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Revealing snapshot of health spend trends

With a swathe of government reviews underway into health spending and funding, and conflict over the supremacy of primary vs tertiary care, today’s AIHW figures on expenditure by sector make for interesting reading.

The headline figures for 2013-14 were:

  • $58.8 billion on hospitals ($892 per person Australia-wide)
  • $54.7 billion on primary health care ($1,002 per person Australia-wide)
  • $32 billion on other health goods and services

According to the AIHW health spending has increased steadily over the last decade, although it has slowed for hospitals and primary care in the past two years.

aihw1

In terms of recurrent expenditure, hospitals’ share remained constant over the 10 years from 2003-04 at around 40% while primary care ranged within a fairly small window of 37-38%.

Over that time, AIHW said capital expenditure went from 4.6% in 2003-04 to a high of 6.1% in 2011-12 before dropping slightly to 5.9% in 2013-14. This spike was due to the establishment in 2009 of the Health and Hospitals Fund.

Despite the overall growth in health spending AIHW said government contributions had slowed in the past two years, with estimated public funding per person at $2,725 in 2013-14.

That was $653 more in real terms than a decade earlier but an increase of just $30 year-on-year.

Over the decade recurrent government spending on hospitals declined from 36.7% to 32.7%. Though less marked, recurrent spending on primary care also fell, from 37.3% in 2012-13 to 36.7% in 2013-14 following a relatively stable four years.

The hospitals shortfall was compensated for by an increase in state and territory funding, rising from 67% to 69.5% in the decade. State and territory funding of primary health care slumped from 23.8% to 21.1% in the same period.

aihw2

The AIHW described government capital expenditure as “generally modest” and having fallen in the last 3 years, from $218 million in 2011-12 to $72 million in 2012-13 and $49 million in 2013-14.

By jurisdiction, per person federal funding (2008/09 – 2013/14) increased in all states and territories except the Northern Territory, where it fell $121. The NT also received the least per capita hospital funding ($735).

The breakdown of primary care spending was:

  • $10.1 billion for benefit-paid pharmaceuticals ($8.5 billion from the government)
  • $9.7 billion other medications ($9 billion from individuals)
  • $10.6 billion unreferred medical services
  • $8.9 billion dental services (60% individual-funded)
  • $5.4 billion other health practitioners (46% individual-funded)
  • $7.8 billion community health and other services (state, territory and local government funded)
  • $2.2 billion public health (even split federal and state/local)

aihw3

Interestingly, research spending rose by an average 9.1% per year over the decade, according to the AIHW, though it had slowed in the latter half.

aihw4

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