A New Zealand trial has shown that hospitalisations can be reduced by removing prescription co-payments for people with high health needs living in areas of high socioeconomic deprivation. A total of 1061 people who took diabetes medication, antipsychotic medication or had chronic obstructive pulmonary disease (COPD), were randomised to be exempt from the standard $5 prescription charges for 1 year (n = 591) or to continue paying these charges (n= 469). Of the 1053 people who completed the study, 49% were Māori. Risk of hospitalisation during the study year was reduced by 30% in the intervention group compared with the control group (odds ratio 0.70; 95% CI 0.54-0.90). There were also significant reductions in the number of hospital admissions for mental health problems (incidence rate ratio [IRR] 0.39; 95% CI 0.17-0.92), number of admissions for COPD (IRR 0.37; 95% CI 0.16-0.85), and length of stay for COPD (IRR 0.20; 95% CI 0.07-0.60). The authors suggested that co-payment charges are likely to increase the overall cost of healthcare, as well as exacerbate ethnic inequalities.
