- Title
- An actuarial investigation into maternal out-of-hospital cost risk factors
- Creator
- William, Jananie; Chojenta, Catherine; Martin, Michael A.; Loxton, Deborah
- Relation
- Annals of Actuarial Science Vol. 13, Issue 1, p. 1-35
- Publisher Link
- http://dx.doi.org/10.1017/S1748499518000015
- Publisher
- Cambridge University Press
- Resource Type
- journal article
- Date
- 2019
- Description
- This paper adopts an actuarial approach to identify the risk factors of government-funded maternal out-of-hospital costs in Australia, with a focus on women who experience adverse birth outcomes. We use a two-phase modelling methodology incorporating both classification and regression trees and generalised linear models on a data set that links administrative and longitudinal survey data from a large sample of women, to address maternal out-of-hospital costs. We find that adverse births are a statistically significant risk factor of out-of-hospital costs in both the delivery and postnatal periods. Furthermore, other significant cost risk factors are in-vitro fertilisation, specialist use, general practitioner use, area of residence and mental health factors (including anxiety, intense anxiety, postnatal depression and stress about own health) and the results vary by perinatal sub-period and the patient's private health insurance status. We highlight these differences and use the results as an evidence base to inform public policy. Mental health policy is identified as a priority area for further investigation due to the dominance of these factors in many of the fitted models.
- Subject
- generalised linear model; classification and regression tree; maternal out-of-hospital costs; adverse birth; mental health policy
- Identifier
- http://hdl.handle.net/1959.13/1414486
- Identifier
- uon:36753
- Identifier
- ISSN:1748-4995
- Rights
- This article has been published in a revised form in the Annals of Actuarial Science http://dx.doi.org/10.1017/S174849951700015X. This version is published under a Creative Commons CC-BY-NC-ND. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed. © Cambridge University Press.
- Language
- eng
- Full Text
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