The problem: The direct costs of cancer treatment delivered out-of-hospital or in private hospitals, are shared between patients and the government and, despite the Medicare safety net, many still out-of-pocket can cause financial distress, though there is a lack of robust evidence to determine the extent of this problem. Still less is known about the indirect costs of receiving cancer treatment such as reduced household income if the patient (and their carer) have to stop working, or reduce their hours. Some may continue to feel the negative impact of reduced labour market attachment, and become increasingly reliant on government supports such as disability, carer, and unemployment payments. The extent and duration of these indirect costs are likely to be correlated with socioeconomic factors, particularly in light of the compounding effect of poorer health outcomes observed for cancer patients from lower socioeconomic groups in Australia.
Objectives: The project measures both direct and indirect costs to allow us to estimate the true economic cost of receiving treatment for cancer in Australia on individuals, households and society.
Data/Methods: The study will use the new, population level linked dataset of the Multi-Agency Data Integration Project (MADIP) managed by the Australian Bureau of Statistics. This detailed, individual-level dataset links federal records from: the Australian Tax Office (ATO), Department of Human Services and Centrelink, the Department of Health and national surveys including the Census.
First we will use population level descriptive statistics and data visualization methods to identify the distribution of out of pocket expenses and government expenditure on MBS and PBS items for cancer treatments. This will lay the foundation to use the richness of the MADIP data to implement a difference-in-difference method comparing outcomes between a ‘treatment group’ and a number of plausible ‘control groups’, before and after a cancer diagnoses/treatment.