scholarly journals The provision of chiropractic, physiotherapy and osteopathic services within the Australian private health-care system: a report of recent trends

2014 ◽  
Vol 22 (1) ◽  
Author(s):  
Roger M Engel ◽  
Benjamin T Brown ◽  
Michael S Swain ◽  
Reidar P Lystad
Keyword(s):  
Health Insurance ◽  
Private Sector ◽  
Private Health Insurance ◽  
Healthcare Services ◽  
Health Practitioner ◽  
Service Utilisation ◽  
Australian Health ◽  
Insurance Cover ◽  
Australian Bureau Of Statistics ◽  
The Cost

Abstract Background Chiropractors, physiotherapists, and osteopaths receive training in the diagnosis and management of musculoskeletal conditions. As a result there is considerable overlap in the types of conditions that are encountered clinically by these practitioners. In Australia, the majority of benefits paid for these services come from the private sector. The purpose of this article is to quantify and describe the development in service utilization and the cost of benefits paid to users of these healthcare services by private health insurers. An exploration of the factors that may have influenced the observed trends is also presented. Methods A review of data from the Australian Bureau of Statistics, Australian Health Practitioner Regulation Agency, and the Australian Government Private Health Insurance Administration Council was conducted. An analysis of chiropractic, physiotherapy and osteopathic service utilisation and cost of service utilisation trend was performed along with the level of benefits and services over time. Results In 2012, the number of physiotherapists working in the private sector was 2.9 times larger than that of chiropractic, and 7.8 times that of the osteopathic profession. The total number of services provided by chiropractors, physiotherapists, and osteopaths increased steadily over the past 15 years. For the majority of this period, chiropractors provided more services than the other two professions. The average number of services provided by chiropractors was approximately two and a half times that of physiotherapists and four and a half times that of osteopaths. Conclusions This study highlights a clear disparity in the average number of services provided by chiropractors, physiotherapists, and osteopaths in the private sector in Australia over the last 15 years. Further research is required to explain these observed differences and to determine whether a similar trend exists in patients who do not have private health insurance cover.

scholarly journals Financial sustainability of home care in the health system of the Republic of Serbia

2013 ◽  
Vol 141 (3-4) ◽  
pp. 214-218 ◽  
Author(s):  
Dejan Konstantinovic ◽  
Vesna Lazarevic ◽  
Valentina Milovanovic ◽  
Mirjana Lapcevic ◽  
Vladan Konstantinovic ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Services ◽  
Home Healthcare ◽  
Fixed Costs ◽  
Home Therapy ◽  
Healthcare Centre ◽  
Therapy Services ◽  
The Republic ◽  
The Cost ◽  
Therapy Team

Introduction. Over the last several years, during the economic crisis, the Ministry of Health and the Republican Health Insurance Fund (RHIF) have been faced with new challenges in the sphere of healthcare services financing both in the primary as well as other types of health insurance in the Republic of Serbia (RS). Objective. Analysis of cost?effectiveness of two models of organization of home treatment and healthcare in the primary insurance, with evaluation of the cost sustainability of a single visit by the in?home therapy team. Methods. Economic evaluation of the cost of home treatment and healthcare provision in 2011 was performed. In statistical analysis, the methods of descriptive statistics were employed. The structure of fixed costs of home healthcare was developed according to the RS official norms, as well as fixed costs of providing services of home therapy by the Healthcare Centre "New Belgrade". The statement of account for provided home therapy services was made utilizing the RHIF price list. Results. The results showed that the cost of home healthcare and therapy of the heterogeneous population of patients in the Healthcare Centre "New Belgrade" was more cost?effective in relation to the cost of providing home therapy services according to the RS official norms. Conclusion. Approved costs utilized when making a contract for services of home therapy and healthcare with the RHIF are not financially sustainable. It was shown that the price of 10 EUR for each home visit by the in?home therapy team enables sustainability of this form of providing healthcare services in RS.

scholarly journals Utilization of complementary and traditional medicine practitioners among middle-aged and older adults in India: results of a national survey in 2017–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Older Adults ◽  
Socioeconomic Status ◽  
Health Insurance ◽  
Tobacco Use ◽  
Health Practitioner ◽  
Middle Aged ◽  
Urban Residence ◽  
Subjective Socioeconomic Status ◽  
Insurance Cover ◽  
Current Tobacco

Abstract Background Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India. Methods The study included 72,262 individuals (45 years and older) from the cross-sectional 2017–2018 Longitudinal Ageing Study in India (LASI) Wave 1. Results The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07–1.34), having pain (AOR: 1.48, 95% CI: 1.29–1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35–1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12–1.50), male sex (AOR: 0.76, 95% CI: 0.68–0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60–0.87), urban residence (AOR: 0.71, 95% CI: 0.57–0.88), diabetes (AOR: 0.66, 95% CI: 0.55–0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37–0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30–0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01–1.35), sleep problems (AOR: 1.28, 95% CI: 1.08–1.51), having pain (AOR: 1.82, 95% CI: 1.55–2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22–1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33–0.51), hypertension (AOR: 0.82, 95% CI: 0.71–0.95), diabetes (AOR: 0.50, 95% CI: 0.39–0.65), urban residence (AOR: 0.25, 95% CI: 0.19–0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58–0.85). Conclusion A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified.

scholarly journals Occurrence of Medical Cases and Utilisation among Enrollees of Private Health Insurance Programme in Kaduna, Nigeria

2020 ◽  
pp. 30-37
Author(s):  
Oni, Oluwatobi Dapo ◽  
Zakari, Mustapha Mohammed ◽  
Okemmiri, Innocentia Chidinma
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Health Coverage ◽  
Primary Case ◽  
Health Maintenance ◽  
Insurance Programme ◽  
Chi Square Analysis ◽  
Health Insurance Programme

Aims: This study examines the occurrence of various medical cases presented by enrollees that have subscribed to access healthcare from a network of healthcare providers (HCPs) managed by a Health Maintenance Organisation (HMO) under its Private Health Insurance Programme (PHIP). Study Design:  A descriptive cross-sectional design was employed. Methodology: Secondary data from collected or submitted medical encounters in form of bills of registered enrollees (principals and their dependants) who have visited and received treatment from their chosen healthcare providers in Kaduna State between the month of January and December 2019 were purposively compiled and analysed. Cases were classified using the National Health Insurance Scheme (NHIS) Operational Guideline. Frequency tables, charts, percentages and Chi-Square analysis were used with the aid of Statistical Package for Social Sciences (SPSS) 22 at P=.05 level of significance. Results: A total of 11,156 medical cases were recorded after attrition, 9,525 (85.38%) primary cases and 1,632 (14.62%) secondary cases. Malaria (41.23%) and Respiratory Tract Infection (11.98%) led the primary case table while Hypertension (3.83%) Urology related cases (2.49%) and Diabetes (0.79%) were among the leading secondary cases. Female enrollees had slightly more cases and therefore higher tendencies to seek medical treatment than their male counterpart even though there was no significant relation between gender and type of case. Conclusion: The study concludes that the awareness and utilization of healthcare services are gradually growing among enrollees under the Private Health Insurance Programme (PHIP). In ensuring that there is an improvement in the health sector of Nigeria and achieving universal health coverage, focus should be on the primary healthcare services with high consideration for research, proper data management and periodic sharing of trends, observations and outcome of researches with the growing health community.

scholarly journals Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

2016 ◽  
Vol 40 (5) ◽  
pp. 490 ◽  
Author(s):  
Suzanne Nielsen ◽  
Gabrielle Campbell ◽  
Amy Peacock ◽  
Kimberly Smith ◽  
Raimondo Bruno ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Pain ◽  
Private Health Insurance ◽  
Healthcare Services ◽  
Opioid Therapy ◽  
Limited Evidence ◽  
Financial Barriers ◽  
Different Types ◽  
Before And After

Objective The aims of the present study were to describe the use, and barriers to the use, of non-medication pain therapies and to identify the demographic and clinical correlates of different non-opioid pain treatments. Methods The study was performed on a cohort (n = 1514) of people prescribed pharmaceutical opioids for chronic non-cancer pain (CNCP). Participants reported lifetime and past month use of healthcare services, mental and physical health, pain characteristics, current oral morphine equivalent daily doses and financial and access barriers to healthcare services. Results Participants reported the use of non-opioid pain treatments, both before and after commencing opioid therapy. Services accessed most in the past month were complementary and alternative medicines (CAMs; 41%), physiotherapy (16%) and medical and/or pain specialists (15%). Higher opioid dose was associated with increased financial and access barriers to non-opioid treatment. Multivariate analyses indicated being younger, female and having private health insurance were the factors most commonly associated with accessing non-opioid treatments. Conclusions Patients on long-term opioid therapy report using multiple types of pain treatments. High rates of CAM use are concerning given limited evidence of efficacy for some therapies and the low-income status of most people with CNCP. Financial and insurance barriers highlight the importance of considering how different types of treatments are paid for and subsidised. What is known about the topic? Given concerns regarding long-term efficacy, adverse side-effects and risk of misuse and dependence, prescribing guidelines recommend caution in prescribing pharmaceutical opioids in cases of CNCP, typically advising a multidisciplinary approach to treatment. There is a range of evidence supporting different (non-drug) treatment approaches for CNCP to reduce pain severity and increase functioning. However, little is known about the non-opioid treatments used among those with CNCP and the demographic and clinical characteristics that may be associated with the use of different types of treatments. Understanding the use of non-drug therapy among people with CNCP is crucial given the potential to improve pain control for these patients. What does this paper add? The present study found that a wide range of non-opioid treatments was accessed by the study sample, both before and after commencing opioids, indicating that in this sample opioids were not the sole strategy used for pain management. The most common treatment (other than opioids) was CAM, reported by two-fifths of the sample. Having private health insurance was associated with increased use of non-opioid treatments for pain, highlighting the importance of considering how treatments are paid for and potential financial barriers to effective treatments. What are the implications for practitioners? Patients’ beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using complementary and alternative approaches with limited evidence to support their use, highlighting the need for clinicians to discuss with patients the range of prescribed and non-prescribed treatments they are accessing and to help them understand the benefits and risks of treatments that have not been tested sufficiently, or have inconsistent evidence, as to their efficacy in improving pain outcomes.

scholarly journals Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

2004 ◽  
Vol 28 (1) ◽  
pp. 34 ◽  
Author(s):  
Jeff R J Richardson ◽  
Leonie Segal
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Public Hospitals ◽  
Common Element ◽  
Cost Shifting ◽  
The Public ◽  
Pharmaceutical Expenditures ◽  
The Government ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients ? which were the primary justification for the assistance to PHI ? do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI ? the need to preserve the market share of private hospitals and relieve pressure upon public hospitals ? is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the ?problem? of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

scholarly journals The economic crisis, the Pharmaceutical Benefits Scheme, and the dilemmas of medicines policy

2009 ◽  
Vol 33 (2) ◽  
pp. 171
Author(s):  
Hans Löfgren
Keyword(s):  
Health Insurance ◽  
Middle Class ◽  
The United States ◽  
Insurance Companies ◽  
Real Economy ◽  
Access To Health Services ◽  
Australian Health ◽  
The Media ◽  
Social Disaster ◽  
The Cost

AS THIS SPECIAL ISSUE of Australian Health Review was finalised, the media reported daily on the global financial debacle and its deepening into a crisis in the real economy. The causes of the crisis are hazy ? but its impact, across the globe, on people?s lives is real and distressing. Many people are affected by worsening poverty and deteriorating access to health services and medicinal drugs. In the United States, unemployment often means the loss of health insurance, reinforcing risks of financial and social disaster for many families who would have previously considered themselves comfortable middle class. For those lucky enough to retain jobs, the cost of health insurance may rapidly become unaffordable; ?Healthcare a Budget-Buster for Families; Even County?s Middle Class Can?t Afford It?, ran a typical recent headline in a non-metropolitan newspaper.1 Even before the present crisis, tens of millions of Americans were excluded from health insurance. Those not excluded pay premiums to insurance companies that spend vast resources trying to insure the healthy, avoid the sick, and deny payment for claims wherever possible. Gaining power partly on a wave of resentment against the excesses of neo-liberalism, President Barak Obama has promised public health insurance for those not otherwise covered. Should this reform be successfully implemented, it will belatedly bring to US citizens a level of security approximating what Australians, and many Europeans, have had for decades.

scholarly journals Has the increase in private health insurance uptake affected the Victorian public hospital surgical waiting list?

2002 ◽  
Vol 25 (6) ◽  
pp. 64 ◽  
Author(s):  
Brian Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Uptake Rate ◽  
Public Hospital ◽  
Private Health Insurance ◽  
Elective Surgery ◽  
Waiting List ◽  
Limited Data ◽  
The Public

It was anticipated that increased uptake of Private Health Insurance (PHI) would reduce demand on public sector surgical waiting lists. The best measure of changed demand is the comparison of the actual cases added to that projected given previous trends in PHI uptake. Detailed Victorian data is available up to 2000-1.The total waiting list has varied little, reflecting significant decreases in both in patients added to and removed. There was a marked increase in private sector elective surgery cases coinciding with the fall in additions to the public sector waiting list and in public sector elective surgical cases. The June 2001 Victorian surgical waiting list would have been 69,599 not 41,838 if the PHI uptake rate had continued to fall in line with pre-1999 trends, and that of June 2002 about 100,000 compared to 40,458 in March 2002.Limited data from other states suggests the Victorian trends are representative of all Australia.

scholarly journals An overview of the role of government in the organisation and provision of health services in Japan

1996 ◽  
Vol 19 (2) ◽  
pp. 75 ◽  
Author(s):  
Christopher Walker
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Private Sector ◽  
Service Providers ◽  
Care Delivery ◽  
Insurance Coverage ◽  
Role Of Government ◽  
Australian Health

This article is illustrated with reference to health services in the Tokyo Prefecture.It seeks to describe the role of government in the organisation and provision of healthservices in Japan. It is based on experiences gained from a three-month placementat the Tokyo Metropolitan Government Bureau of Public Health in late 1994.Wherever possible the article identifies similarities and differences between theJapanese and Australian health care systems. Part of the analysis has been to identifyareas where opportunities exist for Australian health service providers to developfurther cooperation with particular sectors of the Japanese health system and alsowhere the potential for the export of health services may exist.The health systems of Australia and Japan have points of similarity anddifference. Essentially both systems operate within the context of a compulsoryuniversal health insurance system. However, unlike Australia, the bulk of serviceprovision in Japan is left to the private sector, while government retains the primaryrole of regulator. It is interesting to observe that while the Australian health caresystem is currently exploring options to expand the service range and level ofparticipation of private sector services in health care delivery (within the context ofuniversal health insurance), the Japanese health care system appears to be examiningoptions through which further government intervention can improve service accessand service efficiency. Japan presents opportunities to observe the benefits anddisadvantages of predominantly private sector provision within the context ofuniversal health insurance coverage.

scholarly journals Utilisation patterns of privately funded mental health services in Australia

2019 ◽  
Vol 33 (1) ◽  
pp. 5-17
Author(s):  
Joanna Khoo ◽  
Helen Hasan ◽  
Kathy Eagar
Keyword(s):  
Mental Health ◽  
Health Insurance ◽  
Health Service ◽  
Private Health Insurance ◽  
Claims Data ◽  
Service Utilisation ◽  
Insurance Claims ◽  
Content Type ◽  
Health Related ◽  
Insurance Claims Data

Purpose The purpose of this paper is twofold: first, to present patient-level utilisation patterns of hospital-based mental health services funded by private health insurers; and second, to examine the implications of the findings for planning and delivering private mental health services in Australia. Design/methodology/approach Analysing private health insurance claims data, this study compares differences in demographic and hospital utilisation characteristics of 3,209 patients from 13 private health insurance funds with claims for mental health-related hospitalisations and 233,701 patients with claims for other types of hospitalisations for the period May 2014 to April 2016. Average number of overnight admissions, length of stay and per patient insurer costs are presented for each group, along with overnight admissions vs same-day visits and repeat services within a 28-day period following hospitalisation. Challenges in analysing and interpreting insurance claims data to better understand private mental health service utilisation are discussed. Findings Patients with claims for mental health-related hospitalisations are more likely to be female (62.0 per cent compared to 55.8 per cent), and are significantly younger than patients with claims for other types of hospitalisations (32.6 per cent of patients aged 55 years and over compared to 57.1 per cent). Patients with claims for mental health-related hospitalisations have significantly higher levels of service utilisation than the group with claims for other types of hospitalisations with a mean length of stay per overnight admission of 15.0 days (SD=14.1), a mean of 1.3 overnight admissions annually (SD=1.2) and mean hospital costs paid by the insurer of $13,192 per patient (SD=13,457) compared to 4.6 days (SD=7.3), 0.8 admissions (SD=0.6) and $2,065 per patient (SD=4,346), respectively, for patients with claims for other types of hospitalisations. More than half of patients with claims for mental health-related hospitalisations only claim for overnight admissions. However, the findings are difficult to interpret due to the limited information collected in insurance claims data. Practical implications This study shows the challenges of understanding utilisation patterns with one data source. Analysing insurance claims reveals information on mental health-related hospitalisations but information on community-based care is lacking due to the regulated role of the private health insurance sector in Australia. For mental health conditions, and other chronic health conditions, multiple data sources need to be integrated to build a comprehensive picture of health service use as care tends to be provided in multiple settings by different medical and allied health professionals. Originality/value This study contributes in two areas: patient-level trends in hospital-based mental health service utilisation claimed on private health insurance in Australia have not been previously reported. Additionally, as the amount of data routinely collected in health care settings increases, the study findings demonstrate that it is important to assess the quality of these data sources for understanding service utilisation.

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