Melbourne Institute of Applied Economic and Social Research - Research Publications

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Comparing estimates of psychological distress using 7-day and 30-day recall periods: Does it make a difference?

Chilver, MR ; Burns, RA ; Botha, F ; Butterworth, P ; Ng, QX (PUBLIC LIBRARY SCIENCE, 2023-12-08)

Self-report measures are widely used in mental health research and may use different recall periods depending on the purpose of the assessment. A range of studies aiming to monitor changes in mental health over the course of the COVID-19 pandemic opted to shorten recall periods to increase sensitivity to change over time compared to standard, longer recall periods. However, many of these studies lack pre-pandemic data using the same recall period and may rely on pre-existing data using standard recall periods as a reference point for assessing the impact of the pandemic on mental health. The aim of this study was to assess whether comparing scores on the same questionnaire with a different recall period is valid. A nationally representative sample of 327 participants in Australia completed a 7-day and 30-day version of the six-item Kessler Psychological Distress Scale (K6) and a single-item measure of psychological distress (TTPN item) developed for the Taking the Pulse of the Nation survey. Linear mixed models and mixed logistic regression models were used to assess whether altering the recall period systematically changed response patterns within subjects. No substantive recall period effects were found for the K6 or the TTPN, although there was a trend towards higher K6 scores when asked about the past 30 days compared to the past 7 days (b = 1.00, 95% CI: -0.18, 2.17). This may have been driven by the "feeling nervous" item which was rated higher using the 30-day compared to the 7-day recall period. Neither the K6 nor the TTPN item were significantly affected by the recall period when reduced to a binary variable of likely severe mental illness. The results indicate that altering the recall period of psychological distress measures does not substantively alter the score distribution in the general population of Australian adults.
The impact of employment on mental healthcare use among people with disability: distinguishing between part- and full-time employment

Saxby, K ; Dickinson, H ; Petrie, D ; Kavanagh, A ; Aitken, Z (SCANDINAVIAN JOURNAL WORK ENVIRONMENT & HEALTH, 2023)

OBJECTIVE: Employment can improve mental health among people with disability (PWD), however, little is known about how different levels of workforce participation influence mental healthcare use. The aim of this study was to estimate the extent to which different levels of working hours are associated with changes in mental healthcare use among PWD. METHODS: Data on working hours and healthcare use among working age PWD who were receiving government benefits (N=260 825) was obtained from Australian Census-linked administrative records between 2011 and 2019. Individual fixed effects panel models were used to estimate the impact of increased working hours on mental healthcare (services and prescriptions). Heterogeneity analyses by job security and key sociodemographic characteristics were conducted. RESULTS: Compared to not working, we found that working 1-14, 15-29, and ≥30 hours per week was respectively associated with a 3.3%, 18.0%, and 9.9% reduction in the use of mental healthcare prescriptions as well as a 6.8%, 18.4%, and 22.3% reduction in the use of mental healthcare services by PWD. The effects were larger for PWD in more secure work and those living in rural and disadvantaged areas. CONCLUSIONS: Working more hours was associated with reduced mental healthcare use among PWD. Policy interventions should consider the broader benefits of enabling part-time and secure work placements for PWD, particularly for those living in rural and disadvantaged regions.
Are shorter cumulative temporary contracts worse stepping stones? Evidence from a quasi-natural experiment

Kabátek, J ; Liang, Y ; Zheng, K (Elsevier BV, 2023-10)

Temporary employment contracts are often regarded as ‘stepping stones’ for workers’ careers, because they can help inexperienced workers secure a permanent contract. Our study evaluates whether this stepping-stone function is moderated by the contract duration, exploiting a Dutch policy reform that shortened the maximum duration of sequences of temporary contracts with the same employers from 3 years to 2 years. Leveraging a sharp regression discontinuity design and administrative register data, we show that the reform accelerated the transitions of temporary workers to permanent contracts with the same employers, with the effect being strongest among those working for the same employers for 1–2 years. We conclude that the reform brought more job security to temporary workers without impeding the stepping-stone function of their contracts.
Economic conditions and health: Local effects, national effect and local area heterogeneity

Janke, K ; Lee, K ; Propper, C ; Shields, K ; Shields, MA (Elsevier BV, 2023-10-01)
Surveillance and Self-Control

Cobb-Clark, DA ; Dahmann, SC ; Kamhöfer, DA ; Schildberg-Hörisch, H (Oxford University Press (OUP), 2023)

This paper studies important determinants of adult self-control using population-representative data and exploiting Germany’s division as quasi-experimental variation. We find that former East Germans have substantially more self-control than West Germans and provide evidence for government surveillance as a possible underlying mechanism. We thereby demonstrate that institutional factors can shape people’s self-control. Moreover, we find that self-control increases linearly with age. In contrast to previous findings for children, there is no gender gap in adult self-control and family background does not predict self-control.
Generational differences in mental health trends in the twenty-first century

Botha, F ; Morris, RW ; Butterworth, P ; Glozier, N (National Academy of Sciences, 2023-12-05)

Given the observed deterioration in mental health among Australians over the past decade, this study investigates to what extent this differs in people born in different decades-i.e., possible birth cohort differences in the mental health of Australians. Using 20 y of data from a large, nationally representative panel survey (N = 27,572), we find strong evidence that cohort effects are driving the increase in population-level mental ill-health. Deteriorating mental health is particularly pronounced among people born in the 1990s and seen to a lesser extent among the 1980s cohort. There is little evidence that mental health is worsening with age for people born prior to the 1980s. The findings from this study highlight that it is the poorer mental health of Millennials that is driving the apparent deterioration in population-level mental health. Understanding the context and changes in society that have differentially affected younger people may inform efforts to ameliorate this trend and prevent it continuing for emerging cohorts.
A randomised controlled trial of email versus mailed invitation letter in a national longitudinal survey of physicians

Harrap, B ; Taylor, T ; Russell, G ; Scott, A ; Alahdab, F (PUBLIC LIBRARY SCIENCE, 2023-08-22)

Despite their low cost, the use of email invitations to distribute surveys to medical practitioners have been associated with lower response rates. This research compares the difference in response rates from using email approach plus online completion rather than a mailed invitation letter plus a choice of online or paper completion. A parallel randomised controlled trial was conducted during the 11th annual wave of the nationally representative Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of doctors. The control group was invited using a mailed paper letter (including a paper survey plus instructions to complete online) and three mailed paper reminders. The intervention group was approached in the same way apart from the second reminder when they were approached by email only. The primary outcome is the response rate and the statistical analysis was blinded. 18,247 doctors were randomly allocated to the control (9,125) or intervention group (9,127), with 9,108 and 9,107 included in the analysis. Using intention to treat analysis, the response rate in the intervention group was 35.92% compared to 37.59% in the control group, a difference of -1.66 percentage points (95% CI: -3.06 to -0.26). The difference was larger for General Practitioners (-2.76 percentage points, 95% CI: -4.65 to -0.87) compared to other specialists (-0.47 percentage points, 95% CI: -2.53 to 1.60). For those who supplied an email address, the average treatment effect on the treated was higher at -2.63 percentage points (95% CI: -4.50 to -0.75) for all physicians, -3.17 percentage points (95% CI: -5.83 to -0.53) for General Practitioners, and -2.1 percentage points (95% CI: -4.75 to 0.56) for other specialists. For qualified physicians, using email to invite participants to complete a survey leads to lower response rates compared to a mailed letter. Lower response rates need to be traded off with the lower costs of using email rather than mailed letters.
For worse? Financial hardships and intra-household resource allocation among Australian couples

Botha, F ; Ribar, DC (Elsevier, 2023-02-01)

This article investigates differences in husbands' and wives' experiences of financial hardships. It develops and estimates a structural collective household model of expenditures on individual-specific necessities and hardship reporting where each partner has distinct preferences and the household makes Pareto efficient decisions. Using data from the Household, Income, and Labour Dynamics in Australia Survey with unique questions on individual financial hardships, we examine whether differences in preferences, bargaining power, or other characteristics within households affect the distribution of hardships. Wives in our data report more financial hardships than husbands. Estimates from our structural model indicate that wives have weaker preferences than husbands for expenditures on necessary goods for themselves, but there is no evidence of differences in bargaining power. Estimates further indicate that hardships increase with the number of children and spouses' disability status and decrease with spouses’ ages and subjective financial capabilities.
Determinants and Outcomes of Invasive Coronary Angiography in Unselected Patients Presenting With Chest Pain to Emergency Departments in Western Australian Teaching Hospitals

Sanfilippo, FM ; Murray, K ; Hillis, GS ; Rankin, JM ; Latchem, D ; Schultz, CJ ; Yong, J ; Li, IW ; Ihdayhid, A ; Briffa, TG (Elsevier BV, 2023-12-01)
"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

Sabanovic, H ; La Brooy, C ; Mendez, SJ ; Yong, J ; Scott, A ; Elshaug, AG ; Prang, K-H (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.