Financing Maternity and Early Childhood Healthcare in The Australian Healthcare System: Costs to Funders in Private and Public Hospitals Over the First ۱۰۰۰ Days

BackgroundMaternity care is a significant contributor to overall healthcare expenditure, and private care is seen as a mechanism to reduce the cost to public funders. However, public funders may still contribute to part of the cost of private care. The paper aims to quantify (۱) the cost to different funders of maternal and early childhood healthcare over the first ۱۰۰۰ days for both women giving birth in private and public hospitals; (۲) any variation in cost to different funders by birth type; and (۳) the cost of excess caesarean sections in public and private hospitals in Australia. MethodsThis study utilised a whole of population linked administrative dataset, and classified costs by the funding source. The mean cost to different funders for private hospital births, and public hospital births in the Australian state, Queensland are presented by time period and by birth type. The World Health Organization’s (WHO’s) C-model was used to identify the optimal caesarean section rate based upon demographic and clinical factors, and counterfactual analysis was utilised to identify the cost to different funders if caesarean section had been utilised at this rate across Australia. ResultsWe found that for women who gave birth in a public hospital as a public patient, the mean cost was ۲۲ ۴۷۴. For women who gave birth in a private hospital the mean cost was ۲۴ ۷۳۱, and the largest contributor was private health insurers (۱۱ ۵۵۰), followed by Medicare (۷۲۶۱) and individuals (۳۳۱۲). Private hospital births cost government funders ۱۰ ۰۵۰ on average; whereas public hospital public patient births cost government funders ۲۱ ۷۲۳ on average and public hospital private patient births cost government funders ۲۰ ۸۹۹ on average. If caesarean section deliveries were reduced, public hospital funders could save ۹۷۴ million and private health insurers could save ۲۱۶ million. ConclusionPrivate hospital births cost government funders less than public hospital births, but government funders still pay for around ۴۰% of the cost of private hospital births. Caesarean sections, which are more frequently performed in private hospitals, are costly to all funders and reducing them could impart significant cost savings to all funders.

Keywords:

Perinatal Health , Maternal Health , Early Childhood Health , Universal Healthcare , Caesarean Section , Healthcare Costs