Women's choice? The impact of private health insurance on episiotomy rates in Australian hospitals

Midwifery ◽  
2000 ◽  
Vol 16 (3) ◽  
pp. 204-212 ◽  
Author(s):  
Allison Shorten ◽  
Brett Shorten
2019 ◽  
Vol 14 (1) ◽  
pp. 129-137
Author(s):  
Jananie William ◽  
Bronwyn Loong ◽  
Catherine Chojenta ◽  
Deborah Loxton

AbstractIn this article, we investigate differences in the profiles of patients within the Australian mixed public-private maternal health system to examine the extent of adverse selection. There are conflicting influences on adverse selection within the private health sector in Australia due to government regulations that incentivise lower risk segments of the population to purchase community-rated private health insurance. We use a two-phase modelling methodology that incorporates statistical learning and logistic regression on a dataset that links administrative and longitudinal survey data for a large cohort of women. We find that the key predictor of private patient status is having private health insurance, which itself is largely driven by sociodemographic factors rather than health-or pregnancy-related factors. Additionally, transitioning between the public-private systems for a subsequent pregnancy is uncommon; however, it is primarily driven by changes in private health insurance when it occurs. Other significant factors when transitioning to the private system for a second pregnancy are hypertension, increased access to specialists and stress related to previous motherhood experiences. Consequently, there is limited evidence of adverse selection in this market, with targeted financial incentives likely outweighing the impact of community rating even during childbearing years where private health service use increases.


Author(s):  
Chu-Shiu Li ◽  
Chih-Jen Hung ◽  
Sheng-Chang Peng ◽  
Ya-Lee Ho

In this paper, the impact of both gender and age on the claim rates of dread disease and cancer insurance policies were examined using unique data taken from Taiwan’s private health insurance policies issued by non-life insurers during the 2012 to 2015 policy years. Those aged 30–39 served as the reference group. For the total number of dread disease policies, male insureds had a higher non-cancer claim probability than female insureds, while an age under 20 was associated with much lower claim rates for dread disease policies than for ages over 50. The claim rate for dread disease policies increased rapidly beginning at age 40 for both cancerous and non-cancerous diseases amongst male insureds. Amongst female insureds, those under 20 had much lower claim rates for dread disease policies. Only those aged 50–59 had a higher claim rate for non-cancerous diseases. For the total number of cancer insurance policies, male insureds had lower claim rates than female insureds, with an upward trend being associated with age. For male (female) insureds aged over 40 (20), the claim rates of cancer increased with age.


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