NSW patients may be some of the most satisfied in the world, but they are still putting off seeing a doctor because it's too expensive.
That's according to the annual Bureau of Health Information Healthcare in Focus report, which investigated how the state's healthcare system compares with 11 countries.
While satisfaction with the NSW system has doubled in the past three years, the report found the cost of treatment continues to stop people using it.
About 15 per cent of people said they had skipped a consultation to save money.
"It's not the first time that the report has highlighted high cost," Bureau of Health Information chief executive Jean-Frederic Levesque said.
News that makes sense
Your trusted source for staying up-to-date with the world around you. Get free daily news updates and analysis, straight to your inbox.
"When we compare with other systems like the UK, we have a higher proportion having to skip consultations, medications or tests."
With one in four households reporting they spend more than $1000 a year on medical expenses, NSW was second to the United States for out-of-pocket expenditure.
But while it was a continuing problem, Dr Levesque said the number of people skipping expensive treatment had decreased.
He said the report was, on the whole, "very positive" with NSW rating among the top three for population satisfaction with their healthcare.
"Overall the results confirm that NSW provides good care - and that there's good value for money," he said.
Short hospital stays and good follow-up care were positives, he said.
But NSW topped the list for caesarean deliveries and had the lowest rate of blood-pressure screening compared to its international counterparts.
The report drew upon data from the UK, Switzerland, Netherlands, Australia, Norway, New Zealand, Sweden, Germany, France, Canada and the US.
