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Patient-initiated switching between private and public inpatient hospitalisation in Western Australia 1980 - 2001: an analysis using linked data.

Moorin RE, Holman CD - Aust New Zealand Health Policy (2005)

Bottom Line: Overall, privately insured patients were more likely to switch payment classification at their next admission compared with public patients (the average rate of loss across all age groups being 0.55% and 2.16% respectively).In all age groups, the average rate of loss from the privately insured payment classification was greater between 1981 and 1990 compared with that between 1991 and 2001 (3.45% and 3.10% per year respectively).A small but statistically significant reduction in rate of switching away from PHI over the latter period of observation indicated that health care policies encouraging uptake of PHI implemented in the 1990s by the federal government had some of their intended impact on behaviour.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Centre for Economic Research on Health (UWA Campus), School of Population Health, The University of Western Australia, Australia. rachmoor@dph.uwa.edu.au

ABSTRACT

Background: The aim of the study was to identify any distinct behavioural patterns in switching between public and privately insured payment classifications between successive episodes of inpatient care within Western Australia between 1980 and 2001 using a novel 'couplet' method of analysing longitudinal data.

Methods: The WA Data Linkage System was used to extract all hospital morbidity records from 1980 to 2001. For each individual, episodes of hospitalisation were paired into couplets, which were classified according to the sequential combination of public and privately insured episodes. Behavioural patterns were analysed using the mean intra-couplet interval and proportion of discordant couplets in each year.

Results: Discordant couplets were consistently associated with the longest intra-couplet intervals (ratio to the average annual mean interval being 1.35), while the shortest intra-couplet intervals were associated with public concordant couplets (0.5). Overall, privately insured patients were more likely to switch payment classification at their next admission compared with public patients (the average rate of loss across all age groups being 0.55% and 2.16% respectively). The rate of loss from the privately insured payment classification was inversely associated with time between episodes (2.49% for intervals of 0 to 13 years and 0.83% for intervals of 14 to 21 years). In all age groups, the average rate of loss from the privately insured payment classification was greater between 1981 and 1990 compared with that between 1991 and 2001 (3.45% and 3.10% per year respectively).

Conclusion: A small but statistically significant reduction in rate of switching away from PHI over the latter period of observation indicated that health care policies encouraging uptake of PHI implemented in the 1990s by the federal government had some of their intended impact on behaviour.

No MeSH data available.


Related in: MedlinePlus

Distribution of the proportion of first and second episodes in couplets by year.
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Figure 2: Distribution of the proportion of first and second episodes in couplets by year.

Mentions: The distribution of first couplet episodes in each year of observation was more uniform in couplets with less than a one year intra-couplet interval compared with couplets longer intra-couplet interval or all couplets in the data file as shown in figure 2(A). The reduction of first couplet episodes in couplets with intervals = one year was directly proportional to the number of years remaining in which a second episode (thus completing a couplet) could be observed. The lack of first episodes observed in 1980 was the result of a reduced volume of data in the original HMDS file for that year, most likely caused by an extraction error.


Patient-initiated switching between private and public inpatient hospitalisation in Western Australia 1980 - 2001: an analysis using linked data.

Moorin RE, Holman CD - Aust New Zealand Health Policy (2005)

Distribution of the proportion of first and second episodes in couplets by year.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1173079&req=5

Figure 2: Distribution of the proportion of first and second episodes in couplets by year.
Mentions: The distribution of first couplet episodes in each year of observation was more uniform in couplets with less than a one year intra-couplet interval compared with couplets longer intra-couplet interval or all couplets in the data file as shown in figure 2(A). The reduction of first couplet episodes in couplets with intervals = one year was directly proportional to the number of years remaining in which a second episode (thus completing a couplet) could be observed. The lack of first episodes observed in 1980 was the result of a reduced volume of data in the original HMDS file for that year, most likely caused by an extraction error.

Bottom Line: Overall, privately insured patients were more likely to switch payment classification at their next admission compared with public patients (the average rate of loss across all age groups being 0.55% and 2.16% respectively).In all age groups, the average rate of loss from the privately insured payment classification was greater between 1981 and 1990 compared with that between 1991 and 2001 (3.45% and 3.10% per year respectively).A small but statistically significant reduction in rate of switching away from PHI over the latter period of observation indicated that health care policies encouraging uptake of PHI implemented in the 1990s by the federal government had some of their intended impact on behaviour.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Centre for Economic Research on Health (UWA Campus), School of Population Health, The University of Western Australia, Australia. rachmoor@dph.uwa.edu.au

ABSTRACT

Background: The aim of the study was to identify any distinct behavioural patterns in switching between public and privately insured payment classifications between successive episodes of inpatient care within Western Australia between 1980 and 2001 using a novel 'couplet' method of analysing longitudinal data.

Methods: The WA Data Linkage System was used to extract all hospital morbidity records from 1980 to 2001. For each individual, episodes of hospitalisation were paired into couplets, which were classified according to the sequential combination of public and privately insured episodes. Behavioural patterns were analysed using the mean intra-couplet interval and proportion of discordant couplets in each year.

Results: Discordant couplets were consistently associated with the longest intra-couplet intervals (ratio to the average annual mean interval being 1.35), while the shortest intra-couplet intervals were associated with public concordant couplets (0.5). Overall, privately insured patients were more likely to switch payment classification at their next admission compared with public patients (the average rate of loss across all age groups being 0.55% and 2.16% respectively). The rate of loss from the privately insured payment classification was inversely associated with time between episodes (2.49% for intervals of 0 to 13 years and 0.83% for intervals of 14 to 21 years). In all age groups, the average rate of loss from the privately insured payment classification was greater between 1981 and 1990 compared with that between 1991 and 2001 (3.45% and 3.10% per year respectively).

Conclusion: A small but statistically significant reduction in rate of switching away from PHI over the latter period of observation indicated that health care policies encouraging uptake of PHI implemented in the 1990s by the federal government had some of their intended impact on behaviour.

No MeSH data available.


Related in: MedlinePlus