Private general paediatric care availability in Melbourne

Abstract

Objective The aims of the present study were to determine the actual availability of private general paediatric appointments in the Melbourne metropolitan region for children with non-urgent chronic illnesses and the cost of such care. Methods A 'secret shopper' method was used. Telephone calls were made to a random sample of 47 private paediatric clinics. A trained research assistant posed as a parent, requesting the first available appointment with a specific paediatrician. Data regarding appointment availability, total potential charges and net charges after the Medicare rebate were collected. Results Appointments were available in 79% (n=37) of clinics, with 72% (n=34) able to offer an appointment with the requested general paediatrician. The number of days until available appointments varied from same day appointments to a wait of 124 days, with an average wait of 33 days. Of practices that provided information about the appointment cost (n=42), five bulk-billed for the consultation, whereas the remainder (n=37) were fee-paying clinics. The potential maximum charge for an initial consultation in the fee-paying clinics ranged from A$177 to A$430, with an average cost of A$279. The potential maximum out-of-pocket cost for patients ranged from A$40 to A$222, with an average out-of-pocket cost of A$128. Conclusions Private paediatric care in the Melbourne metropolitan region is generally available. The out-of-pocket cost of private paediatric out-patient care may present a potential economic barrier for some families. What is known about the topic? In Australia, out-of-pocket expenses for private specialist care are not covered by private health insurance. There are no data available on the actual cost of private paediatric consultations that are based on real-time assessments. Data collected in 1998 suggested that the average waiting time for a first standard consultation with a general paediatrician in a private room was 14.1 days. There are no recent empirical data on appointment availability and waiting time for appointments with general paediatricians in Australia. What does this paper add? There is high availability of paediatric consultations in the private sector. Waiting times for an appointment vary considerably from same day appointments to a wait of 124 days, with an average wait of 33 days. The cost of a private paediatric consultation in Australia to the patient is considerable, with an average potential maximum up-front charge for an initial consultation of A$279 and an average potential maximum out-of-pocket cost of A$128. What are the implications for practitioners? Data on the availability and cost of private paediatric consultations are imperative to formulate evidence-informed policy and better understand variations in the availability of public and private care.

Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

“…This finding of reduced use of specialists in Australia is consistent with Medicare data for older children in LSAC who are disadvantaged 16. It has been well documented that there are long waiting lists to see publicly funded paediatricians, and wide variation in billing and out-of-pocket expenses for private paediatricians 37…”

The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

“…This finding regarding reduced access to specialists in Australia is consistent with Medicare data for older children in LSAC (16). It has been well documented that there are long waiting lists to see publicly funded paediatricians and wide variation in billing and out of pocket expenses for private paediatricians (32). This is a concerning finding in terms of the important role that paediatricians play in diagnostic evaluation, assessment of underlying causes and comorbidity and access to funding schemes including Carer's Allowance, the National Disability Insurance Scheme and Australia's funding model to provide early intervention to children who are developmentally vulnerable (33).…”

How long and how much? Wait times and costs for initial private child mental health appointments

“…Within the last 10 years, only one other secret shopper study has investigated wait times for private paediatricians in Australia. 9 This study reported a 33-day average wait time for a child with a medical condition. However, consistent with our finding of a 44-day average wait time, paediatricians report that they usually see children with medical conditions sooner than children with developmental and behavioural conditions.…”

“…There is a scarcity of Australian data on wait times and costs for children to see a private mental health specialist. Kunin, Allen 9 found the average wait time for a general paediatric appointment in metropolitan Melbourne was 33 days with an out-of-pocket cost of $128. However, in Kunin et al's study the appointments were for physical health complaints (i.e.…”