Productivity Commission reports facts and figures on healthcare

The Productivity Commission released volume E of its annual Report on Government Services (RoGS) last week, containing valuable data on the equity, efficiency and cost effectiveness of the public healthcare sector.

Covering primary and community health, hospitals and mental health management, the report uses published and unpublished data from a range of sources, including the Australian Institute of Health and Welfare (AIHW), the Department of Health and the Australian Bureau of Statistics.

For the first time, the report also includes some data on allied healthcare, although funding for specialist medical care is not included. Aged care is handled in a separate report.

Overall, the report found that patients were overwhelmingly happy with the care they received from both the primary and the acute care sector, that waiting times in both sectors were relatively stable or trending down, and bulk-billing rates were stable, as was the cost of healthcare to government.

Facts and figures of interest include:

Total expenditure (recurrent and capital) on healthcare services in Australia was estimated to be $147.4 billion in 2012-13. This total was estimated to account for 9.7 per cent of gross domestic product in 2012-13, an increase of 1.2 percentage points from the 8.5 per cent of GDP in 2003-04.

In 2012-13, the combined health expenditure of federal, state and local governments was $100.8 billion, representing 68.4 per cent of total health expenditure in Australia.

The federal government accounted for $61 billion or 41.4 per cent of the total in 2012-13, with state, territory and local governments contributing $39.8 billion or 27.0 per cent of total health expenditure in that year.

The remainder was paid by individuals, health insurance funds, workers compensation and compulsory motor vehicle third-party insurance providers.

Primary care

Bulk billing rates for non-referred patients in 2013-14 ranged from 87.9 per cent in NSW to 77.7 per cent in the Northern Territory, for an Australia-wide average of 83.6 per cent.

The proportion of patients who did not have to wait for more than four hours to see a GP for an urgent appointment was 64.2 per cent nationwide.

On average, 4.9 per cent of patients deferred visiting a GP due to cost, although this figure fluctuates between states, with a low of 3.5 per cent in NSW and a high of 6.9 per cent in Tasmania and the ACT.

On average, 7.6 per cent of patients deferred purchasing prescribed medicines due to cost. This figure also fluctuated between a low of 6.2 per cent in the NT and a high of 9.9 per cent in Queensland.

Ninety per cent of patients who saw a GP in the previous 12 months said the practitioner always or often listened carefully to them. Dentists scored a high average of 94.6 per cent of patients who said the same.

Fee-for-service expenditure – or the cost to government of general practice per person in 2013-14 – was on average $298.60.

Safety and quality measures

According to figures from the Department of Health gathered from its Practice Incentives Program (PIP) data, 86.3 per cent of general practices use electronic health information systems. This figure is the percentage of practices eligible for the PIP that are also enrolled in the eHealth PIP.

EHR use ranges from a high of 89 per cent in Victoria to a low of 78.2 per cent in the NT. It comes with the caveat that 15 per cent of general practices are not registered for the PIP.

Child immunisation coverage was high – 92 per cent were fully immunised in 2013 – but of concern would be a rise in the number of notifications of measles in children aged 0 to 14 years. While figures are incomplete for several states, they show a rise of notifications of measles of four (0.1 notifications per 100,000) in 2006-2007 to 113 (2.6 per 100,000) in 2013-2014.

Flu vaccine coverage for people over 65 was also reasonably high at 78 per cent (2009 figures), and one in three older people had received a health assessment in 2013-2014.

Public hospitals

In 2012-13, Australia had 746 public hospitals, including 17 psychiatric hospitals. Although 71 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 15 per cent of total available beds.

Nationally, there were 58,311 available beds for admitted patients in public hospitals in 2012-13, equivalent to 2.6 beds per 1000 people. These figures are becoming less important, the report says, as same-day hospitalisations and hospital-in-the-home become more common.

AIHW figures show what about 87 per cent of beds in public acute hospitals were available for overnight-stay patients in 2012-13.

Emergency department patients seen within triage category timeframes in 2013-14 were 100 per cent for resuscitation, 82 per cent for emergency, 68 per cent for urgent, 72 per cent for semi-urgent and 91 per cent for non-urgent.

Nationally, there were around 2.2 million GP-type presentations to public hospital emergency departments in 2013-14, and 23.6 per cent of people who went to a hospital ED for their own health thought at the time that care could have been provided at a general practice.

Healthcare associated infections in acute care hospitals per 10,000 patient days were 0.8 per cent.

There were 7.4 adverse events per 100 separations, and four per 1000 separations for falls resulting in patient harm.

85.4 per cent of patients who attended an emergency department said doctors and specialists always or often listened carefully to them, while 89.1 per cent said the same for ED nurses.

There were approximately 5.5 million separations from public (non-psychiatric) hospitals in 2012-13. Total recurrent expenditure on public hospitals was $41.7 billion that year.

Healthcare workforce

There were 32,401 vocationally registered GPs and other medical practitioners (OMPs) billing Medicare Australia, based on MBS claims data, in 2013-14.

Just over 23,000 of these worked on a full-time workload equivalent basis (FTE). 88.5 per cent of GPs were vocationally registered, and 43.2 per cent of Australia’s GP are female.

In total, there are 88,305 medical practitioners on an FTE basis, along with 267,119 FTE nurses and midwives.

There was an annual average growth of 3.9 per cent in medical practitioners from 2009 to 2013 and an average growth of 2.8 per cent in the nursing and midwifery workforce for the same period.

Posted in Australian eHealth

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