The patient co-payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer

A whole of population data linkage study

Emily Callander, Nicole Bates, Daniel Lindsay, Sarah Larkins, Robyn Preston, Stephanie M. Topp, Joan Cunningham, Gail Garvey

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: To quantify the direct out-of-pocket patient co-payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non-Indigenous persons diagnosed with cancer during the first year postdiagnosis.

Methods: CancerCostMod was used, which is a model of cancer costs based upon a whole-of-population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7% Indigenous Australians).

Results: After adjusting for age, sex, rurality, area-based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co-payments at 0–6 months (61% less) and 7–12 months (63% less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0–6 months (21% fewer) and 7–12 months (27% fewer).

Conclusion: There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co-payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.

Original languageEnglish
Pages (from-to)309-315
Number of pages7
JournalAsia-Pacific Journal of Clinical Oncology
Volume15
Issue number6
Early online date16 Jul 2019
DOIs
Publication statusPublished - Dec 2019

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Information Storage and Retrieval
Health Care Costs
Queensland
Costs and Cost Analysis
Population
Neoplasms
Information Systems
Length of Stay
Hospitalization
Censuses
Medicare
Appointments and Schedules
Emergencies
Health
Pharmaceutical Preparations

Cite this

Callander, Emily ; Bates, Nicole ; Lindsay, Daniel ; Larkins, Sarah ; Preston, Robyn ; Topp, Stephanie M. ; Cunningham, Joan ; Garvey, Gail. / The patient co-payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer : A whole of population data linkage study. In: Asia-Pacific Journal of Clinical Oncology. 2019 ; Vol. 15, No. 6. pp. 309-315.
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abstract = "Aim: To quantify the direct out-of-pocket patient co-payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non-Indigenous persons diagnosed with cancer during the first year postdiagnosis. Methods: CancerCostMod was used, which is a model of cancer costs based upon a whole-of-population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7{\%} Indigenous Australians). Results: After adjusting for age, sex, rurality, area-based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co-payments at 0–6 months (61{\%} less) and 7–12 months (63{\%} less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0–6 months (21{\%} fewer) and 7–12 months (27{\%} fewer). Conclusion: There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co-payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.",
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The patient co-payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer : A whole of population data linkage study. / Callander, Emily; Bates, Nicole; Lindsay, Daniel; Larkins, Sarah; Preston, Robyn; Topp, Stephanie M.; Cunningham, Joan; Garvey, Gail.

In: Asia-Pacific Journal of Clinical Oncology, Vol. 15, No. 6, 12.2019, p. 309-315.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - The patient co-payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer

T2 - A whole of population data linkage study

AU - Callander, Emily

AU - Bates, Nicole

AU - Lindsay, Daniel

AU - Larkins, Sarah

AU - Preston, Robyn

AU - Topp, Stephanie M.

AU - Cunningham, Joan

AU - Garvey, Gail

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N2 - Aim: To quantify the direct out-of-pocket patient co-payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non-Indigenous persons diagnosed with cancer during the first year postdiagnosis. Methods: CancerCostMod was used, which is a model of cancer costs based upon a whole-of-population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7% Indigenous Australians). Results: After adjusting for age, sex, rurality, area-based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co-payments at 0–6 months (61% less) and 7–12 months (63% less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0–6 months (21% fewer) and 7–12 months (27% fewer). Conclusion: There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co-payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.

AB - Aim: To quantify the direct out-of-pocket patient co-payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non-Indigenous persons diagnosed with cancer during the first year postdiagnosis. Methods: CancerCostMod was used, which is a model of cancer costs based upon a whole-of-population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7% Indigenous Australians). Results: After adjusting for age, sex, rurality, area-based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co-payments at 0–6 months (61% less) and 7–12 months (63% less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0–6 months (21% fewer) and 7–12 months (27% fewer). Conclusion: There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co-payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.

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KW - financial toxicity

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JO - Asia-Pacific Journal of Clinical Oncology

JF - Asia-Pacific Journal of Clinical Oncology

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