of balancing equity of access to care through the public system while supporting the private sector.

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