Socioeconomic inequity in the utilization of healthcare among people with eating disorders in Australia.

access community healthcare decomposition analysis eating disorders hospitalizations inequality socioeconomic inequity

Journal

Psychological medicine
ISSN: 1469-8978
Titre abrégé: Psychol Med
Pays: England
ID NLM: 1254142

Informations de publication

Date de publication:
04 Oct 2024
Historique:
medline: 4 10 2024
pubmed: 4 10 2024
entrez: 4 10 2024
Statut: aheadofprint

Résumé

Little is known about socioeconomic equity in access to healthcare among people with eating disorders in Australia. This study aims to measure the extent of inequity in eating disorder-related healthcare utilization, analyze trends, and explore the sources of inequalities using New South Wales (NSW) administrative linked health data for 2005 to 2020. Socioeconomic inequities were measured using concentration index approach, and decomposition analysis was conducted to explain the factors accounting for inequality. Healthcare utilization included: public inpatient admissions, private inpatient admissions, visits to public mental health outpatient clinics and emergency department visits, with three different measures (probability of visit, total and conditional number of visits) for each outcome. Private hospital admissions due to eating disorders were concentrated among individuals from higher socioeconomic status (SES) from 2005 to 2020. There was no significant inequity in the probability of public hospital admissions for the same period. Public outpatient visits were utilized more by people from lower SES from 2008 to 2020. Emergency department visits were equitable, but more utilized by those from lower SES in 2020. Public hospital and emergency department services were equitably used by people with eating disorders in NSW, but individuals from high SES were more likely to be admitted to private hospitals for eating disorder care. Use of public hospital outpatient services was higher for those from lower SES. These findings can assist policymakers in understanding the equity of the healthcare system and developing programs to improve fairness in eating disorder-related healthcare in NSW.

Sections du résumé

BACKGROUND BACKGROUND
Little is known about socioeconomic equity in access to healthcare among people with eating disorders in Australia. This study aims to measure the extent of inequity in eating disorder-related healthcare utilization, analyze trends, and explore the sources of inequalities using New South Wales (NSW) administrative linked health data for 2005 to 2020.
METHODS METHODS
Socioeconomic inequities were measured using concentration index approach, and decomposition analysis was conducted to explain the factors accounting for inequality. Healthcare utilization included: public inpatient admissions, private inpatient admissions, visits to public mental health outpatient clinics and emergency department visits, with three different measures (probability of visit, total and conditional number of visits) for each outcome.
RESULTS RESULTS
Private hospital admissions due to eating disorders were concentrated among individuals from higher socioeconomic status (SES) from 2005 to 2020. There was no significant inequity in the probability of public hospital admissions for the same period. Public outpatient visits were utilized more by people from lower SES from 2008 to 2020. Emergency department visits were equitable, but more utilized by those from lower SES in 2020.
CONCLUSIONS CONCLUSIONS
Public hospital and emergency department services were equitably used by people with eating disorders in NSW, but individuals from high SES were more likely to be admitted to private hospitals for eating disorder care. Use of public hospital outpatient services was higher for those from lower SES. These findings can assist policymakers in understanding the equity of the healthcare system and developing programs to improve fairness in eating disorder-related healthcare in NSW.

Identifiants

DOI: 10.1017/S0033291724002290 PMID: 39363540
pubmed: 39363540
doi: 10.1017/S0033291724002290
pii: S0033291724002290
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-13

Auteurs

Moin Ahmed (M)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), The University of Sydney, Sydney NSW 2006, Australia.
ORCID: 0000-0002-1733-5216

Sarah Maguire (S)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Sydney NSW 2006, Australia.
Sydney Local Health District, Sydney NSW 2050, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, NSW 2060, Australia.

Kelly M Dann (KM)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Sydney NSW 2006, Australia.

Francisco Scheneuer (F)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Charles Perkins Centre, The University of Sydney, Sydney, NSW 2060, Australia.
Child Population and Translational Health Research, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2060, Australia.

Marcellinus Kim (M)

Sydney Local Health District, Sydney NSW 2050, Australia.
ORCID: 0000-0002-8944-3283

Jane Miskovic-Wheatley (J)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Sydney NSW 2006, Australia.
ORCID: 0000-0003-2381-5475

Danielle Maloney (D)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Sydney NSW 2006, Australia.

Natasha Nassar (N)

Charles Perkins Centre, The University of Sydney, Sydney, NSW 2060, Australia.
Child Population and Translational Health Research, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2060, Australia.

Michelle Cunich (M)

MAINSTREAM The Australian National Centre for Health System Research and Translation, Sydney, NSW, Australia.
Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), The University of Sydney, Sydney NSW 2006, Australia.
Sydney Local Health District, Sydney NSW 2050, Australia.
Cardiovascular Initiative, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006, Australia.
Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney NSW 2050, Australia.

Classifications MeSH