Use of interstate services for the termination of pregnancy in Australia.
OBJECTIVE
To document the extent to which women in Australia access interstate termination of pregnancy services and to determine whether the pattern of these claims suggests that the legal and political climate in particular jurisdictions is related to the use of services interstate.


METHODS
The differences between the number of claims for Medicare Benefits Schedule item 35643 by place of patient residence and by place of service provision were analysed for 1984/85 to 1999/2000 inclusive. For States and Territories in which the differences were sufficiently large to be interpretable against the differences of contiguous States or Territories, the symmetry and correlation were assessed.


RESULTS
Each year there were more claims by residents than there were claims for services provided in Tasmania (averaging 294 claims/year), Queensland (2,141) and the ACT (1,132). Conversely, each year there were fewer claims for services provided in Victoria (401) and in NSW/ACT combined (2,236). Strong correlations were found between time trends of the difference between claims by State of service and claims by State of residence for NSW/ACT and Queensland (0.983, p < 0.0001) and between trends for Tasmania and Victoria (0.774, p < 0.0005). After assuming that NSW provided all the estimated claims made by Queensland residents for interstate services, the correlation between the ACT and NSW was found to be very strong (0.931, p < 0.0001).


CONCLUSIONS
Residents of some jurisdictions appeared to be accessing services interstate.


CONCLUSIONS
States and Territories that do not provide appropriate services for their residents burden patients with additional costs and reduced support. Ensuring equitable access to termination of pregnancy services remains a public health issue that must be understood and addressed on a national level.
Nickson
Carolyn
C
Australian Research Centre in Sex, Health & Society, La Trobe University, Victoria, Melbourne. c.nickson@latrobe.edu.au
Shelley
Julia
J
Smith
Anthony
A
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D001315:Australia; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007345:Insurance Claim Review; D009313:National Health Programs; D011057:Politics; D011247:Pregnancy; D014195:Travel