NSW has been ranked the worst for healthcare affordability among older patients in the latest survey that pits Australia's most populous state against international health systems.

The results released on Thursday showed a larger proportion of NSW patients 65 and older struggled with their medical costs than their counterparts in Australia overall and 10 other OECD countries.

NSW has been ranked the worst for healthcare affordability among older patients in the latest survey that pits Australia's most populous state against international comparators.

NSW fared worst when it came to the percentage of respondent who said they had problems paying their medical bills (15 per cent), compared to just 1 per cent in Sweden and 10 per cent in the US, found the survey of 24,000 people including 1175 in NSW.

More than one in five (22 per cent) reported spending $1000 or more in out-of-pocket healthcare costs, the third largest proportion after Switzerland (53 per cent) and the US (37 per cent), and well behind the top performer France (3 per cent), according to the the 2017 Commonwealth Fund International Health survey findings released by the Bureau of Health Information (BHI).