ArticleHealth economics review2019
Out-of-pocket healthcare expenditure in Australia: trends, inequalities and the impact on household living standards in a high-income country with a universal health care system.
Article in Health economics review, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- What Interventions Work to Reduce Cost Barriers to Primary Healthcare in High-Income Countries? A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- The Willingness to Pay for Telemedicine Among Patients With Chronic Diseases: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Hidden out-of-pocket spending on health: A cross-sectional study on underestimation of catastrophic health spending in Vietnam.Public health in practice (Oxford, England) · 2026Article
- Developing a patient reported measure on out-of-pocket healthcare expenditure among Aboriginal patients: a formative study.Health promotion international · 2026Article
- A study on the effect of catastrophic health expenditures on socially vulnerable groups.BMC public health · 2026Article
- Regional and Socioeconomic Disparities in Frailty Across Tasmania: Evidence From Island Study Linking Ageing and Neurodegenerative Disease.Australasian journal on ageing · 2026Article
- Quantifying Cancer Healthcare Costs for Adolescents and Young Adults in Queensland, Australia.Healthcare (Basel, Switzerland) · 2025Article
- Delivering Accessible Chiropractic Services in a Culturally Sensitive Manner: The Aboriginal Health in Aboriginal Hands Program.Journal of chiropractic humanities · 2025Article
- Patterns of diagnostic testing for oesophagogastric cancer-related symptoms in Australian primary care: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Factors that influence the preferences for telehealth among family caregivers of disabled elders: a qualitative study.International journal of nursing studies advances · 2025Article
- Paramedic Practitioners within ambulance services: views of Australian policymakers, health professionals, and consumers.BMC health services research · 2025Article
- Retrospective Cohort Study to Determine the Effect of Socioeconomic Status and Distance to Hospital on Negative Appendicectomy Rates in a Rural Setting.The Australian journal of rural health · 2025Article
- Article
- Client preferences in noncommunicable diseases management in Australia: A scoping review.PLOS global public health · 2025Article
- A Comparison of Physical Activity and Exercise Recommendations for Public Health: Inconsistent Activity Messages Are Being Conveyed to the General Public.Sports (Basel, Switzerland) · 2024Review
- Australian general practice registrars' billing patterns: a cross-sectional analysis from the Registrars Clinical Encounters in Training (ReCEnT) study.BMC health services research · 2024Article
- Profiling patterns of patient experiences of access and continuity at team-based primary healthcare clinics (Canada): a latent class analysis.International journal for equity in health · 2024Article
- Identifying health and healthcare priorities in rural areas: A concept mapping study informed by consumers, health professionals and researchers.Health research policy and systems · 2024Article
- Nursing and allied health workforce in Australian public rheumatology departments is inadequate: a cross-sectional observational study.Rheumatology international · 2024Observational
- Out-of-pocket expenditure, need, utilisation, and private health insurance in the Australian healthcare system.International journal of health economics and management · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPoor health increases the likelihood of experiencing poverty by reducing a person's ability to work and imparting costs associated with receiving medical treatment. Universal health care is a means of protecting against the impoverishing impact of high healthcare costs. This study aims to document the recent trends in the amount paid by Australian households out-of-pocket for healthcare, identify any inequalities in the distribution of this expenditure, and to describe the impact that healthcare costs have on household living standards in a high-income country with a long established universal health care system. We undertook this analysis using a longitudinal, nationally representative dataset - the Household Income and Labour Dynamics in Australia Survey, using data collected annually from 2006 to 2014. Out of pocket payments covered those paid to health practitioners, for medication and in private health insurance premiums; catastrophic expenditure was defined as spending 10% or more of household income on healthcare.
resultsAverage total household expenditure on healthcare items remained relatively stable between 2006 and 2014 after adjusting for inflation, changing from $3133 to $3199. However, after adjusting for age, self-reported health status, and year, those in the lowest income group (decile one) had 15 times the odds (95% CI, 11.7-20.8) of having catastrophic health expenditure compared to those in the highest income group (decile ten). The percentage of people in income decile 2 and 3 who had catastrophic health expenditure also increased from 13% to 19% and 7% to 13% respectively.
conclusionsOngoing monitoring of out of pocket healthcare expenditure is an essential part of assessing health system performance, even in countries with universal health care.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.