The excess Medicare costs of long-term medical condition or disability: A longitudinal population-based study of Australian children.

Abstract

Background: Little is known about the longitudinal relationship between the prevalence of childhood medical conditions or disabilities (MCoD) lasting at least six months and associated excess healthcare costs to the public payer (Medicare).

Objective: To determine the additional federally funded Medicare costs for children who have a long-term medical condition or disability and to investigate whether these costs rise due to the recurring presence of the conditions over time.

Methods: This study utilised data from the nationally representative Longitudinal Study of Australian Children, comprising Birth (B) and Kindergarten (K) cohorts, involving 9,224 children. Based on Medicare data linkage, the analysis included 54,285 observations longitudinally. Generalised linear models with a log link and gamma distribution were employed to estimate the impact of childhood MCoD on Medicare costs over 14 years for the B cohort and 12 years for the K cohort. All models were adjusted for demographic, socioeconomic, and selected child medical characteristics.

Results: On average, children with long-term MCoD incurred excess Medicare costs ranging from A$494 to A$784 biennially, in the different age groups of 0-1 to 16-17 years, compared to children without such conditions. Nationally, this translates to an estimated total additional Medicare expenditure of A$313.0 million for a cohort of children from age 0-1 year to 16-17 years.

Conclusion: The findings highlight the significant excess public Medicare costs associated with childhood MCoD in Australia. These results will be beneficial for future cost-effectiveness analysis and for improving public health planning aimed at improving support for children with long-term medical conditions or disabilities.