Mapping Patient Experience and Economic Disadvantage in NSW

This report explores the relationship between economic disadvantage and patient experience of health services across New South Wales. It focuses on the costs, delays and expectations of General Practitioner, private and public dental, and medical specialist services. It recognises that not everyone accesses or experiences health services equally, while there is significant variation by region. Importantly, this report considers economic disadvantage in terms of relative unemployment, low income and labour force status, not just low income. Using complex modelling techniques, NATSEM has identified key social factors that affect patient experiences and then mapped these by ABS small area (SA2 or suburb). This clearly shows the variations in patient experience by geography, demography and socioeconomics. This analysis of multiple variables aligns with a social determinants of health perspective, which emphasises the multiple influences on health outcomes. Overall, this report finds that in NSW, people who are unemployed have the poorest patient access and worst experience of health services. Unemployed people in regional NSW are most likely to delay seeing a GP due to cost and are least likely to access GPs fast for urgent services. When it comes to accessing medical specialists, between 20% and 25% of people living in NSW think they wait too long. Again, it is unemployed people who are most likely to delay visits because of cost, followed by those living alone and young people aged between 15-24. Across NSW, the health service people are most likely to delay because of cost is seeing their dentist. The problem is most acute in regional areas, and particularly for people who are unemployed or living alone. However, across NSW people are more likely to be satisfied with the time their dentist spends with them. In regional NSW, they are least satisfied with time spent by medical specialists, while in metropolitan Sydney it is GPs who give rise to the most dissatisfaction. The report highlights that as well as employment status, being a single parent, living alone and living in regional NSW can be factors associated with poorer experience of health services. And that overall, it is older Australians who are least likely to delay accessing services and more likely to be satisfied with their experience.
However, the report finds that there is no consistent link between low income and poorer access to health services. Some more affluent areas also experience significant health challenges and factors such as access to bulk billing, private health insurance, age and cultural and generational expectations can play a part. These and other findings are explored in detail throughout the report, its accompanying maps and technical appendix.1 This report uncovers trends that confirm and contradict commonly held views on poverty and health, revealing a need for policy makers, health and social service providers to continue developing a deeper understanding of the nature, diversity and complexity of patient experience. This research helps contribute to this understanding and provides robust data and evidence to inform stronger policy and better health outcomes for all.