Australian Healthcare System Flashcards
Medicare (define)
Form of Commonwealth Government-sponsored health insurance that funds hospitals and medical practitioners and provides access to free* healthcare for Australian citizens (and citizens of countries with reciprocal arrangements).
MBS (define)
Medicare benefits schedule pays for consultations by medical practitioners and some investigations/procedures - e.g. GP appointments, diagnostic imaging, pathology.
PBS (define)
Pharmaceutical benefits scheme provides subsidised medicines and covers the balance for patients with concessional entitlements.
National health and hospitals network agreement (explain)
Outlines the responsibilities of state and federal governments for funding of public hospitals. States are primarily responsible for provision of public healthcare (approx. 60% of total expenditure) and Cth provides capped contributions.
Bulk-billing (explain)
Medical practitioners bill Medicare directly for the episode of care and accepts the pre-determined rebate as full settlement of the account.
Cf. private billing where the doctor bills the patient directly with no upward limit of fees and the patient obtains a rebate from Medicare for a percentage of the cost.
Gap Fee (define)
The difference between the Medicare rebate and the doctor’s fee for an episode of care. i.e. the out-pf-pocket expense for the patient.
Primary vs Secondary healthcare
Primary healthcare is provided at the first point of contact for the patient entering the health system - e.g. GP clinics, pharmacies, allied health practises, ACCHOs. It includes treatment for acute episodes of illness in the community and referrals to secondary healthcare. Secondary healthcare is provided by a facility or specialist after receiving a referral from a primary health provider - e.g. hospitals, specialist practices.
Clinical nurse specialist
RN with post-registration qualifications in specialty area of practice. Contributes to specialist knowledge and improvement of clinical practice in workplace.
Clinical nurse educator
RN with clinical experience in specialty area and qualifications in education. Delivers clinical education programs in workplace.
Clinical nurse consultant
RN with masters-level qualifications and 3-7 years full-time post-registration experience in distinct specialty. Provides clinical services, consultancy, leadership, research, education and management.
Nurse unit manager
RN in charge of ward/unit or group of wards. Coordinates patient services, nursing staff and ward management.
Nurse practitioner
Advanced practice RN with AHPRA endorsement. Provides independent/autonomous practice including assessment, diagnosis and management of patients.
Intern (Junior Medical Officer)
New graduate, provisionally registered by MBA, completing 1+ years of supervised practice involving rotation through specialities (medicine, surgery and emergency).
Resident Medical Officer
Fully-registered and licensed by MBA, medical practitioner engaged in independent medical practice.
SRMO - completed 1 year of residency but has not yet applied to training program.
Registrar
Medical practitioner undertaking accredited course of study leading to higher medical qualification and/or admission to specialist medical college.