Melbourne Institute of Applied Economic and Social Research - Research Publications
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ItemNo Preview Available"It's not a one operation fits all": A qualitative study exploring fee setting and participation in price transparency initiatives amongst medical specialists in the Australian private healthcare sector(PERGAMON-ELSEVIER SCIENCE LTD, 2023-12)The Australian government, through Medicare, defines the type of medical specialist services it covers and subsidizes, but it does not regulate prices. Specialists in private practice can charge more than the fee listed by Medicare depending on what they feel 'the market will bear'. This can sometimes result in high and unexpected out-of-pocket (OOP) payments for patients. To reduce pricing uncertainty and 'bill shock' faced by consumers, the government introduced a price transparency website in December 2019. It is not clear how effective such a website will be and whether specialists and patients will use it. The aim of this qualitative study was to explore factors influencing how specialists set their fees, and their views on and participation in price transparency initiatives. We conducted 27 semi-structured interviews with surgical specialists. We analysed the data using thematic analysis and responses were mapped to the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behavior model. We identified several patient, specialist and system-level factors influencing fee setting. Patient-level factors included patient characteristics, circumstance, complexity, and assumptions regarding perceived value of care. Specialist-level factors included perceived experience and skills, ethical considerations, and gendered-behavior. System-level factors included the Australian Medical Association recommended price list, practice costs, and supply and demand factors including perceived competition and practice location. Specialists were opposed to price transparency websites and lacked motivation to participate because of the complexity of fee setting, concerns over unintended consequences, and feelings of frustration they were being singled out. If price transparency websites are to be pursued, specialists' lack of motivation to participate needs to be addressed.
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ItemPrivate or Public? The declining growth in the use of private healthcare in Australia(Melbourne Institute of Applied Economic and Social Research, 2020-10-01)The past five years has seen a steady decline in private health insurance (PHI) membership in Australia. With rising premium prices and out-of-pocket costs, private healthcare has become increasingly unaffordable in an era of low wage growth. Given the private health sector relies heavily on PHI funding, this Research Insight explores how the decline in private health membership has affected the private hospital sector in Australia.
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ItemBehind closed doors: the surge in mental distress of parents(Melbourne Institute of Applied Economic and Social Research, 2020-08-01)The economic downturn caused by the COVID-19 pandemic and its subsequent restrictions has had an alarming effect on Australians' mental health. Particularly worrying is the increase in high mental distress among parents, especially among non-employed fathers and parents of primary school aged children. Financial stress and work-family conflict tend to be the two major sources of mental distress for parents. Using data from the Melbourne Institute's Taking the Pulse of the Nation survey and the Household, Income and Labour Dynamics in Australia (HILDA) Survey, this Research Insight examines the surge in mental distress in parents compared to pre-COVID. The study identifies who has been most impacted, looking at how it impacts mothers and fathers, and how employment status and the age of the child can influence mental distress.
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ItemHelp! High Levels of Parents’ Mental Distress(Melbourne Institute, The University of Melbourne, 2020-12-01)Of the close to 5 million parents with children under 18 in Australia, 24 percent have reported high rates of mental distress since the start of the pandemic. This has persisted well beyond the end of local lockdowns.