Health service use of Australian unemployment and disability benefit recipients: a national, cross-sectional study

Abstract

Background Healthcare is funded and delivered separately from income support programs such as unemployment and disability benefits. Greater understanding of the health service use (HSU) of benefit recipients would support more effective design and delivery of health and income support programs. This study aimed to characterise the HSU of disability and unemployment benefit recipients relative to people earning wages, while controlling for personal, household and health-related factors associated with HSU in benefit recipients. Methods A cross-sectional national survey of 9110 working age Australian adults in three groups: (1) 566 receiving the disability support pension (DSP); (2) 410 receiving unemployment benefits; and (3) 8134 earning wages. Outcomes included prevalence and frequency of health professional consultations, hospital attendance and admission in the past 12 months, as well as medication and supplement use in the past 2 weeks. Analyses compared DSP and unemployment benefit recipients to wage earners using prevalence ratios and incident rate ratios, adjusted for predisposing, enabling and need factors that may affect HSU. Results In adjusted regression models, both DSP and unemployment benefit recipients were significantly more likely than wage earners to have consulted psychologists and social workers. DSP recipients also reported a significantly higher prevalence of consultations with General Practitioners (GPs), specialist physicians and podiatrists.. Both groups reported significantly more frequent consultations with GPs and DSP recipients with specialists. No differences were observed between groups for hospital attendance or admission, or supplement use in fully adjusted models, though the DSP group reported more prevalent medication use than wage earners. Inclusion of confounders including self-assessed health, disability severity, health insurance status, and financial resources attenuated the relationship between benefit receipt and HSU, however significant associations were still observed. Conclusions People receiving unemployment and disability insurance benefits use significantly more health services than wage earners. A range of personal and clinical characteristics explained much, but not all, of the association between greater HSU and benefit receipt. Greater coordination between health and income support systems may improve health, reduce HSU and improve work ability in unemployed and working age people.

Employment Characteristics and Risk of Hospitalization Among Older Adults Participating in the Mayo Clinic Biobank

“…In an Australian study, patients receiving disability pension or unemployment benefits had no differences in hospital use compared with wage-earning patients. 34 A Danish study reported that job loss from plant closure was not associated with an increase in all-cause hospitalization, but there was an increase in hospitalization from alcohol-related diseases. 35 International studies are often difficult to compare, however, because unemployment laws and medical benefits can be markedly different from country to country.…”

The relationship between work disability and subsequent suicide or self-harm: A scoping review

“…There are also gaps in health service delivery. For example one study of disability pension recipients identified that although 69% reported a diagnosed mental health problem, only 16% reported receiving specialist mental health care [8], a finding reflected in similar studies of workers' compensation cohorts [3,10].…”

“…Common diseases and illnesses of working age are the major causes of work disability, and include conditions with high prevalence such as low back pain, depression, anxiety, traumatic injury, as well as cancers and circulatory system disorders [1,2] The consequences of work disability can be significant for workers. People with prolonged work disability suffer worse mental health [3][4][5], have shorter life expectancy [6], attend healthcare consultations more frequently with physical symptoms and report higher levels of pain [7], receive more social care [8], and report reduced quality of life [9]. There are also gaps in health service delivery.…”

The relationship between work disability and subsequent suicide or self-harm: A systematic scoping review

“…Social support is a protective factor that reduces the risk of suicide death in adults (20) that may be adversely impacted during periods of work disability. Finally, many people with work disability and concurrent mental health problems do not receive appropriate mental health treatment, and thus the risk of self-harm or future suicide is more likely to go unrecognised (2,7).…”

“…The consequences of work disability can be significant for workers. People with prolonged work disability suffer worse mental health (2)(3)(4), have shorter life expectancy (5), attend healthcare consultations more frequently with physical symptoms and report higher levels of pain (6), receive more social care (7), and report reduced quality of life (8). There are also gaps in health service delivery.…”