Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease

Blake Angell, Tracey-Lea Laba, Tom Lung, Alex Brown, Sandra Eades, Tim Usherwood, David Peiris, Laurent Billot, Graham Hillis, Ruth Webster, Andrew Tonkin, Christopher Reid, Barbara Molanus, Natasha Rafter, Alan Cass, Anushka Patel, Stephen Jan

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Abstract

BACKGROUND: In spite of bearing a heavier burden of death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other Australians given their elevated risk level. This study analyses the Medicare expenditure and its predictors in a cohort of Indigenous and non-Indigenous Australians at high risk of cardiovascular disease.

METHODS: The healthcare expenditure of participants of the Kanyini Guidelines Adherence with the Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48% Indigenous) participants at high risk of cardiovascular disease (CVD) were recruited through 33 primary healthcare services (including 12 Aboriginal Medical Services) across Australia.

RESULTS: There was no significant difference in the expenditure of Indigenous and non-Indigenous participants in non-remote areas following adjustment for individual characteristics. Indigenous individuals living in remote areas had lower MBS expenditure ($932 per year P 

CONCLUSION: The findings suggest that for the majority of participants, once individuals are engaged with a primary care provider, factors other than whether they are Indigenous determine the level of Medicare expenditure for each person.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 126080005833347.

Original languageEnglish
Article number108
JournalInternational Journal for Equity in Health
Volume16
Issue number1
DOIs
Publication statusPublished - 23 Jun 2017
Externally publishedYes

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Health Expenditures
Cardiovascular Diseases
Delivery of Health Care
Medicare
Primary Health Care
Guideline Adherence
New Zealand
Registries
Linear Models
Randomized Controlled Trials
Clinical Trials

Cite this

Angell, Blake ; Laba, Tracey-Lea ; Lung, Tom ; Brown, Alex ; Eades, Sandra ; Usherwood, Tim ; Peiris, David ; Billot, Laurent ; Hillis, Graham ; Webster, Ruth ; Tonkin, Andrew ; Reid, Christopher ; Molanus, Barbara ; Rafter, Natasha ; Cass, Alan ; Patel, Anushka ; Jan, Stephen. / Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease. In: International Journal for Equity in Health . 2017 ; Vol. 16, No. 1.
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Angell, B, Laba, T-L, Lung, T, Brown, A, Eades, S, Usherwood, T, Peiris, D, Billot, L, Hillis, G, Webster, R, Tonkin, A, Reid, C, Molanus, B, Rafter, N, Cass, A, Patel, A & Jan, S 2017, 'Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease' International Journal for Equity in Health , vol. 16, no. 1, 108. https://doi.org/10.1186/s12939-017-0610-2

Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease. / Angell, Blake; Laba, Tracey-Lea; Lung, Tom; Brown, Alex; Eades, Sandra; Usherwood, Tim; Peiris, David; Billot, Laurent; Hillis, Graham; Webster, Ruth; Tonkin, Andrew; Reid, Christopher; Molanus, Barbara; Rafter, Natasha; Cass, Alan; Patel, Anushka; Jan, Stephen.

In: International Journal for Equity in Health , Vol. 16, No. 1, 108, 23.06.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease

AU - Angell, Blake

AU - Laba, Tracey-Lea

AU - Lung, Tom

AU - Brown, Alex

AU - Eades, Sandra

AU - Usherwood, Tim

AU - Peiris, David

AU - Billot, Laurent

AU - Hillis, Graham

AU - Webster, Ruth

AU - Tonkin, Andrew

AU - Reid, Christopher

AU - Molanus, Barbara

AU - Rafter, Natasha

AU - Cass, Alan

AU - Patel, Anushka

AU - Jan, Stephen

PY - 2017/6/23

Y1 - 2017/6/23

N2 - BACKGROUND: In spite of bearing a heavier burden of death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other Australians given their elevated risk level. This study analyses the Medicare expenditure and its predictors in a cohort of Indigenous and non-Indigenous Australians at high risk of cardiovascular disease.METHODS: The healthcare expenditure of participants of the Kanyini Guidelines Adherence with the Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48% Indigenous) participants at high risk of cardiovascular disease (CVD) were recruited through 33 primary healthcare services (including 12 Aboriginal Medical Services) across Australia.RESULTS: There was no significant difference in the expenditure of Indigenous and non-Indigenous participants in non-remote areas following adjustment for individual characteristics. Indigenous individuals living in remote areas had lower MBS expenditure ($932 per year P CONCLUSION: The findings suggest that for the majority of participants, once individuals are engaged with a primary care provider, factors other than whether they are Indigenous determine the level of Medicare expenditure for each person.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 126080005833347.

AB - BACKGROUND: In spite of bearing a heavier burden of death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other Australians given their elevated risk level. This study analyses the Medicare expenditure and its predictors in a cohort of Indigenous and non-Indigenous Australians at high risk of cardiovascular disease.METHODS: The healthcare expenditure of participants of the Kanyini Guidelines Adherence with the Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48% Indigenous) participants at high risk of cardiovascular disease (CVD) were recruited through 33 primary healthcare services (including 12 Aboriginal Medical Services) across Australia.RESULTS: There was no significant difference in the expenditure of Indigenous and non-Indigenous participants in non-remote areas following adjustment for individual characteristics. Indigenous individuals living in remote areas had lower MBS expenditure ($932 per year P CONCLUSION: The findings suggest that for the majority of participants, once individuals are engaged with a primary care provider, factors other than whether they are Indigenous determine the level of Medicare expenditure for each person.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 126080005833347.

U2 - 10.1186/s12939-017-0610-2

DO - 10.1186/s12939-017-0610-2

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JO - International Journal for Equity in Health

JF - International Journal for Equity in Health

SN - 1475-9276

IS - 1

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