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Doctorate
Thesis:
Socio-economic inequalities in women’s use of
health care services in Australia
Supervisors: Professor
Jim Butler, Dr Mark Clements, Dr Emily Banks. Advisor:
Dr Jane Dixon
University: National
Centre for Epidemiology and Population Health (NCEPH),
Australian National University.
Purpose
of the study:
This project is part of a PhD thesis on socio-economic
inequality in the use of health care in Australia, and
the impact on health outcomes. The purpose of this research
is to investigate whether or not there are inequalities
in health care based on a person’s socio-economic
status (SES, as measured by income, occupational and
educational status, as well as area-level measures of
SES).
The
ALSWH data are being used to address the following research
questions:
1. Is there socio-economic inequality in the use of
ambulatory health care services once health status is
taken into account?
2. What is the effect of health care cards and private
health insurance on socioeconomic inequality in health
service use?
3. What is the effect of accessibility of services,
as measured by remoteness, on socio-economic inequality
in health care use?
4. Have there been changes in inequality in health care
use in the last ten years?
5. Is there socio-economic inequality in women’s
ratings of access to health care services?
Data
analysis is almost complete for questions 1-3. Preliminary
results indicate significant inequality in the use of
ambulatory health care services, favouring more advantaged
women. This is true across a range of SES measures (including
education, household occupation, household income, and
area-level SES) and inequality measures. Pathway analyses
indicate that health care cards protect against inequality
in GP services, while inequality in use of specialist,
allied health and dental services is partly mediated
through private health insurance. Accessibility of services,
as measured by remoteness, has little effect on socio-economic
inequality in health care use, with similar patterns
evident in city and regional/remote areas. Analyses
of questions 4 and 5 are currently underway. All analyses
will be repeated for the Younger and Older cohorts.
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