Lowitja Institute Repository
We are Australia’s only Aboriginal and Torres Strait Islander community controlled health research institute, named in honour of our namesake and co-patron, the late Dr Lowitja O’Donoghue AC CBE DSG. We deliver high-impact quality research, knowledge exchange, and by supporting a new generation of Aboriginal and Torres Strait Islander health researchers. This repository contains information on Lowitja research outputs.
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Browsing Lowitja Institute Repository by Subject "Health economics"
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Item Apunipima baby basket program: a retrospective cost study.(2016-12-03) Edmunds K.; Searles A.; Neville J.; Ling R.; McCalman J.; Mein J.Background: The Baby Basket initiative was developed by Apunipima Cape York Health Council (ACYHC) to address poor maternal and child health (MCH) in Cape York, the northernmost region of Queensland. While positive outcomes for Indigenous MCH programs are reported in the literature, few studies have a strong evidence base or employ a sound methodological approach to evaluation. The aim of the cost study is to identify the resources required to deliver the Baby Basket program in the remote communities of Cape York. It represents an initial step in the economic evaluation of the Apunipima Baby Basket program. The aim of this study was to report whether the current program represents an effective use of scarce resources. Method(s): The cost study was conducted from the perspective of the health providers and reflects the direct resources required to deliver the Baby Basket program to 170 women across 11 communities represented by ACYHC. A flow diagram informed by interviews with ACYHC staff, administrative documents and survey feedback was used to map the program pathway and measure resource use. Monetary values, in 2013 Australian dollars, were applied to the resources used to deliver the Baby Basket program for one year. Result(s): The total cost of delivering the Baby Basket progam to 170 participants in Cape York was $148,642 or approximately, $874 per participant. The analysis allowed for the cost of providing the Baby Baskets to remote locations and the time for health workers to engage with women and thereby encourage a relationship with the health service. Routinely collected data showed improved engagement between expectant women and the health service during the life of the program. Conclusion(s): The Apunipima Baby Basket cost study identifies the resources required to deliver this program in remote communities of Cape York and provides a framework that will support prospective data collection of more specific outcome data, for future cost-effectiveness analyses and cost-benefit analyses. An investment of $874 per Baby Basket participant was associated with improved engagement with the health service, an important factor in maternal and child health. Copyright © 2016 The Author(s).Item Does affirmative action reduce disparities in healthcare use by Indigenous peoples? Evidence from Australia's Indigenous practice incentives program.(2023-01-11) Saxby K.; Byrnes J.; de New S.C.; Nghiem S.; Petrie D.Globally, Indigenous populations experience poorer health but use less primary healthcare than their non-Indigenous counterparts. In 2010, the Australian government introduced a targeted reform aimed at reducing these disparities. The reform reduced, or abolished prescription medicine co-payments and provided financial incentives for GPs to better manage chronic disease care for Indigenous peoples. Exploiting the framework of a natural experiment, we investigate how the reform affected these health disparities in primary and specialist healthcare utilization using longitudinal administrative data from 75,826 Australians, including 1896 Indigenous peoples, with cardiovascular disease. The differences-in-differences estimates indicate that the reform increased primary healthcare use among Indigenous peoples, including 12.9% more prescription medicines, 6.6% more GP services, and 34.0% more chronic disease services, but also reduced specialist attendances by 11.8%. Increases in primary care were larger for those who received the largest co-payment relief and lived in metropolitan regions, whereas the reduction in specialist attendances was concentrated among lower income Indigenous patients. Affirmative action can reduce inequalities in Indigenous use of primary healthcare, albeit careful design is required to ensure that benefits are equitable and do not lead to substitution away from valuable, or necessary, care.Copyright © 2023 The Authors. Health Economics published by John Wiley & Sons Ltd.Item Economic rationalisation of health behaviours: the dangers of attempting policy discussions in a vacuum.(2014-08-03) Reilly R.; Rowley K.; Luke J.; Doyle J.; Ritte R.; O'Shea R.; Brown A.When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health. © 2014 The Authors.Item The patient co-payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer: a whole of population data linkage study.(2019-08-02) Callander E.; Bates N.; Lindsay D.; Larkins S.; Preston R.; Topp S.M.; Cunningham J.; Garvey G.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. Method(s): 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). Result(s): 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(s): 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.Copyright © 2019 John Wiley & Sons Australia, Ltd