Study shows major financial burden of chronic conditions   

The cost of health care is a major burden for people living with chronic conditions and their carers, according to a new study from The Australian National University (ANU). 

The review, led by Associate Professor Jane Desborough, looked at the experiences of more than 1,800 people aged from 0 to 96 with a range of chronic conditions, including arthritis, back pain, cardiovascular disease, mental health conditions and kidney disease.  

“We reviewed 37 studies. Participants in one-third of the studies reported not being able to attend specialist appointments due to the cost,” Associate Professor Desborough said. 

“Cost was also a barrier to visiting a GP, and people actively sought out bulk billing GPs.” 

“People are not seeing specialists or choosing between specialists, only seeing the doctor when it is absolutely essential, or skipping or delaying dental consultations.”  

Cost was a key barrier to accessing allied health services such as physiotherapists and psychologists. 

“While government subsidies are of some assistance, many patients cannot afford to pay either the upfront fee or the gap payment. Some people cannot afford to see any doctor if there is an out-of-pocket cost. Being aware of the cost beforehand is not going to change this,” Associate Professor Desborough said.  

Participants in half of the studies experienced challenges when it came to affording medication. 

“People with chronic conditions often face medication costs that are ongoing and life-long, increasing the financial burden,” Associate Professor Desborough said.  

“People resort to measures such as altering their medication doses, substituting medications or sharing medications with housemates. Most alarming was that many people reported having to choose between paying for medications or other aspects of health care and necessities such as food and household bills. 

“Some participants continued to use their current drug regimens despite side effects, as their finances restricted them from trialling other medications.” 

Transport and parking costs were also a major burden for people living in all areas – urban, regional and remote.  

“For people in urban areas, it was things like difficulty walking to public transport or not being able to afford the cost of taxis or parking fees,” Associate Professor Desborough said. 

“For people in rural and remote areas, the costs of travel and accommodation to attend specialist appointments in the city often resulted in them not attending some appointments.” 

The studies showed the financial impact of having to work less due to ill health has a major impact on many people living with a chronic condition.   

“Our research clearly indicates that Australia is yet to realise its goal to ensure equitable access to health care for everyone, and to protect everyone from health-related debt and impoverishment,” Associate Professor Desborough said.  

“There is an ongoing need to increase the health workforce in many parts of the country, and in other areas, we need to look closely at the transport needs of those with chronic conditions.”  

The research team includes five members with lived experience of chronic conditions.   The study has been published in Health Policy.