Affordability of out-of-pocket health care expenses among older Australians

Carpenter, Anthony; Islam, M. Mofizul; Yen, Laurann; McRae, Ian

doi:10.1016/j.healthpol.2015.03.010

Cited by 40 publications

(57 citation statements)

References 16 publications

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“…Most 2 (n=18) estimates were 60% and above. One study with an extraord inarily low estimate (3.4%) [46], which seemed 3 inconsistent with the other studies, only evaluated three-month cases of out-of-pocket (OOP) expenditures in 4 Australia. Two factors could explain this finding.…”

Section: Costly Multimorbiditymentioning

confidence: 99%

“…Two factors could explain this finding. First, the respondents had a 17% higher average income than the 5 Australian general population [46] and thus underrepresented lower socioeconomic groups (including the indigenous 6 population), who are most likely to experience higher cost burdens. Second, the conditions included in the study 7 were all chronic, wh ich required ongoing treatment [48], and the short duration of the study may not have reflected 8 all incurred costs.…”

Section: Costly Multimorbiditymentioning

confidence: 99%

“…However, both of the studies from the societal perspective defined costs as 8 including only healthcare and social care costs. Twelve studies included both medical and non-medical expenditures 9 when quantifying direct costs [23,24,3,27,28,31,41,37,46,40,32,43].…”

mentioning

confidence: 99%

“…One used a 17 combined bottom-up and top-down approach [35]. Ten studies extracted costs fro m the single database, called an 18 econometric approach [23,24,27,28,41,45,39,46,40,43]. The follow-up periods included lifet ime follow-up in a 19 study that adopted an incidence-based approach [36], six years in one study [44], four years in three studies [29, 33, 20 34] and two years in one study [42].…”

mentioning

confidence: 99%

“…al [43] Singapore societal P revalence Cross-sectional 2013 SGD Carpenter et. al [46] Australia Garis et. al [24] Wolff et.…”

mentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Wang

Liu

Cocker

et al. 2017

Appl Health Econ Health Policy

147

120

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1Objectives: The economic burden of mu ltimo rbid ity is considerable. This review analyzed the methods of cost-of-2 illness (COI) studies and summarized the economic outcomes of mu ltimo rbidity. 3Methods: A systematic review (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) was performed, which was registered with Prospero, reported according 4 to PRISMA, and used a quality checklist adapted for COI studies . The inclusion criteria were peer-reviewed COI 5 studies on multimo rbidity, whereas the exclusion criterion was studies focusing on an index d isease. Ext racted data 6 included the definition, measure, and prevalence of mult imorb idity; the number of included hea lth conditions; the 7 age of study population; the variables used in the COI methodology; the percentage of mu ltimorb idity vs. total costs; 8 and the average costs per capita. 9Results: Among the 26 included articles, 14 defined mult imorbid ity as a simple coun t of 2 or mo re conditions. 10Methodologies used to derive the costs were markedly d ifferent. Given different healthcare systems, OOP pay ments 11 of mult imorbid ity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 condit ions, 12respectively, the ratios of multimo rbid ity to non-mult imorbid ity costs ranged from 2-16 and 2-10. A mong the 10 13 studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest 14 percentage of mult imorb idity costs to social care and inpatient care/med icine, respectively. 15Conclusion: Multimorbid ity was associated with considerable economic burden . Synthesising the cost of 16 mu ltimo rbidity was challenging due to mu ltip le definitions of mult imorb idity and heterogeneity in COI methods. 17Count method was most popular to define mu ltimo rbid ity. There is consistent evidence that multimo rbidity was 18 associated with higher costs.

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Section: Costly Multimorbiditymentioning

confidence: 99%

Section: Costly Multimorbiditymentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…al [43] Singapore societal P revalence Cross-sectional 2013 SGD Carpenter et. al [46] Australia Garis et. al [24] Wolff et.…”

mentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Wang

Liu

Cocker

et al. 2017

Appl Health Econ Health Policy

147

120

View full text Add to dashboard Cite

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Have out‐of‐pocket health care payments risen under free health care policy? The case ofSriLanka

Pallegedara

Grimm

2018

Health Planning & Management

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SummaryCompared to its neighbors, Sri Lanka performs well in terms of health. Health care is provided for free in the public sector, yet households' out‐of‐pocket health expenditures are steadily increasing. We explore whether this increase can be explained by supply shortages and insufficient public health care financing or whether it is rather the result of an income‐induced demand for supplementary and higher quality services from the private sector. We focus on total health care expenditures and health care expenditures for specific services such as expenses on private outpatient treatments and expenses on laboratory and other diagnostic services. Overall, we find little indication that limited supply of public health care per se pushes patients into the private sector. Yet income is identified as one key driver of rising health care expenditures, ie, as households get richer, they spend an increasing amount on private services suggesting a dissatisfaction with the quality offered by the public sector. Hence, quality improvements in the public sector seem to be necessary to ensure sustainability of the public health care sector. If the rich and the middle class increasingly opt out of public health care, the willingness to pay taxes to finance the free health care policy will certainly shrink.

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Out-of-pocket expenditure, need, utilisation, and private health insurance in the Australian healthcare system

Ludlow,

Fooken,

Rose

et al. 2023

Int J Health Econ Manag.

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Despite widespread public service provision, public funding, and private health insurance (PHI), 20% of all healthcare expenditure across the OECD is covered by out-of-pocket expenditure (OOPE). This creates an equity concern for the increasing number of individuals with chronic conditions and greater need, particularly if higher need coincides with lower income. Theoretically, individuals may mitigate OOPE risk by purchasing PHI, replacing variable OOPE with fixed expenditure on premiums. Furthermore, if PHI premiums are not risk-rated, PHI may redistribute some of the financial burden from less healthy PHI holders that have greater need to healthier PHI holders that have less need. We investigate if the burden of OOPE for individuals with greater need increases less strongly for individuals with PHI in the Australian healthcare system. The Australian healthcare system provides public health insurance with full, partial, or limited coverage, depending on the healthcare service used, and no risk rating of PHI premiums. Using data from the Household, Income and Labour Dynamics in Australia survey we find that individuals with PHI spend a greater share of their disposable income on OOPE and that the difference in OOPE share between PHI and non-PHI holders increases with greater need and utilisation, contrary to the prediction that PHI may mitigate OOPE. We also show that OOPE is a greater concern for poorer individuals for whom the difference in OOPE by PHI is the greatest.

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Affordability of out-of-pocket health care expenses among older Australians

Cited by 40 publications

References 16 publications

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Have out‐of‐pocket health care payments risen under free health care policy? The case ofSriLanka

Out-of-pocket expenditure, need, utilisation, and private health insurance in the Australian healthcare system

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