Out of pocket expenditure on health care by Australian mothers: lessons for maternal universal health coverage from a long-established system

Callander, Emily J., Topp, Stephanie, Fox, Haylee, and Corscadden, Lisa (2019) Out of pocket expenditure on health care by Australian mothers: lessons for maternal universal health coverage from a long-established system. Birth. (In Press)

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View at Publisher Website: https://doi.org/10.1111/birt.12457
 
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Abstract

Background:

Designing effective universal health care systems has challenges, including the use of patient co‐payments and the role of the public and private systems. This study sought to quantify the total amount of out‐of‐pocket fees incurred by women who gave birth in private and public hospitals within Australia—a country with universal health coverage—and assess the impact that variation in birth type has on out‐of‐pocket fees.

Methods:

Data came from a linked administrative data set of all women who gave birth in the Australian state Queensland between July 1, 2012, and June 30, 2015, plus their resultant children. Propensity score matching was used to create two similar cohorts of women who gave birth in private and public hospitals.

Results:

The mean total out‐of‐pocket fees for care from conception to the child's first birthday was $2813 (±2683 standard deviation) and $623 (±1202) for women who gave birth in private and public hospitals, respectively. Total fees were higher in both public and private hospitals for women who had a cesarean birth ($716 [±1419] and $3010 [±2988]) than for women who had a vaginal birth without instruments ($556 [±1044] and $2560 [±2284]).

Discussion:

Australia's strong policy incentives for women to take out private health insurance are leaving women with large out‐of‐pocket costs. This should hold important lessons for other countries implementing a universal health care system, to ensure that using a combination of public and private practitioners does not undermine the intention of universal care.

Item ID: 61190
Item Type: Article (Research - C1)
ISSN: 1523-536X
Keywords: birth intervention; out of pocket charges; universal care
Copyright Information: © 2019 Wiley Periodicals, Inc.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC Career Development Fellowship
Date Deposited: 17 Dec 2019 01:43
FoR Codes: 14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111707 Family Care @ 20%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 40%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920206 Health Policy Economic Outcomes @ 60%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 40%
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