Health Policy

ISSN:

0168-8510

国家:

Australia

影响因子:

3.6 (2023)

SCIE收录情况:

SCIE , SSCI

JCR分区:

Q1

Jane Desborough ; Jane Desborough ; Charles Maskell-Knight ; Shelley Wang ; Anne Parkinson ; Danielle Butler ; Hsei-Di Law ; Kamania Butler ; Leanne Watts ; Elisabeth Huynh ; Fiona Hodson ; Samar Ibrahim ; Julie Veitch ; Jillian Kingsford-Smith ; Michael Kidd ; Cam Donaldson
2025-08-01 相关链接

摘要

Background

Despite Australia’s universal health insurance scheme, Medicare, out-of-pocket costs (OOPC) for health care comprises 14 % of total health expenditure. People with chronic conditions spend a greater proportion of their incomes on health care than people without a chronic condition.

Objective

To review the qualitative literature examining experiences of OOPC of out-of-hospital care by people with chronic conditions and to discuss this in relation to current Australian health policy.

Methods

Systematic review and narrative synthesis of the qualitative literature examining OOPC for people with chronic conditions in Australia. Search: Pubmed, CINAHL Complete, Cochrane Library, PsycINFO and EconLit databases from 1999 to 10th April 2025.

Results

37 studies met the inclusion criteria. Reduced or lost employment due to ill-health led to income loss, aggravating the financial burden of health management. While many people were able to access bulk-billing general practitioners, challenges in affording upfront and copayments for medical and allied health consultations, and medication costs were reported. Cost was the greatest barrier to accessing dental care. Trade-offs were described between health management and meeting basic living needs, particularly for people who earned too much to qualify for government welfare payments.

Conclusion

While Australian health policies effectively reduce the financial burden of health care for many people, distinct challenges exist for groups ineligible for concessional thresholds. Future research to identify the priorities and preferences of people with chronic conditions can further inform policy to improve the equity of health financing in Australia.

Out-of-pocket costs; Expenses; Chronic disease; Multimorbidity; Comorbidity; Systematic review; Qualitative

基金支付 ; 慢性非传染性疾病

混合人群

Not Available

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