Out-of-pocket health care expenses for people with and without cancer, New South Wales, 2020: a cross-sectional study.
- Publisher:
- Wiley
- Publication Type:
- Journal Article
- Citation:
- Med J Aust, 2024, 221, (2), pp. 94-102
- Issue Date:
- 2024-07-15
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Field | Value | Language |
---|---|---|
dc.contributor.author | Goldsbury, DE | |
dc.contributor.author |
Haywood, P |
|
dc.contributor.author | Pearce, A | |
dc.contributor.author | Collins, LG | |
dc.contributor.author | Karikios, D | |
dc.contributor.author | Canfell, K | |
dc.contributor.author | Steinberg, J | |
dc.contributor.author | Weber, MF | |
dc.date.accessioned | 2025-05-22T00:04:38Z | |
dc.date.available | 2023-12-18 | |
dc.date.available | 2025-05-22T00:04:38Z | |
dc.date.issued | 2024-07-15 | |
dc.identifier.citation | Med J Aust, 2024, 221, (2), pp. 94-102 | |
dc.identifier.issn | 0025-729X | |
dc.identifier.issn | 1326-5377 | |
dc.identifier.uri | http://hdl.handle.net/10453/187446 | |
dc.description.abstract | OBJECTIVES: To investigate self-reported out-of-pocket health care expenses, both overall and by cost type, for a large population-based sample of Australians, by cancer status and socio-demographic and medical characteristics. STUDY DESIGN: Cross-sectional study. SETTING, PARTICIPANTS: New South Wales residents participating in the 45 and Up Study (recruited aged 45 years or older during 2005-2009) who completed the 2020 follow-up questionnaire; survey responses linked with New South Wales Cancer Registry data. MAIN OUTCOME MEASURES: Proportions of respondents who reported that out-of-pocket health care expenses during the preceding twelve months exceeded $1000 or $10 000; adjusted odds ratios (aORs) for associations with socio-demographic and medical characteristics. RESULTS: Of the 267 357 recruited 45 and Up Study participants, 45 061 completed the 2020 survey (response rate, 53%); 42.7% (95% confidence interval [CI], 42.2-43.1%) reported that overall out-of-pocket health care expenses during the previous year exceeded $1000, including 55.4% (52.1-58.7%) of participants diagnosed in the preceding two years and 44.9% (43.7-46.1%) of participants diagnosed with cancer more than two years ago. After adjustment for socio-demographic factors, out-of-pocket expenses greater than $1000 were more likely to be reported by participants with cancer than by those without cancer (diagnosis in past two years: aOR, 2.06 [95% CI, 1.77-2.40]; diagnosis more than two years ago: aOR, 1.22 [95% CI, 1.15-1.29]). The odds of out-of-pocket expenses exceeding $1000 increased with area-based socio-economic advantage and household income, and were higher for people with private health insurance (v people with Medicare coverage only: aOR, 1.64; 95% CI, 1.53-1.75). Out-of-pocket expenses exceeding $10 000 were also more likely for participants diagnosed with cancer during the past two years (v no cancer: aOR, 3.30; 95% CI, 2.56-4.26). CONCLUSIONS: People diagnosed with cancer during the past two years were much more likely than people without cancer to report twelve-month out-of-pocket health care expenses that exceeded $1000. Out-of-pocket expenses for people with cancer can exacerbate financial strain at a time of vulnerability, and affect health care equity because some people cannot pay for all available treatments. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | Wiley | |
dc.relation.ispartof | Med J Aust | |
dc.relation.isbasedon | 10.5694/mja2.52367 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences | |
dc.subject.classification | General & Internal Medicine | |
dc.subject.classification | 32 Biomedical and clinical sciences | |
dc.subject.classification | 42 Health sciences | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | New South Wales | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Neoplasms | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Health Expenditures | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Neoplasms | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Health Expenditures | |
dc.subject.mesh | New South Wales | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Cross-Sectional Studies | |
dc.subject.mesh | New South Wales | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Neoplasms | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Health Expenditures | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Surveys and Questionnaires | |
dc.subject.mesh | Aged, 80 and over | |
dc.title | Out-of-pocket health care expenses for people with and without cancer, New South Wales, 2020: a cross-sectional study. | |
dc.type | Journal Article | |
utslib.citation.volume | 221 | |
utslib.location.activity | Australia | |
utslib.for | 11 Medical and Health Sciences | |
utslib.for | 17 Psychology and Cognitive Sciences | |
pubs.organisational-group | University of Technology Sydney | |
pubs.organisational-group | University of Technology Sydney/Faculty of Health | |
utslib.copyright.status | open_access | * |
dc.rights.license | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.date.updated | 2025-05-22T00:04:36Z | |
pubs.issue | 2 | |
pubs.publication-status | Published | |
pubs.volume | 221 | |
utslib.citation.issue | 2 |
Abstract:
OBJECTIVES: To investigate self-reported out-of-pocket health care expenses, both overall and by cost type, for a large population-based sample of Australians, by cancer status and socio-demographic and medical characteristics. STUDY DESIGN: Cross-sectional study. SETTING, PARTICIPANTS: New South Wales residents participating in the 45 and Up Study (recruited aged 45 years or older during 2005-2009) who completed the 2020 follow-up questionnaire; survey responses linked with New South Wales Cancer Registry data. MAIN OUTCOME MEASURES: Proportions of respondents who reported that out-of-pocket health care expenses during the preceding twelve months exceeded $1000 or $10 000; adjusted odds ratios (aORs) for associations with socio-demographic and medical characteristics. RESULTS: Of the 267 357 recruited 45 and Up Study participants, 45 061 completed the 2020 survey (response rate, 53%); 42.7% (95% confidence interval [CI], 42.2-43.1%) reported that overall out-of-pocket health care expenses during the previous year exceeded $1000, including 55.4% (52.1-58.7%) of participants diagnosed in the preceding two years and 44.9% (43.7-46.1%) of participants diagnosed with cancer more than two years ago. After adjustment for socio-demographic factors, out-of-pocket expenses greater than $1000 were more likely to be reported by participants with cancer than by those without cancer (diagnosis in past two years: aOR, 2.06 [95% CI, 1.77-2.40]; diagnosis more than two years ago: aOR, 1.22 [95% CI, 1.15-1.29]). The odds of out-of-pocket expenses exceeding $1000 increased with area-based socio-economic advantage and household income, and were higher for people with private health insurance (v people with Medicare coverage only: aOR, 1.64; 95% CI, 1.53-1.75). Out-of-pocket expenses exceeding $10 000 were also more likely for participants diagnosed with cancer during the past two years (v no cancer: aOR, 3.30; 95% CI, 2.56-4.26). CONCLUSIONS: People diagnosed with cancer during the past two years were much more likely than people without cancer to report twelve-month out-of-pocket health care expenses that exceeded $1000. Out-of-pocket expenses for people with cancer can exacerbate financial strain at a time of vulnerability, and affect health care equity because some people cannot pay for all available treatments.
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