AIHW - Patients Spending on Medicare - Out-of-pocket Cost per GP Attendance (PHN) 2016-2017

This dataset presents the footprint of the percentage of patients with GP costs, and out-of-pocket cost per GP attendance at the 25th, 50th, 75th and 90th percentile. The data spans the financial year of 2016-2017 and is aggregated to 2015 Department of Health Primary Health Network (PHN) areas, based on the 2011 Australian Statistical Geography Standard (ASGS).\n\nThe data is sourced from the Medicare Benefits Schedule (MBS) claims data, which are administered by the Australian Government Department of Health. The claims data are derived from administrative information on services that qualify for a Medicare benefit under the Health Insurance Act 1973 and for which a claim has been processed by the Department of Human Services. Data are reported for claims processed between 1 July 2016 and 30 June 2017. The data also contains the results from the ABS 2016-17 Patient Experience Survey, collected between 1 July 2016 and 30 June 2017. The Patient Experience Survey is conducted annually by the Australian Bureau of Statistics (ABS) and collects information from a representative sample of the Australian population. The Patient Experience Survey is one of several components of the Multipurpose Household Survey, as a supplement to the monthly Labour Force Survey.\n\nThe Patients' spending on Medicare Services data accompanies the [Patients' out-of-pocket spending on Medicare services 2016-17 Report](https://www.aihw.gov.au/reports/health-welfare-expenditure/patient-out-pocket-spending-medicare-2016-17/contents/summary).\n\nFor further information about this dataset, visit the data source:[Australian Institute of Health and Welfare - Patients' out-of-pocket spending on Medicare services Data Tables.](https://www.aihw.gov.au/reports/health-welfare-expenditure/patient-out-pocket-spending-medicare-2016-17/data)\n\nPlease note:\n\n * AURIN has spatially enabled the original data using the [Department of Health - PHN Areas.](https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home)\n\n * GP attendances are Medicare-subsidised patient/doctor encounters, such as visits and consultations, for which the patient has not been referred by another doctor. GP attendances exclude services provided by practice nurses and Aboriginal and Torres Strait Islander health practitioners on a GP's behalf.\n\n * Out-of-pocket cost per service is the net cost to the patient of a health service, after deducting the Medicare benefit paid. The measure is calculated per patient (patients' annual out-of-pocket cost for eligible attendances, divided by the number of eligible attendances that the patient claimed in the year), for patients with out-of-pocket costs.\n\n * The data is based on the patient's Medicare enrolment postcode, not where they received the health care service. Most peoples' Medicare enrolment postcode will be their residential postcode.\n\n * If a service was flagged as bulk-billed, then the fee charged was set to equal the benefit paid (so there was no out-of-pocket cost for that service).\n\n * Patients were excluded if the sum of eligible services in the year was less than one, or if their annual out-of-pocket expenditure on the eligible services was equal to or less than zero.\n\n * Includes non-hospital Medicare-subsidised services only.\n\n * NP - Not available for publication. The estimate is considered to be unreliable. Values assigned to NP in the original data have been set to null.\n

本数据集呈现了发生全科医生（General Practitioner, GP）诊疗相关费用的患者占比，以及每例GP诊疗人次的自付费用在25分位、50分位、75分位与90分位上的分布特征。本次数据覆盖2016-2017财年，依据2011年澳大利亚统计地理标准（Australian Statistical Geography Standard, ASGS），聚合至2015年澳大利亚卫生部门基层健康网络（Primary Health Network, PHN）区域范围。

本数据集源自澳大利亚联邦卫生部门管理的医疗保险福利计划（Medicare Benefits Schedule, MBS）理赔数据。该理赔数据源于符合1973年《健康保险法》规定可申领医疗保险福利的服务相关行政记录，且相关理赔已由澳大利亚人类服务部完成审核处理。本次数据对应的理赔审核时段为2016年7月1日至2017年6月30日。

本数据集同时包含2016-2017年澳大利亚统计局（Australian Bureau of Statistics, ABS）患者体验调查的结果，该调查的收集时段同样为2016年7月1日至2017年6月30日。患者体验调查由澳大利亚统计局每年开展，通过澳大利亚人口的代表性样本收集相关信息。该调查作为月度劳动力调查的补充模块，属于多用途家庭调查的组成部分之一。

本医疗保险服务患者支出数据集配套发布于《2016-2017年澳大利亚医疗保险服务患者自付支出报告》（链接：https://www.aihw.gov.au/reports/health-welfare-expenditure/patient-out-pocket-spending-medicare-2016-17/contents/summary）。

如需了解本数据集的更多详情，请访问数据源：[澳大利亚卫生与福利研究所（Australian Institute of Health and Welfare）——医疗保险服务患者自付支出数据集表格]（链接：https://www.aihw.gov.au/reports/health-welfare-expenditure/patient-out-pocket-spending-medicare-2016-17/data）。

请注意：

* 澳大利亚城市与区域研究基础设施网络（Australian Urban and Regional Information Infrastructure Network, AURIN）已依据[卫生部门基层健康网络区域]（链接：https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home）对原始数据完成空间适配处理。

* GP诊疗人次指经医疗保险补贴的患者与医生诊疗互动（如门诊就诊与咨询），且患者未经由其他医生转诊。此类诊疗人次不包含执业护士或原住民与托雷斯海峡岛民健康从业者以全科医生名义提供的服务。

* 单次服务自付费用指患者在享受卫生服务后，扣除已申领的医疗保险福利金后的实际净支出。该指标针对存在自付费用的患者计算，公式为：患者年度内符合条件的诊疗人次自付总费用 ÷ 该患者年度内申报的符合条件的诊疗人次总数。

* 本数据集基于患者的医疗保险登记邮政编码，而非其接受卫生服务的地点。绝大多数患者的医疗保险登记邮政编码与其居住邮政编码一致。

* 若某服务被标记为批量结算（bulk-billed），则该服务的收费金额等同于医疗保险福利金支付额度，因此患者无需为该服务承担自付费用。

* 若患者年度内符合条件的服务总次数少于1次，或其在符合条件的服务上的年度自付支出总额小于等于0，则该患者将被排除出统计范围。

* 本数据集仅包含非住院类的医疗保险补贴服务。

* NP：指不可公开发布。此类估算结果被认定为不可靠，原始数据中标记为NP的数值已被设置为空值。