Jonas Fooken, Macquarie University - Mental healthcare use and cost in Australia

Title: Mental healthcare use and cost in Australia: Inequalities and inequities

Abstract: We study place-based inequalities in the use and cost of mental healthcare across Australia using data from the Person Level Integrated Data Asset (PLIDA) to determine the extent to which area remoteness is associated with disparities in the use of mental health-related pharmaceuticals and services funded through Medicare. While prices and co-payments are regulated, the availability of healthcare and the financial burden faced by individuals may vary by remoteness of areas, where both population characteristics and access to care differ from those in major cities. We find that the use of mental health-related pharmaceuticals and services decreases with increasing remoteness before and after controlling for socioeconomic characteristics, supply-side factors, health status, and preferences, indicating the presence of place-based inequities in mental healthcare utilisation. The differences are particularly pronounced for mental health services, as residents in inner regional, outer regional, and remote or very remote areas used approximately 9.9%, 38.7%, and 39.4% fewer mental health services than those in major cities. For pharmaceuticals, residents in inner and outer regional areas used approximately 5.0% and 16.8% fewer prescriptions, respectively, while the difference between major cities and remote or very remote areas was not statistically significant. Although the use of mental health-related medications and services was generally lower outside major cities, the share of income spent on such care did not vary significantly by remoteness after controlling for important covariates, suggesting that affordability may be a barrier to mental healthcare for residents in more remote areas. We find no evidence that provider supply drives observed inequities by remoteness.

Presenter:  Jonas Fooken, Centre for the Health Economy, Macquarie University

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