Patient out-of-pocket medical expenses over 2 years among Queenslanders with and without a major cancer
Louisa G. Gordon A B C , Thomas M. Elliott
A D , Catherine M. Olsen A C , Nirmala Pandeya A , David C. Whiteman A and for the QSkin study
A QIMR Berghofer Medical Research Institute, Population Health Department, 300 Herston Road, Herston, Brisbane, Qld 4006, Australia.
B Queensland University of Technology, School of Nursing, Ring Road, Kelvin Grove, Brisbane, Qld 4059, Australia.
C The University of Queensland, School of Public Health, 266 Herston Road, Herston, Brisbane, Qld 4006, Australia.
D Corresponding author. Email: thomas.elliott@qimrberghofer.edu.au
Australian Journal of Primary Health 24(6) 530-536 https://doi.org/10.1071/PY18003
Submitted: 08 January 2018 Accepted: 19 August 2018 Published: 22 November 2018
Abstract
Medical out-of-pocket costs paid by patients can be problematic when it adversely affects access to care. Survey research involving patients with out-of-pocket expenses may have selection biases, so accurate estimates are unknown. During 2010–11, 419 participants from the QSkin Sun and Health Study (n = 43 794) had a confirmed diagnosis of either melanoma, prostate, breast, colorectal or lung cancer. These were matched to a general population group (n = 421) and a group of high users of GP services (n = 419). Medical fees charged and out-of-pocket medical expenses for Medicare services were analysed. Over 2 years, three-quarters of individuals with cancer paid up-front provider fees of up to A$20 551 compared with A$10 995 for the high GP user group and A$6394 for the general population group. Out-of-pocket expenses were significantly higher for those with cancer (mean A$3514) compared with the high GP-user group (mean A$1837) and general population group (A$1245). Highest expenses were for therapeutic procedures (mean A$2062). Older individuals, those with poor perceived health or private health insurance had the highest costs. Regardless of private insurance status, patients with one of the main five cancers pay significantly higher out-of-pocket costs for health care compared with those without cancer.
Additional keywords: administrative data, cancer, financial toxicity, out-of-pocket costs, personal expenses, population-based, private health insurance.
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