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Current Issues
Healthy measures - key health statistics
E-Brief: Online Only issued 27 May 2004
Amanda Biggs ,
Information/E-links
Social Policy
Introduction
The Australian health sector has been the
focus of intense policy debate. Health data is quoted with
increasing frequency. Improved measures of the performance of the
health system are critical to the development of health policy. A
good grasp of the sources of health statistics is therefore a
prerequisite for remaining informed in this complex policy area.
This e-brief seeks to inform those with an interest in health
policy by providing an introduction to key health statistics that
measure the performance of the Australian health system. It
provides access to Australian statistical sources with a particular
focus on government health expenditure, Medicare, the
Pharmaceutical Benefits Scheme, hospitals, medical workforce and
private health insurance. It also provides links to some
international comparative data. The e-brief describes the content,
frequency and scope of the available statistics. Links to
statistical sources and key agencies that produce them are also
provided where possible.
Key statistical agencies
The primary agency for health information in
Australia is the Australian
Institute of Health and Welfare (AIHW) which produces
authoritative and comprehensive publications across the broad areas
of health and welfare, including the biennial publications
Australia s Health and
Australia s Welfare.
Along with the AIHW the Australian Bureau of Statistics is a
primary source of health and related data including demographic,
social, and economic and population data.
The Department of Health and Ageing,
State Health departments and the Medicare are all sources of key
government health data.
Key international agencies also
regularly produce comparative health data including the OECD and WHO.
Key statistical publications
Australia
s Health is the AIHW s biennial report to Parliament on the
status and determinants of health in Australia and draws together a
wide range of data on patterns of health and illness, determinants
of health, the supply and use of health services, and health
service costs and performance. It is an essential reference tool
for anyone with an interest in the Australian health system. The
2004 edition will be available from late June.
Since 1977-78, the ABS has conducted a series
of five National Health Surveys (NHS) to collect data on
various health related topics. The last NHS was conducted in 2001
while previous surveys were conducted in 1977-78, 1983, 1989-90 and
1995. The NHS covers the health status of the Australian
population, use of health services, other health related
behaviours, health-related aspects of lifestyle and other health
risk factors. The
National Health Survey Summary of Results (4364.0) was released
in October 2002. The annual
Year Book Australia also provides a good health overview.
The Report on Government
Services is an annual review of government service provision
prepared by the Steering Committee for the Review of Government
Service Provision. The chapter Health concentrates on the
performance of public hospitals, general practice and community
health services, as well as health management of mental health and
breast cancer.
Australian
health expenditure is published annually by the AIHW in its
Health and Welfare Expenditure series, and is available in hardcopy
or
online. It presents expenditure data at the aggregate level; as
a proportion of gross domestic product (GDP); on a per person
basis; by state; by comparison with selected OECD countries; and by
source of funding - Commonwealth, other government and
non-government. The latest online version (released in September
2003) includes updated tables and covers the period 1991- 92 to
2000-01 and presents preliminary estimates for 2001-02.
International sources
The OECD makes publicly available a range of
health data on its website including
Frequently Asked Data and the
OECD in figures which is a useful compendium. It also produces
health data electronically on CD-ROM and in key publications such
as Health at
a glance.
The World Health Report an annual WHO
publication presents an overview of global health organised around
a central theme and is downloadable from the WHO website. Other
useful global information includes the
WHO Statistical Information System (WHOSIS) the WHO
Mortality Database and Burden of
Disease Statistics.
Medicare
Medicare is the cornerstone of the Australian
health system. More information on Medicare is available in the
Parliamentary Library s e-brief Medicare -
background brief.
Medicare Benefits Schedule
While not strictly a statistical publication
the
Medicare Benefits Schedule Book (MBS) is one of the key
resources in the health area. It is published annually in November
with Supplement(s) usually published during the following year,
usually in May. The MBS describes and lists all the items that can
be claimed under Medicare, provides explanatory notes for all major
procedural categories and describes the requirements for
providers.
Medicare Statistics
Medicare Statistics are published quarterly (March, June,
September, December) by the Health Access and Financing Division
within the Department of Health and Ageing and are available in
hard copy or on their
website.
Data includes:
percentage of services bulk-billed including by
Federal Electorate,
average patient contribution,
schedule fee observance,
benefits paid and
fees charged. Data for each quarter is published approximately
4-6 weeks following the end of the quarter. Online data is
presented either as an excel or PDF file and is accompanied by
general comments and
analysis by State/Territory or
broad type of service. Historical financial year data for most
tables is available back to 1984.
Bulk billing statistics
Bulk billing statistics included in the
Medicare Statistics are presented in the following tables:
- Percentage of services bulk-billed including by State/Territory
by quarter and Financial Year (Table
A7); by Quarter and Broad type of Service (Table
B7); and by Broad Type of Service by Financial Year and by
State/ Territory (Table
C3);
- Percentage of GP services bulk billed by Federal Electorate
(Table
E1). Note: electorate data is only available in the online
series and only for calendar end of year;
- Number of Services Bulk Billed by Quarter and Financial Year by
State/Territory Table (Table
A8); and Number of Services Bulk billed by Quarter and
Financial Year by Broad Type of Service (Table
B8)
- Medicare Plus data (Table
F1) covering number of items processed and benefits paid
In addition the online Monthly/Quarterly
Standard Reports produced by HIC includes monthly and quarterly
Medicare data.
Individual electorate GP bulk billing data has
been mapped by the Parliamentary Library and is available through
the Electorate
Information link on the Library s Intranet. Comparative data
from 2000 onwards is presented for each electorate.
Monthly/Quarterly statistics
The Health Insurance Commission (HIC) produces
the online Monthly/Quarterly
Standard Reports which provide quarterly and monthly Medicare
statistics. It includes Key Results (quarterly only), processing
and effective enrolment data, bill type data (eg bulk billed), and
data by electorate (year end only). Data can be selected for
individual quarters or months and downloaded to an excel file
allowing statistical comparison and analysis to be undertaken.
Medicare interactive reports
HIC provides interactive statistical reports
by Medicare
item numbers or Medicare
group Reports. These statistics are based on the item numbers
and groups in the Medicare Benefits Schedule and can be broken down
by patient gender and age group. Services and benefits can be
reported as count, percentage or per capita statistics. Individual
MBS item statistics can be displayed as charts. The reports are
interactive, meaning they can be customised for individual
requirements.
Medicare Plus
From February 1 2004 three new Medicare item
numbers were introduced into the
MBS to cover the additional payment of $5 to medical
practitioners who bulk bill children under 16 and concession card
holders. The new item numbers are:
- 64990 covering the
Diagnostic Imaging
- 74990 covering
Pathology
- 10990 - General Medical
Services (all other services in the MBS when rendered by a GP)
As these new items do not represent additional
Medicare services, but are supplementary payments, they are not
included under the bulk billing statistics as this would involve a
double count. But data on benefits paid and total number processed
is available in the
Medicare Statistics Table F1, and through the interactive
Medicare
item number reports (but in this latter case data is limited to
benefits paid).
From May 1 2004 a new $7.50 incentive payment
became available for GPs in rural and remote areas or anywhere in
Tasmania. Data on this will be treated similarly to the other
recently introduced incentive payments.
Information on the new Medicare Plus
additional payments is available by clicking here.
Enhanced Primary Care
The Enhanced Primary Care Package
(EPC) was announced in the 1999/2000 Budget as a way of improving
the care and well being of older Australians, and those with
complex care needs. Quarterly data by Division of General Practice
is available through the Primary
Care Division website.
Pharmaceutical Benefits Scheme
For an overview of the PBS see the
Parliamentary Library e-brief The
Pharmaceutical Benefits Scheme an overview.
The Schedule of
Pharmaceutical Benefits for approved Pharmacists and Medical
Practitioners (the Schedule) provides information on the
arrangements for the prescribing of pharmaceutical benefits by
medical practitioners and participating dental practitioners, and
the supply of pharmaceutical benefits by approved pharmacists,
approved medical practitioners and approved hospital authorities.
The Schedule is updated quarterly (August, November, February and
May) each year and is searchable online.
Government expenditure on the PBS and
prescription volumes are published as year end data each quarter
(March, June, September and December) by HIC in the PBS Expenditure
and Prescriptions (available in hardcopy or online). The
June issue includes valuable supplementary tables. These
include data on the PBS Safety Net, numbers of Pharmacies,
Historical PBS data (all under Supplement 1); data on the Highly
Specialised Drug Program (eg HIV/AIDS Antiretroviral Agents)
including Hospital expenditures (under Supplement 2); the PBS
information line (Supplement 3) and the National Diabetic Services
Scheme (Supplement 4).
These quarterly statistics also include data
on the Repatriation Pharmaceutical Benefits Scheme (RPBS). The
statistics are based on the item numbers and groups listed in the
Schedule.
The reports are interactive and can be
customised to requirements
More detailed statistics (eg breakdown by age
or gender) are available on a cost recovery basis by contacting
Medicare.
Hospitals
Detailed information on the characteristics
and hospital care of the six million people admitted to public and
private hospitals, including age, sex, diagnoses and procedures is
presented in Australian
Hospital Statistics 2002-03. This tenth report from the AIHW on
the activity and characteristics of Australian hospitals is
published annually. Information on Australian hospitals includes
the number of hospitals and hospital beds, key statistics on the
resources, expenditure and revenue of public hospitals and on the
services they provide. National waiting times for patients admitted
for elective surgery in public hospitals are also presented in this
report. The latest report released in May 2008, is available
online
and includes updated tables.
Hospitals at
a glance provides a quick online summary of information based
on data from the larger report.
Waiting times
National figures on waiting times for elective
surgery are published in
Australian Hospital Statistics 2001-02 (Tables 5.1 to 5.5). But
data on waiting times for individual public hospitals is normally
produced by the relevant State Health agencies. Click on the links
below:
Casemix and performance information
Data on casemix is available through the
Department of Health s website. This site is useful
as a source of information on casemix developments in Australian
public and private hospitals and includes hospital morbidity
data, hospital
cost data (public and private), and hospital
casemix protocol data. In addition, it includes mappings of diseases
and procedures and a list of related
sites.
The AIHW also offers a customised confidential
data service. A charge may apply depending on the exact
requirements and complexity of the analysis undertaken. To request
customised confidential data email hospitaldata@aihw.gov.au
Private hospitals
The annual Private
Hospitals, Australia (ABS: 4390.0) provides details about
the operation of private hospitals, including facilities, beds,
numbers of patients, staffing and finances. The latest version
covering the period 2001-02 was released in October 2003.
Medical workforce data
Data on General Practitioners (GPs) and the
medical workforce is collected and published by a number of
agencies.
A comprehensive overview of medical workforce
data is contained in the publication
Medical Labour Force 2001 (AIHW) which is based on the
main findings of a 2001 national survey of registered medical
practitioners. It includes the number of registered practitioners
in each geographic region and in each state and territory, their
age and sex profiles, areas of practice, medical specialties and
hours worked.
General Practice
The BEACH (Bettering the
Evaluation and Care of Health) project continuously collects
information about general practice in Australia, including patients
seen, reasons for seeking medical care, problems managed and
treatments provided. The AIHW General
Practice activity in Australia 2002-03 provides an overview of
the results from the fifth year of the BEACH survey of general
practice activity. It also investigates changes in morbidity and
management demonstrated over the five years since the program began
in March 1998.
The General Practice
Branch of Department of Health and Ageing also produces
statistical reports on General Practice. Some of their data is less
current than other sources. Reports include the Enhanced
Primary Care Statistics, and the publication General
Practice in Australia (2000). This now outdated
publication is nevertheless useful for a history of general
practice, information on the supply and distribution of GPs,
services, the structural organisation of general practice,
financing, quality, GP education and training, legal matters, and
related issues.
HIC s General
Practice Statistics Reports include General Practice statistics
from Medicare, the PBS and the Practice
Incentives Program (PIP) for particular geographical areas
based around the 120 Divisions of General Practice. The PIP is part
of a blended payment approach for general practice. Government
payments to participating practices are in addition to other income
earned by the general practitioners and the practice, such as
patient payments and Medicare rebates. For more information see the
Medicare
website.
Specialists
The publication
Private Medical Practitioners (ABS: 8689.0) contains
information about private general and specialist medical
practitioners in Australia. In addition to the age and gender of
private medical practitioners, the publication contains information
on number of hours worked per week and number of patient contacts
per week by area. The latest issue was released in 2002.
The Australian
Medical Workforce Advisory Committee (AMWAC) undertakes medical
workforce research and analysis and publishes data on various
medical workforce groups including specialist medical
practitioners. Its reports are available
online.
Nursing workforce
Every two years the AIHW conducts a survey of
the nursing workforce in Australia entitled Nursing Labour
Force. The latest issue was released in December 2003 and
covers employment trends for nurses up to 2002. It is
available
online.
Private Health Insurance
PHIAC
The Private Health Insurance Administration
Council (PHIAC) routinely collects data on coverage and membership
levels of private health insurance. The primary functions of PHIAC
are set out in the National Health Act (under Section
82B). PHIAC issues a number of valuable reports on membership and
the financial solvency and activities of the 44 registered health
benefits organisations.
Membership
and Coverage a quarterly PHIAC publication shows the number of
persons covered by private health insurance for hospital cover and
the proportion of the population these persons represent.
The PHIAC
A Report is another quarterly report detailing, by State, the
membership and benefits paid by Registered Health Benefits
Organisations for the period.
Statistical
trends in Membership and Benefits detail by State trends in the
membership and benefits paid by Registered Health Benefits
Organisations. These reports are compiled from the PHIAC A
quarterly reports and are updated every quarter.
Operations of the Registered Health Benefits Organisations Annual
Report an annual PHIAC report provides information on the
activities of registered health funds. Detailed figures are
provided on membership, benefits paid, types of cover, management
expenses and solvency of the funds.
Medical
Gap Information is a quarterly PHIAC publication on in-hospital
medical services. The proportion of services for which there was no
gap or known gap and the average gap payment are shown for each
state.
PHIO
The Private
Health Insurance Ombudsman (PHIO) is a statutory body that
reports on private health insurance problems and complaints
affecting consumers or service providers. PHIO issues a Quarterly Bulletin that
presents trends in complaints over the previous quarter. It also
provides useful information on market share for each registered
fund. Data from the Quarterly Bulletin is collated for the Annual Report.
Other health insurance reports
The latest ABS data on private health
insurance was released in October 2003 in the publication
Private Health Insurance (ABS 4815.0.55.001). It contains
national statistics about the types and levels of private health
insurance cover held by Australians cross classified with
demographic characteristics, self-assessed health status,
health-related actions, hospital admissions and selected long-term
conditions.
The
Health Insurance Survey (ABS 4335.0) was an irregular survey
which provided statistics on health insurance levels by selected
demographic and socioeconomic characteristics (including income),
reasons for having or not having insurance, and hospital admission
by insurance cover. The latest survey was released in 1999.
Standard & Poors produces an annual
Australian Health Insurance Report (not available online).
This report reviews the performance of the private health insurance
sector, and provides a commentary on key trends and an outlook for
the sector.
General information on private health
insurance is available on the
Department of Health and Ageing website.
Other health statistics
Other useful statistics are produced by HIC on
the Divisions
of General Practice, the
Practice Incentives Program the
Australian Organ Donor Register,
Australian Childhood Immunisation Register and
GP Immunisation coverage. The frequency of these varies.
Infectious disease data is collated by
Communicable Diseases Australia (CDA) through the National
Notifiable Diseases Surveillance System. Detailed information
on the notification rate and incidence of selected diseases is
available by State/Territory and by age/gender. Other national data
is presented on a weekly, monthly and yearly basis.
Australia's
Mothers and Babies (AIHW) provides information on births in
Australia from the perinatal data collections for each state and
territory. The report examines demographic and pregnancy factors of
mothers and the characteristics and outcomes of their babies. Other
perinatal statistics, including data on
assisted conception, is also available through the National Perinatal Statistics Unit
website.
Comprehensive national data on termination of
pregnancy is not available. Data on Medicare funded procedures that
may result in an abortive outcome are available using HIC s
interactive Medicare
item number reports (Medicare item number 35643), but this
includes other medical procedures such as those undertaken as a
result of miscarriage or fetal death. The HIC data is limited to
procedures undertaken on private patients in private or public
hospitals (who are eligible for a Medicare rebate) but excludes
public patients in public hospitals. Hospital
statistics collated by AIHW provides data on terminations in
public and private hospitals using the relevant Australian Refined
Diagnosis Related Group (AR-DRG) classification (O40Z). But there
are limitations here as well as some women presenting for
terminations in private facilities do not always claim the Medicare
rebate.
Useful Links
The following is an alphabetical listing
containing useful links to statistical agencies and organisations
that collect or regularly publish health data:
ABS (Health information)
Australian
Institute of Health and Welfare (AIHW)
Australian
Medical Workforce Advisory Committee (AMWAC)
Australian
Safety and Compensation Council
Communicable Diseases
Australia
Department
of Health and Ageing
Medicare
National
Breast Cancer Centre
NATSEM
OECD
Private
Health Insurance Administration Council PHIAC
Private
Health Insurance Ombudsman (PHIO)
Productivity
Commission
WHO
For copyright reasons some linked
items are only available to Members of Parliament.
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