QIMR Berghofer Medical Research Institute, Brisbane, QLD.
The University of Queensland, Brisbane, QLD.
Med J Aust. 2023 Nov 6;219(9):417-422. doi: 10.5694/mja2.52122. Epub 2023 Oct 9.
To quantify differences, by residential remoteness and socio-economic status, in health care service use by people diagnosed with invasive melanoma in Queensland.
Benefit incidence analysis of CancerCostMod data, comprising Queensland Cancer Registry data linked with Queensland Hospital Admitted Patient Data Collection (QHAPDC), Medicare Benefits Schedule (MBS), and Pharmaceutical Benefits Scheme (PBS) data.
SETTING, PARTICIPANTS: Adults (18 years or older) newly diagnosed with invasive melanoma in Queensland during 1 July 2011 - 31 June 2015 and alive three years after diagnosis.
Concentration curves and indices quantifying differences by residential postcode-based remoteness (Australian Statistical Geography Standard - Remoteness Area) and socio-economic disadvantage (Index of Relative Socioeconomic Disadvantage) in hospital admissions (overall and by type) and use of MBS (overall and by type) and PBS services during the three years following diagnosis of invasive melanoma.
A total of 13 145 adults diagnosed with invasive melanoma during 2011-15 were alive three years after the diagnosis. Public hospital admissions were more frequent for people living in areas of greater socio-economic disadvantage (concentration index, -0.15; 95% confidence interval [CI], -0.19 to -0.12) or outside major cities (concentration index, -0.10; 95% CI, -0.13 to -0.06); private hospital admissions (concentration index, 0.11; 95% CI, 0.07-0.15) and specialist consultations (concentration index, 0.08; 95% CI, 0.07-0.10) were more frequent in areas of lesser disadvantage and in major cities (private hospital admissions: 0.10; 95% CI, 0.06-0.13; specialist services: 0.07; 95% CI, 0.06-0.09). Differences in other melanoma health care service use by residential remoteness and socio-economic disadvantage were not statistically significant.
Variation in health care service use by Queenslanders with primary diagnoses of invasive melanoma by residential socio-economic disadvantage and remoteness were generally minor. Our analysis suggests that access to health care for people with melanoma is fairly equitable in Queensland.
通过居住偏远程度和社会经济地位，量化昆士兰州浸润性黑色素瘤患者的医疗服务使用差异。
对 CancerCostMod 数据的受益发生率进行分析，该数据由昆士兰癌症登记处的数据与昆士兰医院入院患者数据采集系统（QHAPDC）、医疗保险福利计划（MBS）和药品福利计划（PBS）数据组成。
地点、参与者：2011 年 7 月 1 日至 2015 年 6 月 31 日期间在昆士兰州新诊断为浸润性黑色素瘤的成年人（18 岁或以上），并在诊断后三年仍存活。
根据居住邮政编码为基础的偏远程度（澳大利亚统计地理标准-偏远地区）和社会经济劣势（相对社会经济劣势指数），通过浓度曲线和指数量化医院入院（总体和类型）和 MBS（总体和类型）和 PBS 服务使用的差异，在浸润性黑色素瘤诊断后三年。
2011 年至 2015 年期间，共有 13145 名成年人被诊断患有浸润性黑色素瘤，在诊断后三年仍存活。居住在社会经济劣势较大地区（集中指数，-0.15；95%置信区间[CI]，-0.19 至-0.12）或非主要城市的人更常接受公立医院治疗（集中指数，-0.10；95%CI，-0.13 至-0.06）；居住在社会经济劣势较小地区和主要城市的人更常接受私立医院治疗（集中指数，0.11；95%CI，0.07-0.15）和专家咨询（集中指数，0.08；95%CI，0.07-0.10）（私立医院治疗：0.10；95%CI，0.06-0.13；专家服务：0.07；95%CI，0.06-0.09）。居住偏远程度和社会经济劣势对其他黑色素瘤医疗服务使用的差异在统计学上无显著意义。
昆士兰州人原发性浸润性黑色素瘤的医疗服务使用差异因居住的社会经济劣势和偏远程度而存在差异，但总体上差异较小。我们的分析表明，在昆士兰州，黑色素瘤患者获得医疗保健的机会相当公平。
