Australian Healthcare System Flashcards
What makes up the Health Care System?
- Funding mechanisms
- Trained workforce
- Management and administration
- Research, data and policies for Evidence Based Practice
- Facilities and equipment
- Logistics (delivery of materials)
Health System models
- Universal Care Model
- Market Model
Universal Care Model
- Health is a social right for all citizens
- Free to all, regardless of income
- Tax funded health care
Market Model
- Individuals are responsible for their own health and health care
- Individuals pay for health care
- Also funded by private health insurance
What is the definition for UNIVERSAL HEALTH CARE?
Defined as a system that provides organized health coverage to all members of society and is publicly funded through taxation (and may include individual contributions as required).
Market Model cont.
- Services are provided on a user-pays system
- Costs and availability of services are determined by market forces
- Private Health Insurance often contingent on employment
- Many people in Market Model countries cannot afford medical/surgical treatment
What models are the Australian Healthcare System funded with?
Universal Healthcare Model + Market Model
AHCS - Medicare funded Public Health System
All Australians have access to public health care regardless of income. The funding source is through taxation (2% Medicare tax levy).
- Subsidised visits to the GP (75% of scheduled fee)
- Treatment in a Public Hospital
- Pharmaceutical Benefits Scheme
- Subsidised Pathology and X-rays
- Some Community Based Care (Community Health Services)
AHCS – Private Health Insurance
-A voluntary scheme to access additional health care resources through the purchase of Private Health Insurance.
- Subsidised access to treatment in Private Healthcare Facilities
- Subsidised treatment by some Allied Health Care Practitioners (extra insurance required)
Other sources of funding for health care
- Work Cover (controlled at state level): WorkSafe Victoria
- Transport Accident Commission (TAC): Funded through motor vehicle third party insurance
Levels in the AHCS
Primary Care System (does not require referral)
general medical and dental practitioners, nurses, Indigenous health workers, pharmacists and allied health professionals such as physiotherapists, dieticians and speech pathologists.
Secondary Care System (by referral)
Medical specialists
Special facilities (rehabilitation centres)
Hospitals
Private and Public
Choice in Public Health Care
In community: you ALWAYS have a choice of GP
In public hospital:
- you don’t get a choice in health practitioner
- may face long wait times for elective surgery
Choice in Private Health Care
Admission to Private hospitals and specialised facilities (e.g. Psychiatric hospitals)
- Choice of health practitioners
- Timely access to surgery
- Extras – Allied and Complementary Health
General Practitioners
Primary (first) contact practitioner:
Manages acute, chronic and complex conditions
Preventative care and health education
Refers to other practitioners and services
Medicare refunds 75% of the standard fee for attending a GP
On an average day 406,000 visits are made to a GP
In Australia a GP requires additional training and registration with the Royal College of General Practitioners
Why are GP’s are gatekeepers?
They are the first point of contact that needs to be seen in order to have further referral to medical specialists or special Medicare funded schemes: Allied health and Mental health
Registration and Regulation of Health Practitioners
Australian Health Practitioners Regulation Agency (AHPRA)
HPs are registered by their Professional Board
Meet education standards
Legal requirements (particularly criminal record)
Ongoing professional development
Codes of conduct and regulations
Re-register every year
Professional Boards
Aboriginal and Torres Straight Islander Health Practice Board
Chinese Medicine Board, Chiropractic Board, Dental Board
Medical Board, Medical Radiation Practice Board, Nursing and Midwifery Board, Occupational therapy Board,
Optometry Board, Osteopathy Board, Pharmacy Board, Physiotherapy Board, Podiatry Board, Psychology Board
What is the purpose of a Registration Board?
protect the public
What can influence a decision to choose between the Universal healthcare model or the Market model?
- Cost
- Services available
- Location and transport * Family circumstances (other children, babysitting etc.)
*Knowledge of what is available
Comparison of ED expenses
Public Hospital ED:
cost - free
waiting time for low to medium priority: 1 - 4 hours
Private Hospital ED:
cost - $280 - $400
waiting time for low to medium priority: up to 1 hour
Emergency transport
NOT Free
In Victoria, average cost is $1,200 for a
single emergency transport to hospital
Ambulance Insurance costs $49.08 per
year
Allied Health in the community –
Private Practice
- Can choose practitioner(s)
- Availability of
appointments usually
good
Community Health advantages
and disadvantages
Disadvantages
* Long Waiting list * Means test * High Risk only * Availability of appts may be limited
Advantages
* Low cost * Usually ‘Case managed’ * All in same/similar location
Chronic disease GP Management Plan
and Team Care arrangements
GP Management Plan and Team Care Arrangement
Available to certain people with chronic conditions who
require allied health services
- Can claim (through Medicare) only five services
per year. * Patients may be bulk billed by practitioner, or
they must pay a gap fee
