Physician responses to insurance benefit restrictions: The case of ophthalmology.

This study examines the impact of social insurance benefit restrictions on physician behaviour, using ophthalmologists as a case study. We examine whether ophthalmologists use their market power to alter their fees and rebates across services to compensate for potential policy-induced income losses. The results show that ophthalmologists substantially reduced their fees and rebates for services directly targeted by the benefit restriction compared to other medical specialists' fees and rebates.

Provider responses to the expansion of public subsidies in healthcare: The case of oral chemotherapy treatment in Australia.

We examine provider responses to the expansion of public subsidies in 2015 for innovative oral chemotherapy treatment, in a health system where providers were free to determine their own prices. The new treatment was known to have similar efficacy to its traditional intravenous alternative and was preferred by patients for its at-home administration. However, from a policymaker's perspective, the potential for misalignment between patient and provider preferences was significant given the shift to full reimbursement for the oral chemotherapy medication but no change in fee-for-service payments for associated chemotherapy services.

Higher fees and out-of-pocket costs in radiotherapy point to a need for funding reform.

Objective To elucidate the policy implications of recent trends in the funding of radiotherapy services between 2009-10 and 2021-22. Method We use national aggregate claims data to determine time trends in the fees, benefits and out-of-pocket (OOP) costs of radiotherapy and nuclear therapeutic medicine claims funded through the Medicare Benefits Schedule (MBS) program. All dollar figures are expressed in constant 2021 Australian dollars.

Geographic variation in out-of-pocket costs for radiation oncology services.

Objectives: To examine out-of-pocket costs incurred by patients for radiation oncology services and their variation by geographic location.

Design: Analysis of patient-level Medical Benefits Schedule (MBS) claims data linked with data from the Sax Institute 45 and Up Study.

Setting, Participants: People who received Medicare-subsidised radiation oncology services in New South Wales, 2006-2017.

Preterm Birth and Total Health Care Use and Costs in the First 5 Years of Life: A Population-based Study.

Objectives: To investigate the relationship between preterm birth and hospital/out-of-hospital care and costs over the first 5 years of life.

Study Design: Birth data from a population-based cohort of 631 532 infants born between 2007 and 2013 were linked probabilistically with data on hospitalizations, primary and secondary care, and the use of medications. We analyzed the distribution of health care use and public health care costs for infants who survived at least 5 years, comparing the outcomes of extremely preterm (<28 weeks of gestation), very preterm (28-32 weeks), moderate to late preterm (32-37 weeks), and term infants (at least 37 weeks).

Fecal prevalence of Clostridium innocuum DNA in healthy horses and horses with colitis.

This study compared the prevalence of C. innocuum DNA in the feces of healthy horses and horses with acute colitis. C.

Private provider incentives in health care: The case of caesarean births.

Private doctors and hospitals face incentives to intervene in the process of childbirth because they are employed and paid differently from their public counterparts. While private obstetric care has been associated with higher rates of caesarean birth, it is unclear to what extent this is attributable to unobserved selection effects related to clinical need or patient preferences. Using administrative birth data on over 280,000 births in Australia between 2007 and 2012, we implement an instrumental variables framework to account for the endogeneity of choice of care.

Modelling the cost of place of birth: a pathway analysis.

Background: In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.

Birth models of care and intervention rates: The impact of birth centres.

Birth centres offer a midwifery-led model of care which supports a non-medicalised approach to childbirth. They are often reported as having low rates of birth intervention, however the precise impact is obscured because less disadvantaged mothers with less complex pregnancies, and who prefer and often select little intervention, are more likely to choose a birth centre. In this paper, we use a methodology that purges the impact of these selection effects and provides a causal interpretation of the impact of birth centres on intervention outcomes.

Improving outcomes for marginalised rural families through a care navigator program.

Issues Addressed: Health promotion programs are based on the premise that health and well-being is impacted by a person's living circumstances, not just factors within the health arena. Chronic health issues require integrated services from health and social services. Navigator positions are effective in assisting chronic disease patients to access services.

Mapping the trajectories for women and their babies from births planned at home, in a birth centre or in a hospital in New South Wales, Australia, between 2000 and 2012.

Background: In New South Wales (NSW) Australia, women at low risk of complications can choose from three birth settings: home, birth centre and hospital. Between 2000 and 2012, around 6.4% of pregnant women planned to give birth in a birth centre (6%) or at home (0.

Accommodation payment plans in residential aged care: The impact of consumer choice.

Objective: To examine changes in accommodation payments to residential aged care facilities following the introduction of consumer choice reforms in 2014. These reforms have allowed residents to choose between making lump sum refundable deposits and/or rental-style payments.

Methods: Quantitative analysis was undertaken for facility-level quarterly data of 136 separate facilities, which were operated by six providers over the period under study.

The cost of vaginal birth at home, in a birth centre or in a hospital setting in New South Wales: A micro-costing study.

Background: Women want greater choice of place of birth in New South Wales, Australia. It is perceived to be more costly to health services for women with a healthy pregnancy to give birth at home or in a birth centre. It is not known how much it costs the health service to provide care for women planning to give birth in these settings.

Waiting times in aged care: What matters?

Objective: To assess consumer-level socioeconomic factors associated with waiting times for access to aged care services, specifically community-based care and permanent residential care.

Methods: Administrative data on assessment outcomes and admissions to services were linked with survey data at the person-level and were used to implement a competing risks regression model. We estimated the association between health needs, and socioeconomic variables and subsequent waiting periods for individuals with approval for access.

Orthopedic inpatients’ ability to accurately reproduce partial weight bearing orders.

Partial weight bearing is often prescribed for patients with orthopedic injuries. Patients’ ability to accurately reproduce partial weight bearing orders is variable, and its impact on clinical outcomes is unknown. This observational study measured patients’ ability to reproduce partial weight bearing orders, factors influencing this, patients’ and physiotherapists’ ability to gauge partial weight bearing accuracy, and the effect of partial weight bearing accuracy on long-term clinical outcomes.