What we think of our health system

Last month, the Menzies Centre for Health Policy released a health survey where they teamed up with The Nous Group to measure Australian perceptions of our health system. It was a telephone poll with a sample of 1201, giving us an MoE that maxes out around the 3% mark. A fairly broad range of questions were asked, from the way we use the health system through to what we think of it’s quality – right through to our views on  health reform issues generally.

A number of the questions asked this year in the survey were also asked in a previous survey undertaken in 2008 by the Menzies Centre – so we can see if Australian opinion has changed on a few of these over the last couple of years.

First up, respondents were asked to describe their own health – and we’ll break it down by education attainment:

As a whole, nothing has really changed since 2008, with a slight majority still classifying their health as very good to excellent. On the breakdowns however, it was interesting that University grads or higher had the best self-perceived health, while those with trade qualifications or a maximum year 10 education had the worst self-perception on their own health. We know that as a general case, education levels and a broad range of actual health outcomes moderately correlate – so it’s interesting to see that education levels also correlate with the self-perception of ones health as well.

On the age breakdowns, it’s pretty much what we’d expect, with Under 25’s having a “very good to excellent” response of 68%, with each subsequent cohort having that proportion decrease until the Over 65’s come in at 44%.

The next question looked at what parts of the health system we’ve used over the past 12 months:

Again, the numbers were pretty stable over the last 2 years – with only ‘seeing a medical specialist’ being the category most likely to have had movement (up 6% in 2 years – though not quite a statistically significant movement). What it does give us though, is some inkling of just how heavily our health system is used by the broader population. But what do we think of our health system?

Fortuitously, this question was asked with three available responses:

A majority believed that we have some good parts but fundamental changes need to be made. Yet, over the last two years, the big change in public opinion has been in the number of us that believe that the system as a whole works well, with only minor changes needed to make it work better – jumping 9 points from our 2008 views and coming mostly at the expense of ‘good, but fundamental changes are needed’. Also interesting is that for all the horror stories in the press over the health system, only 14% of us believe it needs to be completely rebuilt.

A follow-up question was asked here, getting respondents to nominate the areas which they have most concern about:

Access is by far and away the area which is causing the most grief.

When it comes to our expectations of the health system should we ever become seriously ill, they actually turn out pretty positive – with only health care affordability being slightly problematic, which we can see with the next question:

If we look at the cross-tabs here and have a squiz at how it pans out by self-identified health status:

…what we see is that those with poorer health have lower expectations of our health care system across the board than those of us that see our health as “very good to excellent”. Also worth noting is that on the age cross-tabs, it is the 65 and over cohort that has the highest ratings of all age groups for each of the four questions.

When asked about broad satisfaction levels with various types of medical practitioners, the results came in as:

Public hospitals and aged care/nursing homes are the only two areas which don’t have a majority of the population being satisfied with the quality of the services they provide. Everything else enjoys fairly large to huge majorities.

One of the problems that are most regularly mentioned with our health system is the front entrance – GPs and the time it takes to see them.

One of the big divides here is between capital cities and the rest of Australia. 56% of capital city respondents said that the last time they made an appointment with a GP they got in on the same day, compared to only 33% for non-capital city respondents. This gives a pretty good insight into why GP super clinics will become a seriously important piece of regional health architecture!

On a related note, a further question was asked about individual attachment to a given GP and/or GP practice:

Two thirds of the public always see the same doctor. When we run the cross tabs between these last two questions, we get:

Which sort of points out the obvious – those who have no attachment to a particular GP or clinic, can shop around and get seen earlier. However, when it comes to seeing a GP outside of business hours, the opposite becomes the case – where those who always see the same GP or go to the same GP practice experience a much higher ease of access to after hours GP access. 41% of people who go to different doctors and practices found accessing a GP outside of business hours “very difficult” compared to only 23% of those that always see the same doctor. You can see this additional result in the full report.

The other two questions worth looking at are about health reform. First up, a generically worded, non-partisan question on the Federal governments health reform program with the states.

What we see is fairly significant support – 76% for to 9% against. Yet, if you ask this question a different way, with a more partisan angle, that support would start to drop dramatically. It’s how political parties of all persuasions can play vacuous political games with major policy areas – many of their supporters will simply turn their brains off and do as they’re told.

The other reform question was on nurses taking over some of the minor roles that GPs currently undertake.

Again, big generic support for this idea. Usually, we see resistance to nurses being medical practitioners among the elderly – many of whom have a strong, almost institutionalised view of the role of doctors in not only our health system, but in society generally. Here is no exception.

If we break run the cross-tabs along age cohorts, what see is that the 65 and older group start to drop off significantly in support levels.

Although, still holding a majority view on nurses having an expanded role.

The Menzies Centre health survey is actually much larger than what we’ve covered here and has a dedicated section on aged care. It’s worth downloading the entire report if you’re interested in Australian health issues.