AIHW - Patients Spending on Medicare - Out-of-pocket Cost per Diagnostic Imaging Service (PHN) 2016-2017

This dataset presents the footprint of the percentage of patients with imaging costs, and out-of-pocket cost per diagnostic imaging service 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 * Diagnostic imaging services are Medicare-subsidised diagnostic imaging procedures such as x-rays, computerised tomography scans, ultrasound scans, magnetic resonance imaging scans and nuclear medicine scans.\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影像检查费用的患者占比情况，以及每一次诊断影像服务就诊的自费费用在25分位、50分位、75分位与90分位的分布情况。数据覆盖2016-2017财年，按照2011年澳大利亚统计地理标准（Australian Statistical Geography Standard, ASGS）聚合至2015年澳大利亚卫生与老年护理部基层健康网络（Primary Health Network, PHN）辖区范围。

数据来源于澳大利亚卫生与老年护理部管理的医疗保险福利计划（Medicare Benefits Schedule, MBS）理赔数据。该理赔数据源自符合1973年《健康保险法》规定可申领医疗保险福利、且已由澳大利亚人类服务部完成理赔审核的医疗服务行政记录。报告覆盖的理赔时段为2016年7月1日至2017年6月30日。数据集同时包含2016-17年度澳大利亚统计局（Australian Bureau of Statistics, ABS）患者体验调查的结果，该调查同样于2016年7月1日至2017年6月30日期间开展。患者体验调查由澳大利亚统计局每年开展一次，通过澳大利亚人口代表性样本收集相关信息，属于多用途住户调查的组成部分之一，作为月度劳动力调查的补充模块。

本数据集配套发布于《2016-17年度患者医保服务自费支出报告》（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, AIHW）——《患者医保服务自费支出2016-17年度数据表》（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信息网络（AURIN）已基于澳大利亚卫生与老年护理部PHN辖区范围对原始数据进行空间化处理。

* 诊断影像服务指纳入医保补贴的诊断影像类操作，包括X射线、计算机断层扫描、超声扫描、磁共振成像及核医学扫描等。

* 单次服务自费费用指患者在扣除医保补贴后需承担的净医疗成本。该指标针对存在自费费用的患者计算，公式为：患者年度符合条件就诊的自费总支出 ÷ 该患者年度申报的符合条件就诊次数。

* 本数据基于患者的医保登记邮编，而非其接受医疗服务的地点。绝大多数患者的医保登记邮编与其居住邮编一致。

* 若某一服务被标记为全额医保计费（bulk-billed），则其收费金额等同于医保补贴金额，即该服务无自费成本。

* 若患者年度内符合条件的服务总次数少于1次，或其在符合条件服务上的年度自费支出小于或等于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保补贴医疗服务。

* NP——不予公开出版。该估算值被认为不可靠。原始数据中标记为NP的数值已被设为空值。