Socioeconomic Inequities in Eating Disorder-Related Hospital Utilization Costs in Australia: A Population-Based Study Using Linked Health Administrative Data.
This research aims to explore the extent of socioeconomic inequities in hospital usage costs for individuals with eating disorders (EDs), analyze its trends, and identify associated factors using Queensland (QLD) administrative health linked data from 2013 to 2019.
We have utilized the horizontal inequity (HI) approach to quantify the extent of socioeconomic inequity. Outcome variables are public and private hospital admission costs and emergency department visit costs. Two-part regression models were estimated to identify factors associated with costs.
There was significant socioeconomic inequity in public hospital admission costs of ED care in QLD in 2013 and 2017, concentrated among individuals from higher socioeconomic status (SES) (pro-rich inequity). In recent years (2018 and 2019), there was no evidence of inequity in public hospital admission costs. HI indices for private hospital admission costs were positive from 2014 to 2019, which suggested a pro-rich inequity in private hospital admission costs. On the other hand, emergency department visit costs were concentrated among individuals from lower SES from 2013 to 2019. Individuals living in regional/remote areas had higher annual emergency department visit costs (AUD 279). People from high SES had AUD 1020 higher annual private hospital admission costs due to EDs, on average, compared to those from low SES.
Overall, findings call for more targeted policy and service delivery reforms to address unmet needs for people with EDs and promote more equitable access to hospital ED care, particularly for socioeconomically disadvantaged populations. Additionally, policymakers should continue to prioritize achievement of equitable access to hospital-based ED care.
We have utilized the horizontal inequity (HI) approach to quantify the extent of socioeconomic inequity. Outcome variables are public and private hospital admission costs and emergency department visit costs. Two-part regression models were estimated to identify factors associated with costs.
There was significant socioeconomic inequity in public hospital admission costs of ED care in QLD in 2013 and 2017, concentrated among individuals from higher socioeconomic status (SES) (pro-rich inequity). In recent years (2018 and 2019), there was no evidence of inequity in public hospital admission costs. HI indices for private hospital admission costs were positive from 2014 to 2019, which suggested a pro-rich inequity in private hospital admission costs. On the other hand, emergency department visit costs were concentrated among individuals from lower SES from 2013 to 2019. Individuals living in regional/remote areas had higher annual emergency department visit costs (AUD 279). People from high SES had AUD 1020 higher annual private hospital admission costs due to EDs, on average, compared to those from low SES.
Overall, findings call for more targeted policy and service delivery reforms to address unmet needs for people with EDs and promote more equitable access to hospital ED care, particularly for socioeconomically disadvantaged populations. Additionally, policymakers should continue to prioritize achievement of equitable access to hospital-based ED care.
Authors
Ahmed Ahmed, Sidari Sidari, Hannigan Hannigan, Withington Withington, Catania Catania, Boyd Boyd, Ward Ward, Miskovic-Wheatley Miskovic-Wheatley, Touyz Touyz, Nassar Nassar, Maguire Maguire, Cunich Cunich
View on Pubmed