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Cost-sharing reduction and health service utilisation, health-related lifestyles, and obesity: evidence from the Australian health concession card policy.

BACKGROUND
The Australian Health Concession Card (HCC) policy aims to improve access to affordable health services and medicines by providing reduced patient cost-sharing. This study explored the association between HCC holding and health service utilisation, as well as health-related lifestyles and obesity in Australian adults.


METHODS
The Australian National Health Survey data were used to derive three sets of study outcomes. Multivariable generalised linear regression models were used to estimate the association between concessional status and study outcomes after controlling for socio-demographic factors.


RESULTS
HCC holders, compared to their non-concessional counterparts, had more visits to GPs (1.01, 95% CI: 0.74-1.30), specialists (0.23, 95% CI: 0.02-0.44), outpatient clinics (0.19, 95% CI: 0.06-0.31), and had more hospital admissions (0.04, 95% CI: -0.05-0.91). There was no significant difference in visits to doctors and health professionals about mental health problems among HCC holders and their counterparts. Moreover, less HCC holders consumed alcohol on ≥3days a week (OR: 0.75, 95% CI: 0.59-0.93) and had less of an alcohol risk that exceeded the 2001 alcohol guidelines (0.83, 95% CI: 0.69-0.99).


CONCLUSIONS
This study revealed evidence that reduced patientcost-sharing provided by HCC policy was positively correlated with more health service utilisation after adjusting for socio-demographic characteristics. Strategies to prioritise resources are necessary.