Healing our hospitals: A report on public hospital funding

December 2000

© Commonwealth of Australia 2000

ISBN 0 642 71044 9

Background to the inquiry
Conduct of the inquiry
First Report
Roundtable Discussions
Assistance with the inquiry

The role of hospitals in the health system
Overview of public hospitals in Australia
Future challenges facing the health system
Identifying the key issues, problems, and challenges facing public hospitals
Commonwealth Government’s powers over health policy
Funding arrangements for public hospitals
Conclusion
Cost shifting
Conclusion

Background
Options for reform
Option 1: Major reform to funding and delivery of services
Option 1(A): Commonwealth to take responsibility for funding and delivering services
Option 1 (B): States to take responsibility for funding and delivering services
Assessment and discussion: options 1 (A) and (B)
Conclusion
Option 1 (C):Commonwealth and States/Territories to pool funds
Assessment and discussion: option 1 (C)
Conclusion
Option 2: Funding and delivery of services: incremental/partial reforms
Option 2 (A): Commonwealth to fund all pharmaceutical services
Assessment and discussion: option 2 (A)
Conclusion
Option 2 (B) Commonwealth to fund all medical services
Assessment and discussion: option 2 (B)
Conclusion
Further options
A national health policy
Assessment and discussion: national health policy
Conclusion
Community debate and transparent priorities
Assessment and discussion: community debate and transparent priorities
Conclusion
Redesigning the ‘hospital’

Development of Coordinated Care Trials
The coordinated care model
Aboriginal and Torres Strait Islander trials
Additional Coordinated Care Trials
Evaluation of the trials
Effectiveness of the general trials
Conclusion

Introduction
Background
Response to the fall in coverage
Impact of the rebate on participation rates in private hospital insurance
Private health insurance participation and the demand for hospital services
Cost and equity considerations
Other options for the funding
The Rebate and the Australian Health Care Agreements
Conclusions

Introduction
Overview of the private sector
The interface between the private and public hospital sector
The impact of the change in the delivery of public hospital services
Provision of services for public patients in private hospitals
Competition between the private and public sectors
Co-location
Evaluation of changes to provision of services
Conclusions

Definition of quality improvement
Nature and extent of adverse events
Current approaches to quality improvement
Improving quality and safety in public hospitals
Australian Council for Safety and Quality in Health Care
Collection of data on adverse events
Pilot projects
Financial incentives
Accreditation processes
Education and training in quality improvement
Encouraging best clinical practice
Consumer participation in quality improvement
Performance measurement
Conclusions – strengthening the commitment to quality

Introduction
National structural aspects of health data collection
Key data collections and reports
Shortcomings in data collection and analysis
Data on allied health services
Data on waiting times for elective surgery
Data on health outcomes
Data on quality of care and standards of care
Information technology, quality of care and data collection
Conclusion