Limits...
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

The proportionate discordance among hospital couplets with a private first episode by decade of the second couplet episode. # Significant difference (p < 0.01) between the percentage of discordant second episodes occurring in 1981–1990 versus 1991–2000.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC1173079&req=5

Figure 4: The proportionate discordance among hospital couplets with a private first episode by decade of the second couplet episode. # Significant difference (p < 0.01) between the percentage of discordant second episodes occurring in 1981–1990 versus 1991–2000.

Mentions: Figure 4 shows the degree of switching from private to public episodes over the two designated eras in health care policy. In all age groups the average rate of switching away from the private sector in 1991–2001 (era 2) was lower than that observed in 1981–1990 (era 1). The decrease in rate was small (average across all age groups -0.35% per intra-couplet year) but statistically significant. In addition, significance testing of the difference between each pair of proportions (era 1 versus era 2) indicated a significant difference for the majority as indicated in figure 4.


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)

The proportionate discordance among hospital couplets with a private first episode by decade of the second couplet episode. # Significant difference (p < 0.01) between the percentage of discordant second episodes occurring in 1981–1990 versus 1991–2000.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: The proportionate discordance among hospital couplets with a private first episode by decade of the second couplet episode. # Significant difference (p < 0.01) between the percentage of discordant second episodes occurring in 1981–1990 versus 1991–2000.
Mentions: Figure 4 shows the degree of switching from private to public episodes over the two designated eras in health care policy. In all age groups the average rate of switching away from the private sector in 1991–2001 (era 2) was lower than that observed in 1981–1990 (era 1). The decrease in rate was small (average across all age groups -0.35% per intra-couplet year) but statistically significant. In addition, significance testing of the difference between each pair of proportions (era 1 versus era 2) indicated a significant difference for the majority as indicated in figure 4.

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