Inequitable use of health services for Indigenous mothers who experience stillbirth in Australia
Callander, Emily, Fox, Haylee, Mills, Kyly, Stuart-Butler, Deanna, Middleton, Phillipa, Ellwood, David, Thomas, Joseph, and Flenady, Vicki (2022) Inequitable use of health services for Indigenous mothers who experience stillbirth in Australia. Birth, 49 (2). pp. 194-201.
PDF (Published Version)
- Published Version
Restricted to Repository staff only |
Abstract
Objectives: The purpose of this study was to identify differences in health ser-vice expenditure on Indigenous and non- Indigenous women who experience a stillbirth, women's out- of- pocket costs, and health service use.
Methods: The project used a whole- of- population linked data set called “Maternity1000,” which includes all women who gave birth in Queensland, Australia, between July 1, 2012, and June 30, 2018 (n = 396 158). Multivariable analysis was undertaken to assess differences in mean health service expenditure; and number of health care services accessed between Indigenous and non- Indigenous women who had a stillbirth from birth to twelve months postpartum. Costs are presented in 2019/20 Australian dollars.
Results: There was a total of 1864 babies stillborn to women in Queensland be-tween July 1, 2012, and June 30, 2018, with 135 being born to Indigenous women and 1729 born to non- Indigenous women. There was significantly lower total expenditure per woman for Indigenous women compared with non- Indigenous women ($16 083 and $18 811, respectively). This was consistent across public hospital inpatient ($12 564 compared with $14 075), outpatient ($1127 compared with $1470), community- based services ($198 compared with $313), pharmaceuticals ($8 compared with $22), private hospital ($434 compared with $1265), and for individual out- of- pocket fees ($21 compared with $86). Mean expenditure on emergency department services per woman was higher for Indigenous women compared with non- Indigenous women ($947 compared with $643). Indigenous women who experienced a stillbirth accessed fewer general practitioners, allied health, specialist, obstetrics, and outpatient services, and fewer pathology and diagnostic test than their non- Indigenous counterparts.
Conclusions: Inequities in access to health services exist between Indigenous and non- Indigenous women who experience a stillbirth