Moorin Rachael E, Holman C D'Arcy J
Australian Centre for Economic Research on Health, School of Population Health, The University of Western Australia, Perth, Australia.
Aust New Zealand Health Policy. 2005 Nov 8;2:27. doi: 10.1186/1743-8462-2-27.
The aim of this study was to develop a policy characterisation process based on measuring shifts in use of private health insurance (PHI) immediately following implementation of changes in federal health care policy.
Population-based hospital morbidity data from 1980 to 2001 were used to produce trend lines in the annual proportions of public, privately insured and privately uninsured hospital separations in age-stratified subgroups. A policy characterisation model was developed using visual and statistical assessment of the trend lines associated with changes in federal health care policy.
Of eight changes in federal health care policy, two (introduction of Medicare and Lifetime Health Cover) were directly associated with major changes in the trend lines; however, minor changes in trends were associated with several of the other federal policies. Three types of policy effects were characterised by our model: direction change, magnitude change and inhibition. Results from our model suggest that a policy of Lifetime Health Cover, with a sanction for late adoption of PHI, was immediately successful in changing the private: public mix. The desired effect of the 30% rebate was immediate only in the oldest age group (70+ years), however, introduction of the lifetime health cover and limitations in the model restricted the ability to determine whether or if the rebate had a delayed effect at younger ages.
An outcome-based policy characterisation model is useful in evaluating immediate effects of changes in health care policy.
本研究旨在建立一种政策特征描述流程，该流程基于对联邦医疗保健政策变更实施后立即出现的私人医疗保险（PHI）使用变化的衡量。
利用1980年至2001年基于人群的医院发病率数据，得出不同年龄分层亚组中公立、私人保险和无私人保险的医院出院年度比例的趋势线。通过对与联邦医疗保健政策变更相关的趋势线进行视觉和统计评估，建立了一个政策特征描述模型。
在联邦医疗保健政策的八项变更中，两项（引入医疗保险和终身健康保险）与趋势线的重大变化直接相关；然而，其他几项联邦政策也与趋势的微小变化有关。我们的模型确定了三种政策效应类型：方向变化、幅度变化和抑制。我们模型的结果表明，终身健康保险政策（对延迟采用PHI进行制裁）在改变私人与公共组合方面立即取得了成功。30%回扣的预期效果仅在最年长年龄组（70岁及以上）中立即显现，然而，终身健康保险的引入以及模型中的限制因素限制了我们确定回扣在较年轻年龄组是否有延迟效应的能力。
基于结果的政策特征描述模型有助于评估医疗保健政策变更的即时效果。
