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Out-of-pocket costs influencing health outcomes, Australia

The out-of-pocket costs of health care are rising well above the consumer price index and are influencing patient decisions about their own health, an editorial in Medical Journal of Australia highlights.

Professor Sanchia Aranda from Cancer Council Australia and Professor David Currow from the Cancer Institute NSW explained that out-of-pocket expenses accounted for 57% of non-government health expenditure in 2011-12 and over 17% of all health care expenditure.

“The net burden of costs are reported by clinicians to influence some decisions that patients make, with the potential for detrimental health outcomes for individuals and for Australia’s health as a whole,” the authors wrote.

Many patients aren’t informed of the full cost of a procedure and whether there are alternatives that offer similar benefits, which “may be as important to the patient as the side effects or risks of an intervention”.

Patients are sometimes not informed about comparative waiting times in the public and private systems, particularly important as public surgical waiting times for cancers are very short.

“Publicly available data on waiting times and service quality are critical for supporting informed treatment decisions, especially when out-of-pocket expenses can vary from zero to tens of thousands of dollars for the same procedure,” the authors wrote.

Failure by medical practitioners to inform patients of all these financial costs could prevent many patients from avoiding additional suffering.

“A new standard for financial disclosure is required – a standard that moves beyond disclosure of the costs of a single procedure to one that accounts for the costs of a full pathway of treatment and all the alternatives open to the patient,” the authors concluded.

Article: Financial toxicity in clinical care today: a “menu without prices”, David Currow and Sanchia Aranda, Medical Journal of Australia, doi: 10.5694/mja16.00182, published 20 June 2016.