The patient co‐payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer: a whole of population data linkage study

Callander, Emily, Bates, Nicole, Lindsay, Daniel, Larkins, Sarah, Preston, Robyn, Topp, Stephanie M., Cunningham, Joan, and Garvey, Gail (2019) The patient co‐payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer: a whole of population data linkage study. Asia-Pacific Journal of Clinical Oncology, 15 (6). pp. 309-315.

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DOI: 10.1111/ajco.13180

View at Publisher Website: https://doi.org/10.1111/ajco.13180

Abstract

Aim: To quantify the direct out‐of‐pocket patient co‐payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non‐Indigenous persons diagnosed with cancer during the first year postdiagnosis.

Methods: CancerCostMod was used, which is a model of cancer costs based upon a whole‐of‐population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7% Indigenous Australians).

Results: After adjusting for age, sex, rurality, area‐based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co‐payments at 0–6 months (61% less) and 7–12 months (63% less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0–6 months (21% fewer) and 7–12 months (27% fewer).

Conclusion: There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co‐payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.


Item ID:	59162
Item Type:	Article (Research - C1)
ISSN:	1743-7563
Keywords:	cancer; expenses; financial toxicity; indigenous; out-of-pocket costs
Copyright Information:	© 2019 John Wiley & Sons Australia, Ltd
Funders:	Menzies School of Health Research, National Health and Medical Research Council (NHMRC), Cancer Council NSW (CC), Cancer Council WA, Lowitja Institute (LI)
Projects and Grants:	NHMRC Grants 1041111, 1105399, 0158244, CC Grant SRP 13-01
Date Deposited:	06 Aug 2019 23:40
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 30% 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450409 Aboriginal and Torres Strait Islander health services @ 35% 38 ECONOMICS > 3801 Applied economics > 380108 Health economics @ 35%
SEO Codes:	92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 30% 92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 35% 91 ECONOMIC FRAMEWORK > 9199 Other Economic Framework > 919999 Economic Framework not elsewhere classified @ 35%
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