Older people were more likely to receive at least one of these Medicare-subsidised services. In 2020–21, 92% of people aged 65 and over had at least one pathology service, compared with 74% of people aged 45–64 and 49% of people aged 44 and under.
Females were more likely than males to have had one or more Medicare-subsidised pathology service (68% of females had at least one service, compared with 55% of males). This trend was also apparent for diagnostic imaging services, where 44% of females received a service compared with 34% of males.
In 2020–21, similar proportions of people living in Major cities, Inner regional and Outer regional areas received these types of services, compared with Remote and Very remote areas, where lower percentages of people received them. This was most apparent with diagnostic imaging, where 39% of people living in Major cities, Inner regional and Outer regional areas received a service, compared with 31% of people living in Remote areas and 23% of people living in Very remote areas.
In 2020–21, $8.7 billion was spent on Medicare-subsidised pathology, imaging and other diagnostic services in non-hospital settings. This comprised:
- $8.2 billion in Medicare benefits paid by the Australian Government
- $518.5 million in out-of-pocket costs paid by patients.
About $3.6 billion was spent on Medicare-subsidised pathology services in non-hospital settings, and $4.1 billion on diagnostic imaging services in 2020–21.
In 2020–21, 179 million (97%) of these diagnostic services were bulk-billed (indicating that patients did not incur costs for these services). Pathology services contributed a large proportion of this figure (Figure 2). For those who did incur out-of-pocket costs, diagnostic imaging had the highest average cost per patient ($195) in 2020–21, whereas pathology had the lowest ($75) for all services received in the year.
Trends in spending
In the 5 years between 2015–16 and 2020–21, spending on Medicare-subsidised pathology, imaging and other diagnostic services outside of hospital increased:
- Medicare benefits paid by the Australian Government increased in real terms (after adjusting for inflation), from $6.3 billion in 2015–16 to $8.2 billion in 2020–21 (Figure 2). Per patient, this was an increase in real terms from $409 to $461 over the same period.
- Patient out-of-pocket costs increased in real terms, from $511.4 million in 2015–16 to $518.5 million in 2020–21 (Figure 2). On a per patient basis, there was an increase in real terms from $167 to $170 in this period.
For pathology services, the number of patients who had an out-of-pocket cost decreased – from around 305,000 in 2015–16 to 152,000 in 2020–21. Over the same period, the average cost per patient (for those who had out-of-pocket costs) also decreased from $77 to $75 per patient in real terms.
However, for diagnostic imaging services, the number of patients who had an out-of-pocket cost has been stable between 2015–16 and 2020–21 – approximately 2.1 million in each year. The average cost per patient (for those who had an out-of-pocket cost) increased in real terms from $187 in 2015–16 to $195 in 2020–21.