Co-payments and parental decision-making: A cross-sectional survey of the impact on general practice and emergency department presentations

Background Co-payments for medical services have been a controversial topic in Australia. Objective The aim of this study was to assess parents' perspectives on the potential impact of co-payments for general practice and emergency department (ED) services for children. Methods A cross-sectional survey was conducted between May and November 2014 in the EDs of four metropolitan hospitals in Melbourne. The participants were 1531 parents of children presenting with lower urgency conditions. The outcome measures were the potential impact of a $7 general practice co-payment or a $ 7 ED co-payment on the use of services for children. Results Seventy-three per cent (n = 1089) of parents reported that a $ 7 general practice co-payment would not increase their use of EDs for lower urgency problems for their children. Increased use was associated with younger parent or guardian age and lower household income. Ninety per cent (n = 1343) reported that a $ 7 ED co-payment would not have an impact on ED attendance. Impact was associated with younger parent or guardian age and lower income. Discussion For most parents presenting to an ED with their child, a $ 7 general practice or ED co-payment is unlikely to affect health service use, although significant differences in response were found according to parent or guardian age and household income.