Australian Institute of Health and Welfare (2021) Health Expenditure Australia 2019-20., AIHW, Australian Government, accessed 28 January 2022
Australian Institute of Health and Welfare. (2021). Health Expenditure Australia 2019-20. Retrieved from https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20
Health Expenditure Australia 2019-20. Australian Institute of Health and Welfare, 17 December 2021, https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20
Australian Institute of Health and Welfare. Health Expenditure Australia 2019-20 [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 Jan. 28]. Available from: https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20
Australian Institute of Health and Welfare (AIHW) 2021, Health Expenditure Australia 2019-20, viewed 28 January 2022, https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20
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The AIHW has been reporting on health expenditure in Australia for more than 3 decades as part of preparing Australia’s National Health Accounts (ANHA). This Health expenditure Australia report presents estimates of the amount spent on health goods and services in Australia for 2019–20, and the decade leading up to this. This report’s estimates are based on data from the AIHW’s Health Expenditure Database (HED), a collation of more than 50 data sources capturing health spending by governments, individuals, private health insurers and other private sources. The purpose is to use the best available data to provide the most comprehensive picture of (i) how much was spent on health, (ii) funded by who, and (iii) on what areas of health goods and services.
The ANHA aims to support a long-term, whole-of-system understanding of health spending nationally and over time. This system is unique in Australia and it varies from other health system reporting in scope, degree of stability over time and classification systems used. Other systems tend to focus on specific funding programs, jurisdictions or time periods.
The long-term holistic approach within the ANHA requires methods to appropriately allocate spending figures from multiple and often overlapping data sources. These sources change over time to the relatively stable ‘area’ and ‘source’ categories used in the ANHA. In doing so, care is taken to avoid the risk of misallocation, unnecessary breaks in the time series, missed data and double counting.
The methods used in the ANHA are overseen by the Health Expenditure Advisory Committee (HEAC). The HEAC includes subject matter experts and representatives from the Australian Government and all state and territory governments, as well as some non-government organisations. The AIHW has worked with the HEAC over many years to develop approaches to maximise the completeness and accuracy of the estimates over time and minimise the risk of double counting. For example, when estimating total spending on hospital services in a year, the funds the Australian Government gives to states and territories are subtracted from the hospital spending reported by the states and territories to derive the amount that the states and territories spent from their own resources.
The holistic approach, unique classification system and methods developed for the ANHA mean the figures reported here often vary from other data sources, particularly where other reporting tends to focus on specific funding programs, institutions, funders or purposes. For example, program-specific reporting such as for the Medicare Benefits Scheme, government budget papers or health department annual reports vary from the figures here due to differing classifications, scopes and methods used to account for double counting.
As part of ongoing data quality improvement activities, the AIHW, through the HEAC, works with the Australian Bureau of Statistics (ABS), the Australian Government, state and territory governments, the National Health Funding Body (NHFB), the Organisation for Economic Co-operation and Development (OECD) and other data suppliers to ensure the estimates presented in the ANHA are as complete and accurate as possible and reflect changes in health system financing over time.
This report includes Department of Defence spending in more detail than in previous iterations as well as reference to potential adjustments to estimates surrounding spending on services provided in hospitals (particularly certain services funded through the Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS)). These potential adjustments suggest that some spending on referred medical services or pharmaceuticals could be captured in hospital spending (i.e. a re-allocation of spending between categories). At this point, data limitations prevent a full inclusion of these adjustments within the ANHA, however, an attempt to quantify the potential impacts has been included in this report and the AIHW continues to work with data providers to resolve the outstanding issues for future reporting.
A summary of some of the broad issues is provided below. See Australian National Health Account: concepts, methodology and data sources and Comparison and alignment of Australian health expenditure estimates for more information on data sources and methodologies, as well as a comparison between this report and other health spending figures published elsewhere.
Examples of other health expenditure reporting
Examples of other health expenditure reporting include:
2019–20 was the first year of the COVID-19 pandemic in Australia. The pandemic did not only affect the health spending in direct (mainly through governments’ programs such as the NPCR) and indirect ways (mainly through reduced activities due to pandemic-related lockdowns, restrictions, and temporary suspension of non-urgent elective surgery), but also affected the data collection and processing for health expenditure itself. Among more than 50 data sources that contributed to the ANHA, some key data suppliers could only submit their data for 2019–20 many months after the initial schedule. The publication of this report was later than usual, reflecting the impact of COVID-19 on the data collection, validation and analysis process.
This report also covers the Australian bushfires 2019–20. However, the annual basis of the ANHA data does not allow for testing a hypothesis on any clear impact of bushfires on health spending.
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