Key concepts

Expenditure on mental health services

Key concept Description
Average cost per patient day Average cost per patient day is determined by dividing the total recurrent expenditure of the specialised mental health service by the total number of patient days as presented in the Specialised mental health care facilities section.
Constant price Constant price estimates are derived by adjusting the current prices to remove the effects of inflation. This allows for expenditures in different years to be compared and for changes in expenditure to reflect changes in the volume of health goods and services. Generally, the constant price estimates have been derived using annually re-weighted chain price indexes produced by the Australian Bureau of Statistics (ABS). In some cases, such indexes are not available, and ABS implicit price deflators have been used instead (AIHW 2018 ).
Current price Current price refers to expenditures reported for a particular year, unadjusted for inflation. Changes in current price expenditures reflect changes in both price and volume (AIHW 2018 ).
Health expenditure Health expenditure is reported in terms of who incurs the expenditure rather than who ultimately provides the funding. In the case of public hospital care, for example, all expenditures (that is, expenditure on medical and surgical supplies, drugs, salaries of doctors and nurses, and so forth) are incurred by the states and territories, but a proportion of those expenditures are funded by transfers from the Australian Government (AIHW 2018).
Health funding Health funding is reported in terms of who provides the funds that are used to pay for health expenditure. In the case of public hospital care, for example, the Australian Government and the states and territories together provide over 90% of the funding; these funds are derived ultimately from taxation and other sources of government revenue. Some other funding comes from private health insurers and from individuals who choose to be treated as private patients and pay hospital fees out of their own pockets (AIHW 2018). The national recurrent expenditure on all mental health-related services can be estimated by combining funding from 3 sources:
  • State and territory contributions to specialised mental health services
  • Australian government expenditure on mental health-related services and contributions to specialised mental health services
  • private health insurance fund component estimated by the Department of Health.
Patient days Patient days are days of admitted patient care provided to admitted patients in public psychiatric hospitals or specialised psychiatric units or wards in public acute hospitals and in residential mental health services. The total number of patient days is reported by specialised mental health service units. For consistency in data reporting, the following patient day data collection guidelines apply: admission and discharge on the same day equals 1 day; all days are counted during a period of admission except for the day of discharge; and leave days are excluded from the total. Note that the number of patient days reported to the National Mental Health Establishments Database is not directly comparable with the number of patient days reported either to the National Hospital Morbidity Database (Overnight admitted patient mental health-related care section) or the number of residential care days reported to the National Residential Mental Health Care Database (Residential mental health services section).
Program type Public sector specialised mental health hospital services can be categorised based on program type, which describes the principal purpose(s) of the program rather than the classification of the individual patients. Acute care admitted patient programs involve short‑term treatment for individuals with acute episodes of a mental disorder, characterised by recent onset of severe clinical symptoms that have the potential for prolonged dysfunction or risk to self and/or others. Non‑acute care refers to all other admitted patient programs, including rehabilitation and extended care services (see METeOR identifier 288889).
Recurrent expenditure Recurrent expenditure refers to expenditure that does not result in the acquisition or enhancement of an asset—for example, salaries and wages expenditure and non‑salary expenditure such as payments to visiting medical officers (AIHW 2018 ).
Target population

Some specialised mental health services data are categorised using 5 target population groups (see METeOR identifier 445778):

  • Child and adolescent services focus on those aged under 18 years.
  • Youth services focus on those aged 16–24 years.
  • Older person programs focus on those aged 65 years and over.
  • Forensic health services provide services primarily for people whose health condition has led them to commit, or be suspected of, a criminal offence or make it likely that they will reoffend without adequate treatment or containment.
  • General provides services to the adult population, aged 18 to 64, however, these services may also provide assistance to children, adolescents or older people.

Note that, in some states, specialised mental health beds for aged persons are jointly funded by the Australian and state and territory governments. However, not all states or territories report such jointly funded beds through the National Mental Health Establishments Database.


Alternative text for Expenditure on mental health services figures

Figure EXP.1

Stacked line chart showing the per capita spending on specialised mental health services from 1992–93 to 2016–17. Public psychiatric hospital spending has decreased over the period. Spending increased for specialised psychiatric units of wards in public hospitals, community mental health care services, residential mental health services, grants to non-government-organisations and other indirect expenditure. Refer to Table EXP.4. Back to figure EXP.1.

Figure EXP.2

Stacked vertical bar chart showing the per capita spending by the Australian Government on specialised mental health services between 2007–08 and 2016–17. Spending increased for Medicare Benefits Schedule, National programs and initiatives, research, private health insurance premium rebates and the National Mental Health Commission. Spending decreased for the Pharmaceuticals Benefit Scheme and mental health specific payments to states and territories. Refer to table EXP.31. Back to figure EXP.2.

Figure EXP.3

Stacked vertical bar chart showing the Australian Government per capita expenditure on Medicare-subsidised mental health-specific services by provider type and states and territories in 2017–18. There was no consistent trend across the states and territories as to which provider had the highest per capita expenditure, with psychiatrists, clinical psychologists and general practitioners all having the highest per capita expenditure in at least one state or territory. Per capita expenditure for Other allied health was the lowest of all providers in every state and territory. Back to figure EXP.3.

Figure EXP.4

Stacked vertical bar chart showing the Australian Government per capita expenditure on mental health-related medications subsidised under the PBS/RPBS by type of medication prescribed and states and territories in 2017–18. The highest per capita spend was on Antipsychotics in all states and territories, except for Tasmania where Antidepressants was the highest. Hypnotics and sedatives had the lowest per capita spend across all states and territories. Refer to Table EXP.28. Back to figure EXP.4.

Reference

AIHW 2018. Health expenditure Australia 2016–17. Health and welfare expenditure series no. 58. Cat. no. HWE 68. Canberra: AIHW.