Variations in utilisation of colorectal cancer services in South Australia indicated by MBS/PBS benefits: a benefit incidence analysis

Abstract

Objective: This study investigated variations in healthcare expenditure for colorectal cancer (CRC) patients in South Australia by socioeconomic position (SEP) and remoteness area.Methods: Benefits incidence analysis (BIA) was used to examine healthcare expenditure and utilisation in relation to CRC patients by SEP and remoteness areas. Utilisation data was obtained for patients diagnosed with CRC in 2003-2013 from a dataset linked to a populationbased cancer registry, Medicare Benefits Scheme (MBS), Pharmaceutical Benefits Scheme (PBS), hospital and death data. Concentration indices estimated the distribution of health expenditure on MBS, MBS palliative care, PBS and general practitioners. Costs of claims data and length of stay in hospital were used as indicators of healthcare utilisation. Results:The results indicated that MBS palliative healthcare services utilisation favoured the more advantaged groups for both SEP and remoteness area (Concentration index (CI)= 0.1681, t-value=54.42 (SEP) and CI=0.1546, t-value=41.64). MBS expenditure was also favourable to the more advantaged groups (CI: 0.0785 and 0.0493).PBS and MBS general practitioner expenditure were equal (-0.0093 to 0.0250). Conclusion:Overall MBS and PBS healthcare expenditure for CRC patients was close to equality, however utilisation of MBS-funded palliative healthcare services was less concentrated in low SEP and more remote areas.Implications for public health: Whether the differences in palliative healthcare utilisation supplied by private providers are offset by other services requires investigation to determine if there is a need for initiatives to improve equality and give greater support to those who choose to die at home.

The Prediction of Survival Outcome and Prognosis Factor in Association with Comorbidity Status in Patients with Colorectal Cancer: A Research-Based Study

“…Although individual and geographical survival rates for CRC vary, this research-based study aimed to look at the various prognostic factors that influence the survival rate of CRC patients in HUSM. This study outcome shows that the overall five-year survival rate in patients with colorectal cancer was 62.5%, which is similar to the data (60%) reported by Barnous, Somi [ 23 ] and 64.5% reported from the Surveillance, Epidemiology and End Results (SEER) Program from 2008 to 2014, as well as in the United States (64.8%) [ 24 ], Australia (63.4%) [ 25 ], including the Asian nations of China (60.1%) [ 26 ], Japan (68.4%) [ 27 ] (68.4%), South Korea (60.0%) [ 28 ], and Iran (58.5%) [ 29 ]. Given the advanced presentation of CRC in the present study among the age groups, the elderly age group (70 years and above) have the poorest survival rate (54.1%) among all the age groups, just as reported in a study in the UK, which revealed that the incidence rates of CRC in the UK are primarily diagnosed in persons aged 75 and above, the highest among 85–89-year-olds, and this groups is associated with the poorest survival prognosis [ 30 , 31 ].…”

Birthing on country service compared to standard care for First Nations Australians: a cost-effectiveness analysis from a health system perspective

“…The Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) set the fee schedules for private healthcare service subsidies. 16 Services to low-income groups, such as women in our study, receive higher subsidies up to 100%. We conducted a cost-effectiveness analysis, from a health system perspective, to compare the BiOC service with Standard Care in reducing preterm birth.…”

DAta Linkage to Enhance Cancer Care (DaLECC): Protocol of a Large Australian Data Linkage Study

“…In SA, previous linked data projects have addressed a range of questions, including concordance with treatment guidelines [40], variation in healthcare expenditure [41], use of colonoscopy pre-colorectal cancer diagnosis [10], and screening-treatment-mortality pathways [42]. A Cancer Data and Aboriginal Disparities (CanDAD) linked dataset was also established, comprising all Aboriginal people living in SA at the time of their cancer diagnosis between 1990 and 2010, and one matched non-Aboriginal person with cancer for each Aboriginal member of the cohort [12].…”