176 research outputs found
Supplementary Material, AUT688331_Lay_Abstract – The impact of childhood autism spectrum disorder on parent’s labour force participation: Can parents be expected to be able to re-join the labour force?
No full textSupplementary Material, AUT688331_Lay_Abstract for The impact of childhood autism spectrum disorder on parent’s labour force participation: Can parents be expected to be able to re-join the labour force? by Emily J Callander and Daniel B Lindsay in Autism</p
The cost of Hypertensive Disorders of Pregnancy to the Australian healthcare system
No full textIn Australia, Hypertensive Disorders of Pregnancy are one of the leading causes of maternal death. Additionally, mothers and babies can experience significant morbidity associated with Hypertensive Disorders of Pregnancy. Currently, there is little understanding about the resources spent on this pregnancy complication in Australia. Therefore, using a linked administrative dataset from the Queensland population in Australia, this study aims to determine the difference in government expenditure between mothers that have Hypertensive Disorders of Pregnancy and mothers who do not. The total government expenditure on mothers that had HDP was significantly higher than in mothers who did not have HDP (11,395 respectively). Most notably, the greatest difference in costs were experienced during the time of birth (6509).No Full Tex
The personal and national costs of lost labour force participation due to arthritis: an economic study
No full textArthritis is a common and costly health condition internationally. The direct medical costs of arthritis are significant, with the condition being the fourth most common reason for seeking general practitioner medical care. Treatment of arthritis in Australia cost around $4 billion (AU) in health system expenditure in 2004–05, the fourth largest cause of health expenditure in the country. However, this figure covers only the direct medical costs, and the indirect costs, are considered to be larger. Within Australia arthritis has been listed as a ‘National Health Priority Area’, and affects 15% of the population. By 2020 the prevalence of the condition is estimated to increase, with arthritis potentially affecting 35% of the Australian population. Arthritis can cause significant activity limitation, and is responsible for around 13% of the disability reported in Australia. Due to its impact on functional ability, arthritis is associated with decreased labour force participation rates. Within Australia the impact of arthritis on labour force participation among people in the pre-retirement age group of 45 to 64 years is significant – with people suffering from arthritis being 3 times more likely to be out of the labour force than those with no chronic health condition.Authors: Deborah J Schofield, Rupendra N Shrestha, Richard Percival, Megan E Passey, Emily J Callander and Simon J Kell
Arthritis and the risk of falling into poverty: a survival analysis using Australian data
No full textObjective: Low income is known to be associated with having arthritis. However, no longitudinal studies have documented the relationship between developing arthritis and falling into poverty. This paper focuses upon Australians who develop arthritis to determine if they have an elevated risk of falling into poverty.
Methods: Survival analysis using Cox regression models applied to nationally representative, longitudinal survey data between the years 2007 and 2012 for Australian adults aged 21 years and over.
Results: The hazard ratio for falling into income poverty for females who develop arthritis is 1.51 (95% CI: 1.50 – 1.53), and for males the hazard ratio for falling into income poverty is 1.22 (95% CI: 1.21 – 1.23), relative those who never developed arthritis. The hazard ratio for falling into multidimensional poverty for females who develop arthritis is 1.87 (95% CI: 1.84 – 1.90) and for males the hazard ratio is 1.29 (95% CI: 1.29 – 1.30).
Conclusion: Developing arthritis increases the risk of falling into income poverty and multidimensional poverty. The risk for income and multidimensional poverty is higher for females. Given the high prevalence of arthritis, the condition is an overlooked driver of poverty
Postnatal Major Depressive Disorder in Australia: Inequalities and Costs of Healthcare to Individuals, Governments and Insurers.
No full textBACKGROUND: Perinatal mental health has pervasive impacts on the wellbeing of both the mother and child, affecting quality of life, bonding and attachment and cognitive development. OBJECTIVES: The aim of this study was to (i) quantify the costs to government healthcare funders, private health insurers and individuals through out-of-pocket fees, of women with postnatal major depressive disorder (MDD); and (ii) identify any socioeconomic inequalities in health service use and costs amongst these women. METHODS: A whole-of-population linked administrative dataset containing the clinical records and health service use for all births in the state of Queensland, Australia between 01 July 2012 and 30 June 2015 was used (n = 189,081). Postnatal MDD was classified according to ICD-10 code, with women hospitalised for MDD in the 12 months after birth classified as having 'postnatal MDD' (n = 728). Health service use and costs from birth to 12 months post-birth were included. Total costs included cost to government funders and private health insurers and out-of-pocket fees. Total costs and costs to different funders were compared for women with postnatal MDD and for women without an inpatient event for postnatal MDD, with unadjusted means presented. A generalised linear model was used to compare the difference in total costs, adjusting for key confounders. Costs to different funders and number of different services accessed were then compared for women with postnatal MDD by socioeconomic status, with unadjusted means presented. RESULTS: The total costs from birth to 12 months post-birth were 636% higher for women with postnatal MDD than women without an inpatient event for postnatal MDD, after accounting for differences in private hospital use, mode of birth, clinical characteristics and socioeconomic status. Amongst women with postnatal MDD, the cost of all services accessed was higher for women of highest socioeconomic status than for women of lowest socioeconomic status (A11,916.94). The cost of services for women of highest socioeconomic status was higher for private health insurers (A2555.26), but lower for public hospital funders (A6582.09) relative to women of lowest socioeconomic status. Outside of public hospitals, costs to government funders was higher for women of highest socioeconomic status (A1952.00). Women of highest socioeconomic status accessed more inpatient (8.2 vs 3.1) and specialist services (13.4 vs 5.5) and a higher proportion had access to psychiatric specialist care (39.7% vs 13.6%) and antidepressants (97.6% vs 93.8%). CONCLUSION: MDD is costly to all funders of healthcare. Amongst women with MDD, there are large differences in the types of services accessed and costs to different funders based on socioeconomic status. There may be significant financial and structural barriers preventing equal access to care for women with postnatal MDD.No Full Tex
Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department
No full text"This is the pre-peer reviewed version of the following article: Alele, F. O., Callander, E. J., Emeto, T. I., Mills, J. and Watt, K. (2018), Socio‐economic composition of low‐acuity paediatric presentation at a regional hospital emergency department. J Paediatr Child Health, 54: 1341-1347. doi:10.1111/jpc.14079, which has been published in final form at http://dx.doi.org/10.1111/jpc.14079 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."Aim
Despite increasing rates of emergency department (ED) utilisation, little is known about low‐acuity presentations in children ≤5 years. The aims of the study were to estimate the proportion and cost of low‐acuity presentations in children ≤5 years presenting to the ED and to determine the relative effect of socio‐economic status (SES) on paediatric low‐acuity presentations at the ED.
Methods
This is a retrospective observational study of children ≤5 years presenting to the Cairns Hospital ED over 4 years. A multivariate logistic regression model was used to assess the association between SES and low‐acuity presentations. Cost of low‐acuity presentations was calculated based on triage score and admission status, using costs obtained from the National Hospital Cost Data Collection.
Results
A total of 23 086 children were included in the study, of whom 56.7% were male (mean age = 1.85 ± 1.63 years). Approximately one‐third of ED visits were low‐acuity presentations (32.4%), and low‐acuity presentations increased progressively with SES. In multivariate analysis, children from families with very high SES were twice as likely to have a low‐acuity presentation (odds ratio 2.17; 95% confidence interval, 1.66–2.85). Low‐acuity ED presentations cost the health‐care system in excess of A1 110 000 per year.
Conclusions
These findings demonstrate that a significant proportion of paediatric ED visits are of low acuity and that these visits yield a substantial cost to the health system. Further research is required regarding care givers' rationale and potentially other reasons underlying these low‐acuity ED presentations.Publishe
Inequities in vulnerable children's access to health services in Australia
No full textINTRODUCTION: Children born into families at risk of becoming or remaining poor are at significant risk of experiencing childhood poverty, which can impair their start to life, and perpetuate intergenerational cycles of poverty. This study sought to quantify health service utilisation, costs and funding distribution amongst children born into vulnerable compared to non-vulnerable families. METHODS: This study used a large linked administrative dataset for all women giving birth in Queensland, Australia between July 2012 and July 2018. Health service use included inpatient, emergency department (ED), general practice, specialist, pathology and diagnostic imaging services. Costs included those paid by public hospital funders, private health insurers, Medicare and out-of-pocket costs. RESULTS: Vulnerable children comprised 34.1% of the study cohort. Compared with non-vulnerable children, they used significantly higher average numbers of ED services during the first 5 years of life (2.52±3.63 vs 1.97±2.77), and significantly lower average numbers of specialist, pathology and diagnostic imaging services. Vulnerable children incurred significantly greater costs to public hospital funders compared with non-vulnerable children over the first 5 years of life (10 247), and significantly lower private health insurer, Medicare and out-of-pocket costs. CONCLUSION: There are clear inequities in vulnerable children's health service utilisation in Australia. Greater examination of the uptake and cost-effectiveness of maternal and child services is needed, as these services support children's development in the critical first 1000 days of life.Full Tex
Health inequality in the tropics and its costs: a Sustainable Development Goals alert
No full textBackground: It is known that health impacts economic performance. This article aims to assess the current state of health inequality in the tropics, defined as the countries located between the Tropic of Cancer and the Tropic of Capricorn, and estimate the impact of this inequality on gross domestic product (GDP).
Methods: We constructed a series of concentration indices showing between-country inequalities in disability-adjusted life years (DALYs), taken from the Global Burden of Disease Study. We then utilized a non-linear least squares model to estimate the influence of health on GDP and counterfactual analysis to assess the GDP for each country had there been no between-country inequality.
Results: The poorest 25% of the tropical population had 68% of the all-cause DALYs burden in 2015; 82% of the communicable, maternal, neonatal and nutritional DALYs burden; 55% of the non-communicable disease DALYs burden and 61% of the injury DALYs burden. An increase in the all-cause DALYs rate of 1/1000 resulted in a 0.05% decrease in GDP. If there were no inequality between countries in all-cause DALY rates, most high-income countries would see a modest increase in GDP, with low- and middle-income countries estimated to see larger increases.
Conclusions: There are large and growing inequalities in health in the tropics and this has significant economic cost for lower-income countries
Inequality in out of pocket fees, government funding and utilisation of maternal health services in Australia
No full textThis study aimed to assess the distribution of service utilisation, out-of-pocket fees and government funding for maternal health care in Australia by socioeconomic group. A large linked administrative dataset was utilised. Women were grouped into socioeconomic quintiles using an area-based measure of socioeconomic status. Descriptive statistics were used to quantify the distribution of number of services, out of pocket fees, and government funding by socioeconomic quintile. Needs-adjusted concentration indices (CINA) were utilised to quantify inequity. The mean out of pocket fees for women of least socioeconomic advantage was 2,432 (CINA 0.093, 95% CI: 0.088 – 0.098). However, use of many services were higher for women of most socioeconomic advantage: private obstetrician (CINA: 0.035, 95% CI: 0.032 – 0.038), other specialist services (CINA: 0.089, 95%CI: 0.083 – 0.094), and diagnostic and pathology tests (CINA: 0.027, 95%CI: 0.025 – 0.030). Federal government funding through Medicare was distributed towards women of most socioeconomic advantage (CINA: 0.036, 95%CI: 0.033 – 0.039); whereas government public hospital funding was skewed towards women of least socioeconomic advantage (CINA: -0.05, 95%CI: -0.057 - -0.046). Future policy changes in Australia's healthcare system need to ensure that women of least socioeconomic advantage have adequate access to maternity and early childhood care, and out of pocket fees are not an access barrier.No Full Tex
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