Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia
Abstract Background Patient medical out-of-pocket expenses are thought to be rising worldwide yet data describing trends over time is scant. We evaluated trends of out-of-pocket expenses for patients in Australia with one of five major cancers in the first-year after diagnosis. Methods Participants...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-021-08756-x |
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| author | Astrid J. Rodriguez-Acevedo Raymond J. Chan Catherine M. Olsen Nirmala Pandeya David C. Whiteman Louisa G. Gordon |
| author_facet | Astrid J. Rodriguez-Acevedo Raymond J. Chan Catherine M. Olsen Nirmala Pandeya David C. Whiteman Louisa G. Gordon |
| author_sort | Astrid J. Rodriguez-Acevedo |
| collection | DOAJ |
| description | Abstract Background Patient medical out-of-pocket expenses are thought to be rising worldwide yet data describing trends over time is scant. We evaluated trends of out-of-pocket expenses for patients in Australia with one of five major cancers in the first-year after diagnosis. Methods Participants from the QSKIN Sun and Health prospective cohort Study with a histologically confirmed breast, colorectal, lung, melanoma, or prostate cancer diagnosed between 2011 and 2015 were included (n = 1965). Medicare claims data on out-of-pocket expenses were analysed using a two-part model adjusted for year of diagnosis, health insurance status, age and education level. Fisher price and quantity indexes were also calculated to assess prices and volumes separately. Results On average, patients with cancer diagnosed in 2015 spent 70% more out-of-pocket on direct medical expenses than those diagnosed in 2011. Out-of-pocket expenses increased significantly for patients with breast cancer (mean AU$2513 in 2011 to AU$6802 in 2015). Out-of-pocket expenses were higher overall for individuals with private health insurance. For prostate cancer, expenses increased for those without private health insurance over time (mean AU$1586 in 2011 to AU$4748 in 2014) and remained stable for those with private health insurance (AU$4397 in 2011 to AU$5623 in 2015). There were progressive increases in prices and quantities of medical services for patients with melanoma, breast and lung cancer. For all cancers, prices increased for medicines and doctor attendances but fluctuated for other medical services. Conclusion Out-of-pocket expenses for patients with cancer have increased substantially over time. Such increases were more pronounced for women with breast cancer and those without private health insurance. Increased out-of-pocket expenses arose from both higher prices and higher volumes of health services but differ by cancer type. Further efforts to monitor patient out-of-pocket costs and prevent health inequities are required. |
| first_indexed | 2024-12-17T04:51:54Z |
| format | Article |
| id | doaj.art-5662e3e2b70c4bfca5a04be58d184336 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-17T04:51:54Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-5662e3e2b70c4bfca5a04be58d1843362022-12-21T22:02:52ZengBMCBMC Cancer1471-24072021-09-0121111210.1186/s12885-021-08756-xOut-of-pocket medical expenses compared across five years for patients with one of five common cancers in AustraliaAstrid J. Rodriguez-Acevedo0Raymond J. Chan1Catherine M. Olsen2Nirmala Pandeya3David C. Whiteman4Louisa G. Gordon5QIMR Berghofer Medical Research Institute, Population Health DepartmentQueensland University of Technology (QUT), School of Nursing and Cancer and Palliative Care Outcomes CentreQIMR Berghofer Medical Research Institute, Population Health DepartmentQIMR Berghofer Medical Research Institute, Population Health DepartmentQIMR Berghofer Medical Research Institute, Population Health DepartmentQIMR Berghofer Medical Research Institute, Population Health DepartmentAbstract Background Patient medical out-of-pocket expenses are thought to be rising worldwide yet data describing trends over time is scant. We evaluated trends of out-of-pocket expenses for patients in Australia with one of five major cancers in the first-year after diagnosis. Methods Participants from the QSKIN Sun and Health prospective cohort Study with a histologically confirmed breast, colorectal, lung, melanoma, or prostate cancer diagnosed between 2011 and 2015 were included (n = 1965). Medicare claims data on out-of-pocket expenses were analysed using a two-part model adjusted for year of diagnosis, health insurance status, age and education level. Fisher price and quantity indexes were also calculated to assess prices and volumes separately. Results On average, patients with cancer diagnosed in 2015 spent 70% more out-of-pocket on direct medical expenses than those diagnosed in 2011. Out-of-pocket expenses increased significantly for patients with breast cancer (mean AU$2513 in 2011 to AU$6802 in 2015). Out-of-pocket expenses were higher overall for individuals with private health insurance. For prostate cancer, expenses increased for those without private health insurance over time (mean AU$1586 in 2011 to AU$4748 in 2014) and remained stable for those with private health insurance (AU$4397 in 2011 to AU$5623 in 2015). There were progressive increases in prices and quantities of medical services for patients with melanoma, breast and lung cancer. For all cancers, prices increased for medicines and doctor attendances but fluctuated for other medical services. Conclusion Out-of-pocket expenses for patients with cancer have increased substantially over time. Such increases were more pronounced for women with breast cancer and those without private health insurance. Increased out-of-pocket expenses arose from both higher prices and higher volumes of health services but differ by cancer type. Further efforts to monitor patient out-of-pocket costs and prevent health inequities are required.https://doi.org/10.1186/s12885-021-08756-xcancerOut-of-pocket medical costsPopulation-basedPrivate health insurance |
| spellingShingle | Astrid J. Rodriguez-Acevedo Raymond J. Chan Catherine M. Olsen Nirmala Pandeya David C. Whiteman Louisa G. Gordon Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia BMC Cancer cancer Out-of-pocket medical costs Population-based Private health insurance |
| title | Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia |
| title_full | Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia |
| title_fullStr | Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia |
| title_full_unstemmed | Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia |
| title_short | Out-of-pocket medical expenses compared across five years for patients with one of five common cancers in Australia |
| title_sort | out of pocket medical expenses compared across five years for patients with one of five common cancers in australia |
| topic | cancer Out-of-pocket medical costs Population-based Private health insurance |
| url | https://doi.org/10.1186/s12885-021-08756-x |
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