private out-of-pocket expenditure in australia’s health ... · statistics on australia’s...
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Private outPrivate out--ofof--pocket expenditure pocket expenditure in Australiain Australia’’s Health Accountss Health Accounts
Lindy InghamLindy InghamSenior AnalystSenior Analyst
Australian Institute of Health and Australian Institute of Health and WelfareWelfare
Overview of presentationOverview of presentation
Sources of private outSources of private out--ofof--pocket pocket expenditure dataexpenditure data
oo Administrative byAdministrative by--productproductoo ABS census and survey dataABS census and survey dataoo Industry dataIndustry data
Statistics on AustraliaStatistics on Australia’’s outs out--ofof--pocket expenditure on healthpocket expenditure on health
YearYear AmountAmount
$ billion$ billion
Percentage Percentage share of total share of total
health health expenditureexpenditure
%%
19921992--9393 6.06.0 18.218.2
20022002--0303 14.514.5 20.720.7
Private outPrivate out--ofof--pocket expenditure in pocket expenditure in 20022002--03, allocated by type of data 03, allocated by type of data
sourcesourceAmountAmount
$ billion$ billion
Percentage share of Percentage share of total outtotal out--ofof--pocket pocket
expenditureexpenditure%%
Administrative Administrative byby--productproduct 3.6 3.6 2525ABS dataABS data 7.27.2 5050Industry dataIndustry data 3.73.7 2525TotalTotal 14.514.5 100100
Area of expenditure by type of dataArea of expenditure by type of dataArea of expenditureArea of expenditure Private outPrivate out--ofof--pocket pocket
expenditure $ millionexpenditure $ millionType of data sourceType of data source
Medical servicesMedical services 1,4231,423 Administrative byAdministrative by--productproduct
Benefit paid pharmaceuticalsBenefit paid pharmaceuticals 951951 Administrative byAdministrative by--productproduct
HighHigh--level residential carelevel residential care 903903 Administrative byAdministrative by--productproduct
Public hospitalsPublic hospitals 331331 Administrative byAdministrative by--productproduct
Dental servicesDental services 2,9692,969 ABSABS
AmbulanceAmbulance 393393 ABS and PHIACABS and PHIAC
Private hospitalsPrivate hospitals 266266 ABSABS
Other professional servicesOther professional services 1,5761,576 ABSABS
Aids and appliancesAids and appliances 1,9871,987 ABSABS
All other pharmaceuticalsAll other pharmaceuticals 3,6873,687 IndustryIndustry
Total private Total private oopoop expenditureexpenditure 14,48614,486
Administrative byAdministrative by--product dataproduct data
Medical servicesMedical servicesBenefitBenefit––paid pharmaceuticalspaid pharmaceuticalsHighHigh--level residential carelevel residential carePublic hospitalsPublic hospitals
Medical ServicesMedical Services
Provider data sourceProvider data source–– Australian Government Department of Health Australian Government Department of Health
and Ageingand AgeingMedical Benefits SchemeMedical Benefits Scheme
Derived by:Derived by:-- Fees charged less Benefits paidFees charged less Benefits paid
BenefitBenefit--paid pharmaceuticalspaid pharmaceuticals
Provider data sourceProvider data source–– Australian Government Department of Health and Australian Government Department of Health and
AgeingAgeingPharmaceuticals Benefits Scheme (PBS)Pharmaceuticals Benefits Scheme (PBS)
–– Australian Government Department of VeteransAustralian Government Department of Veterans’’ AffairsAffairsRepatriation Pharmaceuticals Benefits Scheme (RPBS)Repatriation Pharmaceuticals Benefits Scheme (RPBS)
Derived by:Derived by:-- Patient contributionPatient contribution
HighHigh--level residential carelevel residential care
Provider data sourceProvider data source–– Australian Government Department of Health Australian Government Department of Health
and Ageingand AgeingAged and Community Care Management Aged and Community Care Management Information System (ACCMIS) database.Information System (ACCMIS) database.
Derived by:Derived by:-- Client feesClient fees
Public hospitalsPublic hospitals
Provider data sourceProvider data source–– Operating statements of Public nonOperating statements of Public non--psychiatric psychiatric
and psychiatric hospitalsand psychiatric hospitalsAustralian Institute of Health and WelfareAustralian Institute of Health and Welfare’’s s National Public Hospital Establishments National Public Hospital Establishments DatabaseDatabase
Derived by:Derived by:-- Patient revenuePatient revenue
ABS dataABS data
Private hospitals Establishments Collection Private hospitals Establishments Collection for:for:–– Private hospitalsPrivate hospitalsHousehold final consumption expenditure Household final consumption expenditure (HFCE) for:(HFCE) for:–– Other professional servicesOther professional services–– Aids and appliancesAids and appliances–– Dental servicesDental services–– AmbulanceAmbulance
Establishments Collection for Private Establishments Collection for Private hospitalshospitals
Annual census of all licensed private Annual census of all licensed private hospitals in Australiahospitals in Australia
Data item : Patient revenueData item : Patient revenue
Household final consumption Household final consumption expenditureexpenditure
ByBy--product of ABS National Accountsproduct of ABS National AccountsCovers all personal outlays on health Covers all personal outlays on health products and services but excludes:products and services but excludes:–– Medicare levyMedicare levy–– Refunds from MedicareRefunds from Medicare--covered servicescovered services
Aids and appliancesAids and appliances
HFCE Medicines, aids and appliancesHFCE Medicines, aids and appliances–– less patient contribution from PBS and RPBSless patient contribution from PBS and RPBS–– less private expenditure on all other less private expenditure on all other
pharmaceuticals (to be discussed later)pharmaceuticals (to be discussed later)–– equals equals private outprivate out--ofof--pocket expenditure for pocket expenditure for
aids and appliancesaids and appliances
Aids and appliancesAids and appliances
Source: Retail Trade census ( approximately Source: Retail Trade census ( approximately 5 yearly) supplemented by monthly retail 5 yearly) supplemented by monthly retail sales surveysales surveyBut AIHW consider the scope of ABS retail But AIHW consider the scope of ABS retail trade census is too narrow as it:trade census is too narrow as it:–– omits sales from specialty medical device omits sales from specialty medical device
shops, and disease based organisations such shops, and disease based organisations such as Diabetes Australia, etc.as Diabetes Australia, etc.
Other professional servicesOther professional services
HFCE Doctors and other professional HFCE Doctors and other professional servicesservices–– less patient contribution from medical servicesless patient contribution from medical services–– equals equals private outprivate out--ofof--pocket expenditure on pocket expenditure on
other professional servicesother professional services
Source: Australian Taxation Office dataSource: Australian Taxation Office data
Dental servicesDental services
HFCE dentistsHFCE dentists–– Based on the gross income of dentistsBased on the gross income of dentists–– equals equals private outprivate out--ofof--pocket expenditure on pocket expenditure on
dental servicesdental services
Source: Australian Taxation Office dataSource: Australian Taxation Office data
Ambulance servicesAmbulance services
Based on HFCE Ambulance, which is no Based on HFCE Ambulance, which is no longer produced separately by ABSlonger produced separately by ABSMovements in estimates of benefits paid by Movements in estimates of benefits paid by private health funds for ambulance services private health funds for ambulance services applied to HFCE Ambulance applied to HFCE Ambulance –– equals equals private outprivate out--ofof--pocket expenditure for pocket expenditure for
ambulance servicesambulance servicesSource: Private health insurance advisory Source: Private health insurance advisory council data and ABScouncil data and ABS
Industry dataIndustry data
““All other pharmaceuticalsAll other pharmaceuticals”” –– pharmaceuticals for pharmaceuticals for which no PBS or RPBS is paidwhich no PBS or RPBS is paidIncludes:Includes:–– pharmaceuticals listed in the PBS or RPBS, the total costs of whpharmaceuticals listed in the PBS or RPBS, the total costs of which ich
are equal to, or less than, the statutory patient contribution fare equal to, or less than, the statutory patient contribution for the or the class of patient concernedclass of patient concerned
–– medicines dispensed through private prescriptions for items not medicines dispensed through private prescriptions for items not listed in the PBS or RPBSlisted in the PBS or RPBS
–– overover--thethe--counter medicines such as aspirin, cough and cold counter medicines such as aspirin, cough and cold medicines, vitamins and minerals, some herbal and other medicines, vitamins and minerals, some herbal and other complementary medicines, and a range of medical complementary medicines, and a range of medical nonnon--durables, such as bandages, band aids and condoms.durables, such as bandages, band aids and condoms.
Private prescriptions and Private prescriptions and prescriptions under coprescriptions under co--paymentpayment
Provider data sourceProvider data source–– Pharmacy GuildPharmacy Guild
Drug Utilisation Sub CommitteeDrug Utilisation Sub Committee
OverOver--thethe--counter pharmaceuticalscounter pharmaceuticals
Provider data sourceProvider data source–– Annual publication:Annual publication: Retail PharmacyRetail Pharmacy
OTC pharmaceuticals sold through OTC pharmaceuticals sold through pharmaciespharmacies
–– Annual publication:Annual publication: Retail WorldRetail WorldOTC pharmaceuticals sold through OTC pharmaceuticals sold through supermarketssupermarkets
OverOver--thethe--counter pharmaceuticalscounter pharmaceuticals
Have unit price and sales volume dataHave unit price and sales volume data–– from over 70 major grocery manufacturers from over 70 major grocery manufacturers
((Retail WorldRetail World) and) and–– from over 330 large pharmacy stores in from over 330 large pharmacy stores in
Australia, grossed to Australian totals by Aztec Australia, grossed to Australian totals by Aztec Information Systems (Information Systems (Retail PharmacyRetail Pharmacy))
No data on sales of OTC pharmaceuticals No data on sales of OTC pharmaceuticals through convenience stores (thought to be through convenience stores (thought to be insignificant)insignificant)
Link to our latest publicationLink to our latest publication
http://www.aihw.gov.au/publications/index.cfmhttp://www.aihw.gov.au/publications/index.cfm/title/10204/title/10204