Changes in out‐of‐pocket charges associated with obstetric care provided under Medicare in Australia

Callander, Emily; Fox, Haylee

doi:10.1111/ajo.12760

Cited by 13 publications

(16 citation statements)

References 12 publications

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“…To the best of our knowledge, this is the first national study using data from 31 provinces reporting private ED status in mainland China. Hospitals included in this study were characteristically distinct from previous studies in high‐income settings or comparatively in studies from other Asian countries …”

Section: Discussionmentioning

confidence: 95%

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Jin

Zhang

Seery

et al. 2019

Health Planning & Management

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Summary The number of private healthcare facilities has rapidly increased since the progressive open market policies, which began in the 1980s; however, little is known about the development of private emergency departments (EDs). This cross‐sectional study was part of the National Control Information System (NCIS) project, which collects data annually from hospitals across China. Emergency services data were extracted and included location, infrastructure, human resources, beds, and number of patients; 4529 hospitals across 31 provinces in mainland China were eventually included, consisting of 988 private and 3541 public EDs. Evidence shows that most private EDs are located in central China, where local economies are relatively developed. Most private EDs (91.6%) are found in secondary hospitals but have significantly fewer beds and smaller workforces compared with public EDs. An imbalance of emergency medical resources was observed across China, and this disparity becomes even more profound in rural hospitals. These findings may initiate collaborative, public‐private partnerships in emergency health services provision and suggest there is a need to offer tax breaks to incentivize investors, but further research is required. We may also need to rethink health insurance policies, which could enable more equitable access to private emergency care. Future planning and health policies must be based upon the strongest available evidence, if we are to address imbalanced health services distribution and growing demand.

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Section: Discussionmentioning

confidence: 95%

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Jin

Zhang

Seery

et al. 2019

Health Planning & Management

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“…What is known within Australia is that the out‐of‐pocket charges for single occasions of obstetric services are increasing drastically. Between 1992/1993 and 2016/2017, out‐of‐pocket fees for out‐of‐hospital services rose by 1035%—the largest increase for any type of health service . Not only did the out‐of‐pocket fees for a single service increase rapidly over the past two decades, but the cost of these services is also high compared with other types of services.…”

Section: Introductionmentioning

confidence: 99%

“…Not only did the out‐of‐pocket fees for a single service increase rapidly over the past two decades, but the cost of these services is also high compared with other types of services. The average out‐of‐pocket fee was AU$781 for an in‐hospital obstetric service in 2016/2017 and AU$265 for an out‐of‐hospital obstetric service . These charges can be so high despite universal health care, because of care being delivered through both the public and private systems within Australia.…”

Section: Introductionmentioning

confidence: 99%

“…Between 1992/1993 and 2016/2017, out-ofpocket fees for out-of-hospital services rose by 1035%-the largest increase for any type of health service. 13 Not only did the out-of-pocket fees for a single service increase rapidly over the past two decades, but the cost of these services is also high compared with other types of services. The average out-of-pocket fee was AU$781 for an in-hospital obstetric service in 2016/2017 and AU$265 for an out-of-hospital obstetric service.…”

mentioning

confidence: 99%

“…The average out-of-pocket fee was AU$781 for an in-hospital obstetric service in 2016/2017 and AU$265 for an out-of-hospital obstetric service. 13 These charges can be so high despite universal health care, because of care being delivered through both the public and private systems within Australia. Care is provided free of charge to the patient only within a public hospital, and all other care potentially attracts an out-of-pocket charge.…”

mentioning

confidence: 99%

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Out‐of‐pocket expenditure on health care by Australian mothers: Lessons for maternal universal health coverage from a long‐established system

Callander

Topp

Fox

et al. 2019

Birth

Self Cite

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Background Designing effective universal health care systems has challenges, including the use of patient co‐payments and the role of the public and private systems. This study sought to quantify the total amount of out‐of‐pocket fees incurred by women who gave birth in private and public hospitals within Australia—a country with universal health coverage—and assess the impact that variation in birth type has on out‐of‐pocket fees. Methods Data came from a linked administrative data set of all women who gave birth in the Australian state Queensland between July 1, 2012, and June 30, 2015, plus their resultant children. Propensity score matching was used to create two similar cohorts of women who gave birth in private and public hospitals. Results The mean total out‐of‐pocket fees for care from conception to the child's first birthday was $2813 (±2683 standard deviation) and $623 (±1202) for women who gave birth in private and public hospitals, respectively. Total fees were higher in both public and private hospitals for women who had a cesarean birth ($716 [±1419] and $3010 [±2988]) than for women who had a vaginal birth without instruments ($556 [±1044] and $2560 [±2284]). Discussion Australia's strong policy incentives for women to take out private health insurance are leaving women with large out‐of‐pocket costs. This should hold important lessons for other countries implementing a universal health care system, to ensure that using a combination of public and private practitioners does not undermine the intention of universal care.

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Postnatal Major Depressive Disorder in Australia: Inequalities and Costs of Healthcare to Individuals, Governments and Insurers

Callander¹,

Gamble

Creedy

2021

PharmacoEconomics

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Changes in out‐of‐pocket charges associated with obstetric care provided under Medicare in Australia

Cited by 13 publications

References 12 publications

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Out‐of‐pocket expenditure on health care by Australian mothers: Lessons for maternal universal health coverage from a long‐established system

Postnatal Major Depressive Disorder in Australia: Inequalities and Costs of Healthcare to Individuals, Governments and Insurers

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