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

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.

Context matters for primary health care access: a multi-method comparative study of contextual influences on health service access arrangements across models of primary health care

“…Access arrangements were improved when financial viability was underpinned by capitation style funding models and not totally reliant on FFS funding. This is consistent with the findings of a Canadian study of PHC models and is possibly linked to the broad context of Australia’s universal health scheme regulations [ 29 ]. In England, PHC services with higher levels of funding have been associated with better patient outcomes [ 30 ].…”

Conventional and complementary health care use and out-of-pocket expenses among Australians with a self-reported mental health diagnosis: a cross-sectional survey

“…Furthermore, these reports do not include CM use. Accounting for the impact of CM use on OOP costs can be a complicated matter, as rebate funding via either the public (Medicare) or private systems (private health insurance) or a consumers socioeconomic status (SES; i.e., discretionary spending capacity) can have a differential impact on the decision-making process regarding choice of health care services or treatments, and in turn, overall OOP costs [ 6 , 34 ]. The cost of mental health care is known to be a factor in help-seeking, obtaining treatment and support in both the short and longer term, and is correlated with subsequent mental or physical health status [ 35 ].…”

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

“…There is evidence within Australia of ‘price discrimination’, where providers are able to charge higher prices to patients who they believe can afford to pay. Large variations in out‐of‐pocket fees are being experienced across different geographic areas and across different levels of socioeconomic status . As such, there is a strong need across all medical professions for greater transparency of fees, allowing patients, as consumers, to make use of the free‐market nature of the healthcare system and choose providers based upon value.…”