Inequity in healthcare use among the indigenous population living in non-remote areas of Australia.

Pulok, MH; van Gool, K; Hall, J

Inequity in healthcare use among the indigenous population living in non-remote areas of Australia.

Pulok, MH van Gool, K Hall, J

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Public health, 2020, 186, pp. 35-43
Issue Date:: 2020-08-05

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Field	Value	Language
dc.contributor.author	Pulok, MH
dc.contributor.author	van Gool, K
dc.contributor.author	Hall, J https://orcid.org/0000-0002-2191-0543
dc.date.accessioned	2020-09-22T05:25:54Z
dc.date.available	2020-06-24
dc.date.available	2020-09-22T05:25:54Z
dc.date.issued	2020-08-05
dc.identifier.citation	Public health, 2020, 186, pp. 35-43
dc.identifier.issn	0033-3506
dc.identifier.issn	1476-5616
dc.identifier.uri	http://hdl.handle.net/10453/142797
dc.description.abstract	OBJECTIVES:Although several studies have examined the gap in healthcare use between indigenous and non-indigenous people, empirical evidence on inequity in healthcare use within indigenous populations is limited. This study aims to fill this gap in the literature by investigating income-related inequity (unequal use for equal need) in healthcare use among indigenous Australians living in non-remote areas. STUDY DESIGN:This is a cross-sectional study. METHODS:This study used data from the Australian Aboriginal and Torres Strait Islander Health Survey, 2012-13. Logistic regression analysis was used to determine the association of income with the probability of a general practitioner (GP) visit, a specialist visit and inpatient admission. The horizontal inequity (HI) index and decomposition analysis were also used to quantify and explain inequity in healthcare use. RESULTS:No consistent association was found between income and the probability of GP visit or inpatient admission after controlling for health need. However, the likelihood of visiting a specialist was about three times (odds ratio = 2.96, P = 0.028) higher for the richest compared with the poorest population subgroups. The inequity index was 0.016 (P < 0.001), indicating a pro-rich inequity for the probability of visiting a specialist. Income inequality, unequal distribution of private health insurance and inequality in education were the main factors explaining the pro-rich inequity in specialist utilisation. CONCLUSIONS:Although there was no income-related inequity in GP visits or inpatient admissions, wealthier indigenous Australians had a higher probability of visiting a specialist than their poorer counterparts, after adjusting for need. Specific policies and initiatives are required to address the inequity faced by low-income indigenous people in Australia.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Public health
dc.relation.isbasedon	10.1016/j.puhe.2020.06.051
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.title	Inequity in healthcare use among the indigenous population living in non-remote areas of Australia.
dc.type	Journal Article
utslib.citation.volume	186
utslib.location.activity	Netherlands
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/DVC (International)
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
dc.date.updated	2020-09-22T05:25:46Z
pubs.publication-status	Published
pubs.volume	186

Abstract:

OBJECTIVES:Although several studies have examined the gap in healthcare use between indigenous and non-indigenous people, empirical evidence on inequity in healthcare use within indigenous populations is limited. This study aims to fill this gap in the literature by investigating income-related inequity (unequal use for equal need) in healthcare use among indigenous Australians living in non-remote areas. STUDY DESIGN:This is a cross-sectional study. METHODS:This study used data from the Australian Aboriginal and Torres Strait Islander Health Survey, 2012-13. Logistic regression analysis was used to determine the association of income with the probability of a general practitioner (GP) visit, a specialist visit and inpatient admission. The horizontal inequity (HI) index and decomposition analysis were also used to quantify and explain inequity in healthcare use. RESULTS:No consistent association was found between income and the probability of GP visit or inpatient admission after controlling for health need. However, the likelihood of visiting a specialist was about three times (odds ratio = 2.96, P = 0.028) higher for the richest compared with the poorest population subgroups. The inequity index was 0.016 (P < 0.001), indicating a pro-rich inequity for the probability of visiting a specialist. Income inequality, unequal distribution of private health insurance and inequality in education were the main factors explaining the pro-rich inequity in specialist utilisation. CONCLUSIONS:Although there was no income-related inequity in GP visits or inpatient admissions, wealthier indigenous Australians had a higher probability of visiting a specialist than their poorer counterparts, after adjusting for need. Specific policies and initiatives are required to address the inequity faced by low-income indigenous people in Australia.

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http://hdl.handle.net/10453/142797