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Costs of medicines and health care: a concern for Australian women across the ages

BACKGROUND: Evidence from Australia and other countries suggests that some individuals struggle to meet the costs of their health care, including medicines, despite the presence of Government subsidies for low-income earners. The aim of our study was to elucidate women’s experiences with the day to...

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Autores principales: Walkom, Emily J, Loxton, Deborah, Robertson, Jane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225494/
https://www.ncbi.nlm.nih.gov/pubmed/24252248
http://dx.doi.org/10.1186/1472-6963-13-484
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author Walkom, Emily J
Loxton, Deborah
Robertson, Jane
author_facet Walkom, Emily J
Loxton, Deborah
Robertson, Jane
author_sort Walkom, Emily J
collection PubMed
description BACKGROUND: Evidence from Australia and other countries suggests that some individuals struggle to meet the costs of their health care, including medicines, despite the presence of Government subsidies for low-income earners. The aim of our study was to elucidate women’s experiences with the day to day expenses that relate to medicines and their health care. METHODS: The Australian Longitudinal Study on Women’s Health (ALSWH) conducts regular surveys of women in three age cohorts (born 1973–78, 1946–51, and 1921–26). Our data were obtained from free text comments included in surveys 1 to 5 for each cohort. All comments were scanned for mentions of attitudes, beliefs and behaviours around the costs of medicines and health care. Relevant comments were coded by category and themes identified. RESULTS: Over 150,000 responses were received to the surveys, and 42,305 (27%) of these responses included free-text comments; 379 were relevant to medicines and health care costs (from 319 individuals). Three broad themes were identified: costs of medicines (33% of relevant comments), doctor visits (49%), and complementary medicines (13%). Age-specific issues with medicine costs included contraceptive medicines (1973–78 cohort), hormone replacement therapy (1946–51 cohort) and osteoporosis medications (1921–26 cohort). Concerns about doctor visits mostly related to reduced (or no) access to bulk-billed medical services, where there are no out-of-pocket costs to the patient, and costs of specialist services. Some women in the 1973–78 and 1946–51 cohorts reported ‘too much income’ to qualify for government health benefits, but not enough to pay for visits to the doctor. In some cases, care and medicines were avoided because of the costs. Personal feelings of embarrassment over financial positions and judgments about bulk-billing practices (‘good ones don’t bulk-bill’) were barriers to service use, as were travel expenses for rural women. CONCLUSIONS: For some individuals, difficulty in accessing bulk-billing services and increasing out-of-pocket costs in Australia limit affordability of health services, including medications. At greatest risk may be those falling below thresholds for subsidised care such as self-funded retirees and those on low-middle incomes, in addition to those on very low incomes, who may find even small co-payments difficult to manage.
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spelling pubmed-42254942014-11-11 Costs of medicines and health care: a concern for Australian women across the ages Walkom, Emily J Loxton, Deborah Robertson, Jane BMC Health Serv Res Research Article BACKGROUND: Evidence from Australia and other countries suggests that some individuals struggle to meet the costs of their health care, including medicines, despite the presence of Government subsidies for low-income earners. The aim of our study was to elucidate women’s experiences with the day to day expenses that relate to medicines and their health care. METHODS: The Australian Longitudinal Study on Women’s Health (ALSWH) conducts regular surveys of women in three age cohorts (born 1973–78, 1946–51, and 1921–26). Our data were obtained from free text comments included in surveys 1 to 5 for each cohort. All comments were scanned for mentions of attitudes, beliefs and behaviours around the costs of medicines and health care. Relevant comments were coded by category and themes identified. RESULTS: Over 150,000 responses were received to the surveys, and 42,305 (27%) of these responses included free-text comments; 379 were relevant to medicines and health care costs (from 319 individuals). Three broad themes were identified: costs of medicines (33% of relevant comments), doctor visits (49%), and complementary medicines (13%). Age-specific issues with medicine costs included contraceptive medicines (1973–78 cohort), hormone replacement therapy (1946–51 cohort) and osteoporosis medications (1921–26 cohort). Concerns about doctor visits mostly related to reduced (or no) access to bulk-billed medical services, where there are no out-of-pocket costs to the patient, and costs of specialist services. Some women in the 1973–78 and 1946–51 cohorts reported ‘too much income’ to qualify for government health benefits, but not enough to pay for visits to the doctor. In some cases, care and medicines were avoided because of the costs. Personal feelings of embarrassment over financial positions and judgments about bulk-billing practices (‘good ones don’t bulk-bill’) were barriers to service use, as were travel expenses for rural women. CONCLUSIONS: For some individuals, difficulty in accessing bulk-billing services and increasing out-of-pocket costs in Australia limit affordability of health services, including medications. At greatest risk may be those falling below thresholds for subsidised care such as self-funded retirees and those on low-middle incomes, in addition to those on very low incomes, who may find even small co-payments difficult to manage. BioMed Central 2013-11-20 /pmc/articles/PMC4225494/ /pubmed/24252248 http://dx.doi.org/10.1186/1472-6963-13-484 Text en Copyright © 2013 Walkom et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Walkom, Emily J
Loxton, Deborah
Robertson, Jane
Costs of medicines and health care: a concern for Australian women across the ages
title Costs of medicines and health care: a concern for Australian women across the ages
title_full Costs of medicines and health care: a concern for Australian women across the ages
title_fullStr Costs of medicines and health care: a concern for Australian women across the ages
title_full_unstemmed Costs of medicines and health care: a concern for Australian women across the ages
title_short Costs of medicines and health care: a concern for Australian women across the ages
title_sort costs of medicines and health care: a concern for australian women across the ages
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225494/
https://www.ncbi.nlm.nih.gov/pubmed/24252248
http://dx.doi.org/10.1186/1472-6963-13-484
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