Healthy measures - key health statistics


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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.

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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.
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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.
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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.
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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.
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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.
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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.
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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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