Burns victims struggling to pay

Living away from community and country, Aboriginal families of children with severe burns also face critical financial stress to cover the associated costs of health care and treatment, a new study shows.

An Australian study, led by Flinders researchers Dr Courtney Ryder and Associate Professor Tamara Mackean, found feelings of crisis were common in Aboriginal families with children suffering severe burns, with one family reporting skipping meals and others selling assets to reduce costs while in hospital.

The economic hardship was found to be worse in families who live in rural areas – some households travelling more than five hours for treatment, creating undue financial strain.

Participants included families from SA, NSW and Queensland who are already part of the larger-Australia-wide Coolamon study on burns injuries in Aboriginal and Torres Strait Islander children.

Their children had sustained severe burns that required at least one night in hospital and follow up care.

So far, the Coolamon study has explored the health inequity of burns incidents and severity in Aboriginal children, with hospitalisation rates found to be 2-3 times greater than other Australian children.

This research conducted by Flinders University in conjunction with The George Institute for Global Health and UNSW School of Population Health also found Aboriginal and Torres Strait Islander children spent five times longer in hospital.

Dr Courtney Ryder, from Flinders University’s College of Medicine and Public Health, says out-of-pocket health expenditure are costs not covered by Medicare or health insurance, and could include gap payments, pharmaceutical costs, and travel costs such as transport, car parking, food, and accommodation.

She says results were “astounding” with some families reaching credit card limits, not paying other bills or even selling assets to get by.

“Even though we have Medicare, there are always additional out-of-pocket expenses for health care, and I don’t think it’s understood the depth or breadth of cost for those Aboriginal families who have a child with an acute burns injury,” Dr Ryder says.

“Burns injuries are quite intensive, very invasive and require a lot of follow up. While the expenses might be as simple as sterilised water and bandages, quite often there are additional expenses such as costs associated with travelling away from home.

“One family spoke about having to spend $700 each time they went to town, and they were even staying with family close to the tertiary setting.”

Participants also reported not being made aware of government initiatives, such as the Patient Assisted Travel Scheme (PATS), aimed at South Australians who need to travel more than 100km to access medical services.

Dr Ryder says a review of PATS is needed, as Aboriginal and Torres Strait Islanders often face barriers in accessing the scheme, including families who still live in regional areas but within the 100km range.

“There was one family who, because of where they were located, couldn’t get assistance through PATS,” she says.

“They were having to travel for an hour or more every day to the hospital, then there were parking costs and time spent away from work, so it was still significant.”

Despite the stress and financial burden reported by participants, they often commented on the significant role their family networks played in helping and keeping them away from significant financial burden.

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This research is supported by a National Health and Medical Research Council (NHMRC) project grant, while Dr Courtney Ryder was supported by an NHMRC postgraduate scholarship.

Ryder, C., Mackean, T., Hunter, K., Coombes, J., Holland, A.J. and Ivers, R. (2021), Yarning up about out?of?pocket healthcare expenditure in burns with Aboriginal families. Australian and New Zealand Journal of Public Health. https://doi.org/10.1111/1753-6405.13083