THE DEMAND FOR PRIVATE PSYCHIATRIC SERVICES IN A HEALTH INSURED POPULATION

Abstract

SummaryThis paper reports a study of the pattern of utilization of private psychiatric services by health insured persons who are members of a single large fund. The data show an increase in the average number of services per person consulting a psychiatrist with little change in the number of persons. There is a strong relation between private psychiatric contact rates and the socio‐economic index of the LGA of patient residence. Contributor units containing a medical practitioner are examined as an example of the utilization pattern of a socially elite group. The financial and administrative significance of the findings is discussed.Very little information is available in Australia concerning the relationship between the demand for health services and the socioeconomic characteristics of the clients or potential clients of the health services. Since Australian governments have shown a substantial reliance on voluntary health insurance as a mechanism for financing health care, this lack of information is surprising. Studies in the United States of America and England suggest that the upper socio‐economic classes receive more medical services than the lower, although these conclusions are not clear cut. It becomes a useful a priori hypothesis that a relationship between socio‐economic status and the demand for medical services exists in Australia, even within a health insured population.In this paper we examine the utilization of private psychiatric services by persons who were members of a single large health insurance fund in New South Wales. Claim history and membership demographic data were obtained from the health fund computer record system for the years 1977, 1978 and the period January to June, 1979. Since this fund covers about onethird of all persons with private health insurance in that state, we believe that the study may rellect the relationships for health insured populations in Australia generally. Private psychiatric services have been examined, not only because the itemization of psychiatric services is simple and data analysis is easy, but also because there is ample anecdotal evidence that the demand for psychiatric services is determined partly by client status and education. This should help establish the existence or otherwise of some socioeconomic gradient with respect to the demand for services.