Cost-sharing reduction and health service utilisation, health-related lifestyles, and obesity: evidence from the Australian health concession card policy
Qin Zhou A * and Wei Du B CA School of Public Administration and Policy, Renmin University of China, Beijing, China.
B Key Laboratory of Environmental Medicine Engineering, Ministry of Education; School of Public Health, Southeast University, Nanjing, China.
C Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
Australian Journal of Primary Health 29(1) 81-90 https://doi.org/10.1071/PY21025
Submitted: 8 February 2021 Accepted: 30 August 2022 Published: 28 September 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University
Abstract
Background: The Australian Health Concession Card (HCC) policy aims to improve access to affordable health services and medicines by providing reduced patient cost-sharing. This study explored the association between HCC holding and health service utilisation, as well as health-related lifestyles and obesity in Australian adults.
Methods: The Australian National Health Survey data were used to derive three sets of study outcomes. Multivariable generalised linear regression models were used to estimate the association between concessional status and study outcomes after controlling for socio-demographic factors.
Results: HCC holders, compared to their non-concessional counterparts, had more visits to GPs (1.01, 95% CI: 0.74–1.30), specialists (0.23, 95% CI: 0.02–0.44), outpatient clinics (0.19, 95% CI: 0.06–0.31), and had more hospital admissions (0.04, 95% CI: −0.05–0.91). There was no significant difference in visits to doctors and health professionals about mental health problems among HCC holders and their counterparts. Moreover, less HCC holders consumed alcohol on ≥3 days a week (OR: 0.75, 95% CI: 0.59–0.93) and had less of an alcohol risk that exceeded the 2001 alcohol guidelines (0.83, 95% CI: 0.69–0.99).
Conclusions: This study revealed evidence that reduced patient cost-sharing provided by HCC policy was positively correlated with more health service utilisation after adjusting for socio-demographic characteristics. Strategies to prioritise resources are necessary.
Keywords: Australia, ex ante moral hazards, health concession policy, health-related lifestyles, health service utilisation, mental health services, obesity, patient cost-sharing.
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