澳大利亚 healthcare overview

澳大利亚’s health system is underpinned by Medicare – a universal health insurance scheme.

The healthcare spend is funded by national taxes (43%), state and territory 政府ernment taxes (28%), patient out-of-pocket payments (14%), private health insurance (8%) and accident compensation schemes (7%)[1].

联邦医疗保险由国家政府通过税收收入提供资金,称为医疗保险征费(目前为应税收入的2%)。. 大约45%[2] 人口也有私人健康保险(PHI),国家政府鼓励居民通过额外的税收和补贴参加PHI. 没有适当PHI水平的居民在1-1之间被收取额外的医疗保险征费附加费.5% of taxable income, based on age and income. 如果居民在以后的生活中接受PHI,国家政府也会收取终身健康保险的费用, being an extra 2% on PHI premiums for each year above the age of 31. The higher premium is charged for a maximum of 10 years of continuous PHI coverage. As an additional incentive, 拥有PHI的居民有资格在每个财政年度结束时获得私人健康保险退税. This is based on age and income and varies between 8.2% – 32.8%[3].

保健政策和医疗保险由卫生和老年保健部在全国范围内管理. The delivery of healthcare is mostly managed at two levels of 政府ernment.

The national (Federal) 政府ernment regulates the delivery of primary care, 药品, therapeutic goods and aged care. The management of primary care is delegated to 31 primary health networks (PHN), 谁在其区域内协调和委托初级卫生服务,以满足其人口的需求.

The six state and two territory 政府ernments manage public hospitals, 救护车, public dental services, 社区卫生, inpatient mental health services and some aged care services. Each has their own healthcare system, regulations and policies. 它们都通过某种形式的地方医院网络(LHN)管理公立医院和社区卫生服务。.  每个LHN管理一个地理区域内的一个或一组公立医院,并负责协调该区域内的公立医院服务和任何相关的社区卫生服务.

州/地区政府负责对私立医院和保健工作人员进行注册和发放执照. 在投入使用之前,任何新的或修改的服务都必须得到州/地区卫生部门的批准和审核. The national 政府ernment is responsible for management of 药品.

澳大利亚卫生保健安全和质量委员会为医院制定国家安全和质量标准和临床护理标准. 每个州/地区政府决定在其管辖范围内强制实施哪些标准, which is tested via an accreditation process.

Healthcare funding in 澳大利亚

All residents have access to free healthcare in the public health system under Medicare. 根据医疗福利计划(MBS),联邦医疗保险将为初级和专科医疗支付的费用由国家政府设定。. If charged at the published MBS-rate, Medicare covers 100% of the cost of GP visits (referred to as "bulk-billing"), public hospital care, and 85% of outpatient specialist costs. If a GP or specialist charges a rate higher than the MBS, patients must cover the gap with out-of-pocket payments or private health insurance, depending on where the service is delivered.

政府亦透过药物福利计划,以折扣价格提供处方药。. Medicare does not cover costs for dental examinations or treatment, 救护车 services, private allied health (e.g. outpatient physiotherapy, occupational therapy, 言语病理学, podiatry services), or glasses or all home nursing (co-payment usually required).

公立医院提供的所有医疗保健服务都是根据与诊断有关的团体(DRG)的活动提供资金的。. Treatment in a public hospital is free for all residents, however patients are not able to choose their own specialist. Patients can choose to be treated in a private facility under their selected specialist.

私立医院提供的专家服务按医疗保险规定费率的85%供资, as long as the treatment is listed on the MBS. The remaining 15% of the specialist fee and the hospital costs (e.g. 住宿, 剧院, 护理和食品由私人健康保险和/或病人支付(共同支付), excess or self-funded). 私立医院与私人保健基金协商费率,以支付私人保险患者的住院费用. 每个基金将谈判费率,并有自己的偿还要求和业绩指标. 

私立医院可以从自雇专家(称为来访医疗官员- VMOs)那里获得一些资金,用于使用咨询室和行政服务.  然而, VMOs are paid separately by Medicare, 病人和/或私人保健基金也将分别与私人保健基金谈判报销问题.

For out-of-hospital services, funding will depend on the service provided.  Outpatient specialist consultations are funded by Medicare for 85% of the MBS rate. Mental health funding is shared between national and state/territory 政府ernments. When delivered as an inpatient service within a private hospital, 精神病医生的费用由医疗保险支付,住院费用必须由病人和/或私人健康保险支付.

Allied health delivered as an outpatient service maybe funded by Medicare, private health insurance or the patient to self-fund, depending on the service and if it is listed on the MBS

处方药由国家政府根据药品福利计划(PBS)提供补贴。. 补贴的金额取决于药物,大多数患者需要共同支付处方药的费用.  然而, not all prescribed medications are on the PBS.

Healthcare providers

澳大利亚的专家通常要么受雇于公立医院,要么是自雇顾问. 在公立医院工作的医生要么由州/地区卫生部门支付工资,要么根据MBS支付经过修改的服务费.

一些自雇专家将在一些私立医院执业,也可能签约在公立医院提供固定时间的服务.

在私立医院执业的专家必须获得每家医院医疗咨询委员会的认可,才能在该医院执业.  VMO认证每3年审查一次,并要求专家在AHPRA(澳大利亚卫生从业人员监管机构)注册。, carry appropriate medical liability insurance and undertake regular peer reviews.

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