Centre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
Eur J Health Econ. 2021 Jun;22(4):643-658. doi: 10.1007/s10198-021-01281-5. Epub 2021 Mar 19.
Cardiovascular diseases (CVDs) remain a global health challenge due to number of deaths and use of healthcare services related to the condition. Although a plethora of studies have shown the impact of unemployment on health outcomes, evidence on the unemployment effects on the demand for expensive cardiac healthcare services is rare. This study exploits longitudinal cohort dataset to examine the impact of variations in local level unemployment rate on the demand for healthcare services among working aged people with CVD in Australia. Our findings show an inverse relationship between unemployment and the demand for healthcare services. Specifically, we find that a rising unemployment reduces the demand for primary and secondary healthcare services, with the largest effect observed for hospital admissions and hospitalisation days. We further show that rising unemployment at the local level has a greater impact on CVD patients with comorbidities and those who live in nonremote areas. Finally, our estimates suggest that increasing local level unemployment averts a substantial number of healthcare services use, leading to an unintended cost savings of $1.2 million to the health sector.
心血管疾病（CVDs）仍然是一个全球性的健康挑战，因为与这种疾病相关的死亡人数和医疗服务的使用量都很多。尽管大量研究表明失业对健康结果有影响，但关于失业对昂贵的心脏保健服务需求的影响的证据却很少。本研究利用纵向队列数据集，考察了澳大利亚工作年龄段 CVD 患者所在地区失业率的变化对医疗服务需求的影响。我们的研究结果表明，失业与医疗服务需求之间存在反比关系。具体而言，我们发现失业率的上升降低了对初级和二级医疗服务的需求，其中对住院人数和住院天数的影响最大。我们进一步表明，当地失业率的上升对患有合并症的 CVD 患者和居住在非偏远地区的患者的影响更大。最后，我们的估计表明，增加当地失业率可以避免大量的医疗服务使用，从而为卫生部门节省 120 万美元的意外成本。
