The AIHW Disease Expenditure Database
The main source of information for this web report is the AIHW’s Disease Expenditure Database. It provides a broad picture of the use of health system resources classified by disease groups and conditions, and is a reference point for planners and researchers interested in costs and use patterns for particular diseases.
Generally, the methods used for estimating disease expenditure is a mixture of ‘top-down’ and ‘bottom-up’ approaches, where total expenditure across the health system is estimated and then allocated to the relevant conditions based on the available service use data. An advantage of this approach is that it yields consistency, good coverage and totals that add up to known expenditure but it is not as comprehensive for any specific disease as a detailed ‘bottom-up’ analysis, which would include the actual costs incurred for that disease. In most cases, however, a lack of amenable data sources means that a more granular ‘bottom-up’ analysis is not possible.
Estimates in the Disease Expenditure Database have been derived by combining information from the:
- National Hospital Morbidity Database (NHMD),
- National Public Hospitals Establishments Database (NPHED),
- National Non-admitted Patient Emergency Department Care Database (NNAPEDC),
- National Non-admitted Patient Databases (aggregate, NAPAGG, and unit record, NAPUR),
- National Hospital Costs Data Collection (NHCDC),
- Private Hospital Data Bureau (PHDB) collection,
- Bettering the Evaluation and Care of Health (BEACH) survey,
- Health Expenditure Database.
The Disease Expenditure Database contains estimates of expenditure by Australian Burden of Disease Study condition, age group, and sex for admitted patient, emergency department, and outpatient hospital services, out-of-hospital medical services, and prescription pharmaceuticals. It is not technically appropriate or feasible to allocate all expenditure on health goods and services by disease. For example, neither administration expenditure nor capital expenditure can be meaningfully attributed to any particular condition due to their nature.
Funding for these health-care sectors comes from both government and non-government sources (including private health insurance and individuals).
The AIHW is continually seeking to improve the methods used to produce these estimates. As a consequence, disease expenditure estimates are subject to revision and the most recently published results are not directly comparable with previously published data.
A detailed methods report, Disease Expenditure 2015–16 Study: Overview of analysis and methodology, is available to download. It provides further information regarding analytical and estimation methods, and aspects of the quality of the data being reported by the AIHW and is included to help readers understand the limitations of the data and make informed judgements about their use.