Dr Rosemary Korda: Socio-economic inequalities in women's use of health care services in Australia.

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.
The results from this project (described in the December 2007 report) were included in the PhD thesis, which was submitted in March 2008. The thesis was approved on 28 August, 2008 and the project is now completed.