Inequitable use of health services for Indigenous mothers who experience stillbirth in Australia

Emily Callander, Haylee Fox, Kyly Mills, Deanna Stuart-Butler, Philippa Middleton, David Ellwood, Joseph Thomas, Vicki Flenady

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to identify differences in health service expenditure on Indigenous and non-Indigenous women who experience a stillbirth, women's out-of-pocket costs, and health service use. Methods: The project used a whole-of-population linked data set called “Maternity1000,” which includes all women who gave birth in Queensland, Australia, between July 1, 2012, and June 30, 2018 (n = 396 158). Multivariable analysis was undertaken to assess differences in mean health service expenditure; and number of health care services accessed between Indigenous and non-Indigenous women who had a stillbirth from birth to twelve months postpartum. Costs are presented in 2019/20 Australian dollars. Results: There was a total of 1864 babies stillborn to women in Queensland between July 1, 2012, and June 30, 2018, with 135 being born to Indigenous women and 1729 born to non-Indigenous women. There was significantly lower total expenditure per woman for Indigenous women compared with non-Indigenous women ($16 083 and $18 811, respectively). This was consistent across public hospital inpatient ($12 564 compared with $14 075), outpatient ($1127 compared with $1470), community-based services ($198 compared with $313), pharmaceuticals ($8 compared with $22), private hospital ($434 compared with $1265), and for individual out-of-pocket fees ($21 compared with $86). Mean expenditure on emergency department services per woman was higher for Indigenous women compared with non-Indigenous women ($947 compared with $643). Indigenous women who experienced a stillbirth accessed fewer general practitioners, allied health, specialist, obstetrics, and outpatient services, and fewer pathology and diagnostic test than their non-Indigenous counterparts. Conclusions: Inequities in access to health services exist between Indigenous and non-Indigenous women who experience a stillbirth.

Original languageEnglish
Pages (from-to)194-201
Number of pages8
JournalBirth: Issues in Perinatal Care
Volume49
Issue number2
DOIs
Publication statusPublished - Jun 2022

Keywords

  • bereavement
  • maternal health
  • Women's health

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