Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Variations in out-of-pocket costs for primary care services across Australia: a regional analysis

Emily Callander A D , Sarah Larkins B and Lisa Corscadden C
+ Author Affiliations
- Author Affiliations

A Australian Institute of Tropical Health and Medicine, Building 48, James Cook University, Townsville, Qld 4814, Australia.

B College of Medicine and Dentistry and Anton Breinl Research Centre for Health Systems Strengthening, Building 39, James Cook University, Townsville, Qld 4814, Australia.

C Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW 2057, Australia.

D Corresponding author. Email: emily.callander@jcu.edu.au

Australian Journal of Primary Health 23(4) 379-385 https://doi.org/10.1071/PY16127
Submitted: 10 October 2016  Accepted: 18 February 2017   Published: 15 May 2017

Abstract

The aim of this study is to describe average out-of-pocket costs across different regions of Australia, as defined by Primary Health Network (PHN) boundaries, and assess the association between population characteristics and out-of-pocket costs for selected primary care services. A combination of descriptive and regression analysis was undertaken using administrative data from the Australian Department of Human Services reporting on the health services used across PHNs in Australia. Those in regional areas paid significantly more for Allied Health services than those in capital cities (A$5.68, P = 0.006). The proportion of an area’s population aged 65 years and over was inversely related to out-of-pocket charges for Allied Mental Health (–A$79.12, P = 0.029). Some areas had both high charges and disadvantaged populations: Country South Australia, Northern Queensland, Country Western Australia, Tasmania and Northern Territory, or populations with poor health: Northern Territory and Tasmania. Although there was a large amount of variation in out-of-pocket charges for primary care services between PHNs in Australia, there was little evidence of inequality based on health, age and socioeconomic characteristics of a population or the proportion of Aboriginal and Torres Strait Islander people.


References

Australian Institute of Health and Welfare (2015) Health expenditure Australia 2013–14. Health and welfare expenditure series number 54. Catalogue number HWE 63. AIHW, Canberra, ACT, Australia.

Bourke L (2015) Health Minister Sussan Ley backs away from plan to cut Medicare rebate. The Sydney Morning Herald, 15 January 2015. (Fairfax Media: Sydney, NSW, Australia) Available at http://www.smh.com.au/federal-politics/political-news/health-minister-sussan-ley-backs-away-from-plan-to-cut-medicare-rebate-20150115-12qp0n.html [Verified 30 March 2017]

Callander EJ, Corscadden L, Levesque J-F (2017) Out-of-pocket healthcare expenditure and chronic disease – do Australians forgo care because of the cost? Australian Journal of Primary Health 23, 15–22.
Out-of-pocket healthcare expenditure and chronic disease – do Australians forgo care because of the cost?CrossRef |

Cant R, Aroni R (2007) Melbourne dietitians’ experience of Medicare policy on allied health services (Strengthening Medicare; Enhanced Primary Care) in the first 12 months. Nutrition & Dietetics: the Journal of the Dietitians Association of Australia 64, 43–49.
Melbourne dietitians’ experience of Medicare policy on allied health services (Strengthening Medicare; Enhanced Primary Care) in the first 12 months.CrossRef |

Department of Health (2015a) Chronic disease management – individual allied health services under Medicare – patient information. (Australian Government: Canberra, ACT, Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/health-medicare-allied-health-brochure.htm [Verified 6 January 2017]

Department of Health (2015b) ‘MBS data by PHN.’ (Australian Government: Canberra, ACT, Australia)

Department of Health (2016a) Better outcomes in mental health care. (Australian Government: Canberra, ACT, Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/content/mental-boimhc [Verified 6 January 2017]

Department of Health (2016b) COAG improving access to primary care in rural and remote areas – COAG s19(2) exemptions initiative. (Australian Government: Canberra, ACT, Australia) Available at http://www.ruralhealthaustralia.gov.au/internet/rha/publishing.nsf/Content/COAG_Improving_Access_to_Primary_Care_Services_in_Rural_and_Remote_areas-s19_2_Exemptions_Initiative [Verified 4 February 2017]

Department of Health (2016c) Primary Health Networks (PHNs). (Australian Government: Canberra, ACT, Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home [Verified 6 January 2017]

Department of Human Services (2014a) Budget 2013–14: extended Medicare safety net. (Australian Government: Canberra, ACT, Australia) Available at http://www.humanservices.gov.au/corporate/publications-and-resources/budget/1314/measures/health-matters/20-60516 [Verified 23 January 2015]

Department of Human Services (2014b) Budget 2014–15: Pharmaceutical Benefits Scheme. (Australian Government: Canberra, ACT, Australia) Available at http://www.humanservices.gov.au/corporate/publications-and-resources/budget/1415/measures/health-matters-and-health-professionals/35-90114 [Verified 23 January 2017]

Department of Human Services (2015) Medicare services. (Australian Government: Canberra, ACT, Australia) Available at http://www.humanservices.gov.au/customer/subjects/medicare-services [Verified 6 January 2017]

Duckett S, Boxall A, Baum F, Daube M, Clarke P, Javanparast S (2014) Federal budget 2014: health experts react. The Conversation, 13 May 2014. (The Conversation Media Group) Available at https://theconversation.com/federal-budget-2014-health-experts-react-26577 [Verified 30 March 2017]

Farag I, Sherrington C, Ferreira M, Howard K (2013) A systematic review of the unit costs of allied health and community services used by older people in Australia. BMC Health Services Research 13, 69
A systematic review of the unit costs of allied health and community services used by older people in Australia.CrossRef |

Jan S, Essue BM, Leeder SR (2012) Falling through the cracks: the hidden economic burden of chronic illness and disability on Australian households. The Medical Journal of Australia 196, 29–31.
Falling through the cracks: the hidden economic burden of chronic illness and disability on Australian households.CrossRef |

Lucas N, Bayer JK, Gold L, Mensah FK, Canterford L, Wake M, Westrupp EM, Nicholson JM (2013) The cost of healthcare for children with mental health difficulties. The Australian and New Zealand Journal of Psychiatry 47, 849–858.
The cost of healthcare for children with mental health difficulties.CrossRef |

National Health Performance Authority (2015) ‘Medicare Benefits Schedule GP and Specialist Attendances and Expenditure in 2013–14.’ (National Health Performance Authority: Canberra, ACT, Australia)

OECD (2014) ‘Out-of-Pocket Expenditure on Health 2014/15. Health: Key Tables from OECD.’ (Organization for Economic Co-operation and Development: Paris, France)

Owler R (2015) AMA letter to Tony Abbott. (SCRIBD: Sydney, NSW, Australia) Available at https://www.scribd.com/document/252665670/AMA-letter-to-Tony-Abbott [Verified 23 January 2017]

Public Health Information Development Unit (2014) ‘Social Health Atlas of Australia.’ (Australian Government: Canberra)

Yusuf F, Leeder S (2013) Can’t escape it: the out-of-pocket cost of health care in Australia. Medical Journal of Australia 199, 475–478.



Supplementary MaterialSupplementary Material (141 KB) Export Citation

View Altmetrics