Accessible and affordable healthcare? Views of Australians with and without chronic conditions.

Background With 50% of Australians having chronic disease, health consumer views are an important barometer of the "health" of the healthcare system for system improvement and sustainability. Aims To describe the views of Australian health consumers with and without chronic conditions when accessing healthcare. Methods A survey of a representative sample of 1,024 Australians aged over 18 years, distributed electronically and incorporating standardised questions and questions co-designed with consumers. Results Respondents were aged 18-88 years (432 males, 592 females) representing all states and territories, and rural and urban locations. General practices (84.6%), pharmacies (62.1%) and public hospitals (32.9%) were the most frequently accessed services. Most care was received through face-to-face consultations; only 16.5% of respondents accessed care via telehealth. The 605 (59.0%) respondents with chronic conditions were less likely to have private health insurance (50.3% vs 57.9%), more likely to skip doses of prescribed medicines (53.6% vs 28.6%), and miss appointments with doctors (15.3% vs 10.1%) or dentists (52.8% vs 40.4%) because of cost. Among 480 respondents without private health insurance unaffordability (73.5%) or poor value for money (35.3%) were the most common reasons. Most respondents (87.7%) were confident that they would receive high-quality and safe care. However, only 57% of people with chronic conditions were confident that they could afford needed healthcare compared with 71.3% without. Conclusions Health consumers, especially those with chronic conditions, identified significant cost barriers to access of healthcare. Equitable access to healthcare must be at the centre of health reform. This article is protected by copyright. All rights reserved.