Factors that affect out-of-pocket costs
Local area variation in the amount that patients spend out-of-pocket on health services is influenced by a number of factors, including:
- the type and amount of health services required to meet a patient’s needs
- income and lifestyle, which can influence a patient’s ability to pay fees
- the fees charged by health providers in a local area (at the discretion of the health provider and may be influenced by differences in operating costs)
- the availability of bulk-billed services
- differences in the availability and use of non-hospital primary and specialist services that are subsidised by Medicare (some people may use services not funded by Medicare, including allied health services or a hospital emergency department, or may be unable to get services due to other factors, such as the availability of nearby health care providers).
Variation in out-of-pocket costs and patients’ experiences of cost barriers can highlight gaps in access to affordable health services. However, if an area has high out-of-pocket costs, it does not necessarily mean that people living there have difficulty obtaining these services, as service use is also influenced by a person’s financial situation and needs. Knowledge of the local area can assist in understanding results for individual areas.