A report on Aboriginal people's perceptions of the NSW hospital system showed a gulf between their experiences and those of non-Aboriginal people in several key measures, which were more pronounced in rural hospitals.

Aboriginal patients were particularly lukewarm on the quality of their communications with clinical staff, whether they had enough privacy when discussing their treatment and whether appropriate arrangements were made for their discharge.

But there was little difference between them and non-Aboriginal patients in the way that they rated the physical environment and comfort, safety and hygiene.

The NSW Bureau of Health Information teased out the 2682 responses of Aboriginal patients to its annual survey of admitted patients for 2014 to produce this more jaded perspective of the state's health system.

In rural areas, 71 per cent of Aboriginal patients said they would "speak highly" about their care compared with 79 per cent of non-Aboriginal patients. Overall, 72 per cent of Aboriginal people said they would "speak highly" of their experience, compared with 76 per cent of non-Aboriginals.

BHI chief executive Jean-Frederic Levesque said Aboriginal patients had given very high ratings to the system in general, but there were clear areas for improvement.

"In some cases, health districts might want to target specific aspects of care where they can see that there is a gap, really trying to make the level of care similar between the two groups," Dr Levesque said.

"It tends to be the case that people in rural areas have a better experience of care compared to urban areas. But we can see bigger gaps in rural areas when you compare Aboriginal patients and non-Aboriginal patients and that's an important finding of this report."

The biggest differences in responses were to questions about whether patients were "always" given enough privacy when discussing their condition or treatment (72 per cent of Aboriginal patients compared to 81 per cent of non-Aboriginal patients), and whether doctors "always" answered important questions in an understandable way (Aboriginal patients 66 per cent and non-Aboriginal 74 per cent).

There were also significant differences between geographical regions, with Aboriginal patients from the Murrumbidgee, Western NSW and Western Sydney giving their hospital experience significantly poorer ratings than non-Aboriginal people.

In the Hunter New England and Sydney local health districts, there was little difference in the way hospitals were marked by Aboriginal and non-Aboriginal patients.

The report said this suggested the gaps between the experiences of the two groups were not inevitable.

Murrumbidgee Local Health District chief executive Jill Ludford said she acknowledged services could be "enhanced".

"We are strengthening the cultural awareness of our staff by reinvigorating our Respecting the Difference face-to-face training and developing a new orientation program for staff," Ms Ludford said.

"The local health district is also striving to improve communication and engagement with Aboriginal people when they are being treated in our hospitals and on discharge home."

The federal government committed in 2008 to a series of targets aimed at "closing the gap" between Aboriginal and non-Aboriginal people, including lifting the indigenous life expectancy to that of the general population by 2031 and halving the mortality rate of children under five by 2018.

NSW Health said in a statement it was working to improve Aboriginal patients' experience of care, by giving NSW Health employees training to improve their cultural understanding.

It also had an Aboriginal health plan that recognised the importance of working in partnership with Aboriginal people and organisations.