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Learning Outcomes About Australia

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Learning Outcomes About Australia Module 1 - Topic 1: Delivery of Health Services Learning outcomes When you have completed this topic, you should be able to: 1. Describe the structure of the Australian Health Care System In particular, you should be able to: Describe health services provided to Australians. Differentiate private from public health care services. Identify health care initiatives for special populations, including people in rural and remote areas and Indigenous Australians. Explain the role of the Australian and State and Territory Governments with regard to funding and service provision. Outline how health services are regulated. Identify other health agencies that support the Australian Health Care System. About Australia Australia is a vast continent with a land mass roughly the same size as Western Europe or the United States of America (excluding Alaska). It has a total population of nearly 23 million.1 The majority of whom (over 80%) live within 50km of the coastline. There are large regions of Australia that have only small, scattered settlements or which are unpopulated. Settlement of Australia began more than 40 thousand years ago by people now known as 'Indigenous Australians' (also known as 'Aboriginal and Torres Strait Islander' peoples). Indigenous Australians are identified as comprising approximately 3% of the total population.1 In June 2011, NSW had the largest Aboriginal and Torres Strait Islander population (208,400 people), followed by Queensland (188,900 people) and Western Australia (88,300 people). These three states combined comprised 72.5% of the total Aboriginal and Torres Strait Islander population of Australia. Settlement by people from Great Britain and other countries began in 1788 and the cultural and linguistic diversity of Australia's resident population has been reshaped over many years by migration. Historically, more people immigrate to, than emigrate from, Australia. At 30 June 2011, 27% of the estimated resident population was born overseas (6.0 million people). This was an increase from ten years earlier at 23.1% (4.5 million people). Persons born in the United Kingdom continued to be the largest group of overseas-born residents, accounting for 5.3% of Australia's total population at 30 June 2011. This was followed by persons born in New Zealand (2.5%), China (1.8%), India (1.5%) and Vietnam and Italy (0.9% each).2 The Australian population is ageing: over the past two decades the median has increased to just over 37 years of age.1 The proportion of people aged 65 years and over has increased to 13.7%. During the same period, the proportion of the population aged 85 years and over has more than doubled to 1.8%. Over the next several decades, population ageing is projected to have significant implications for Australia in many spheres, including health, labour force participation, housing and demand for skilled labour.3 Australia is a developed country with a generally high standard of living. Overall, Australians have one of the highest life expectancies in the world – 81.7 years.4 The burden of disease (premature mortality in terms of years of life lost) is mostly attributed to chronic conditions, such as cardiovascular disease and cancer. Indigenous Australians, however, have much poorer health than other Australians, with a higher burden of both infectious and non-infectious disease, including high rates of diabetes. The life expectancy of Indigenous Australians is also considerably lower, with a difference of approximately 11 years.4 Primary health care Primary health care is typically the first health service in Australia visited by patients with a health concern. It includes most services not provided by hospitals and involves a wide range of professions, such as general practitioners (GPs), pharmacists, ambulances, community health workers, Aboriginal health workers, practice nurses and dentists.5 For many people the first point of contact with the health system is through a GP. For specialised care, patients can be referred by GPs to specialist medical practitioners, other health professionals, and hospitals or community-based health-care organisations. Community-based services—some of which can also be accessed directly by patients—provide care and treatment for such health concerns as mental health, alcohol and other drug use, family planning and sexual health services. Australians also visit dentists and other private sector health professionals, such as physiotherapists, chiropractors and natural therapists. General practice General practice plays an integral role in the provision of primary health care in Australia. GPs diagnose, treat and manage health complaints, provide preventive advice and care, prescribe medicines, and refer patients to other primary, secondary and tertiary care where required, including specialists, hospitals and aged care. GPs often operate out of a dedicated location, known as a general practice. There can be one or more GPs operating out of a single general practice. Some general practices include many GPs, and general practices can be co-located with other health facilities, such as pharmacies, dental surgeries and physiotherapists. Many GPs work closely with other professionals within a general practice, such as practice nurses, to provide services.5 Other primary health care services and service providers Non-GP primary health care includes many different service providers and disciplines, such as ambulances, dentists, dieticians, midwives, occupational therapists, optometrists, pharmacists, physiotherapists, psychologists, nurses, nutritionists and speech pathologists. These service providers operate through a diverse range of service models and settings, including: small private practices with one or two practitioners specialising in a particular discipline large multidisciplinary centres with many service providers operating out of a single facility outreach services where the practitioners work in the community with targeted individuals or groups research environments at universities and other research facilities.5 Hospitals A mix of public and private sector providers deliver health services. Public hospitals Public hospitals include hospitals established by governments and, in some instances, hospitals originally established by religious or charitable bodies, now directly funded by government. There are a small number of hospitals built and managed by private organisations that provide public hospital services under arrangements with state governments. Most acute beds and emergency outpatient clinics are in public hospitals. Large urban public hospitals provide the majority of complex types of hospital care such as intensive care, major surgery, organ transplants, renal dialysis and specialist outpatient clinics.6 Private hospitals Private hospitals are owned by for-profit or not-for-profit organisations such as large corporate operators, religious operators, and private health insurance funds. Private hospitals traditionally provided less complex, non- emergency care, such as simpler elective surgery, but have extended their clinical capacity since the advent of more accessible technology and also new procedures such as minimally invasive surgery. Their increased range of clinical services thus offers an alternative to elective surgery in public hospitals for which there are long waiting lists.7 Separate centres for same-day surgery and other non-inpatient operating room procedures are found mostly in the private sector. Many public hospitals provide such services on the same site as inpatient care.6 Doctors Many doctors are self-employed. Others are salaried employees of the government (all levels). Salaried specialist doctors in public hospitals often have rights to treat some patients as private patients in the hospital, charging fees to those patients and usually contributing some of their fee income to the hospital.6 Health services The following health services are provided in Australia Aged care Australia's aged care system is structured around two main forms of care delivery: Residential (accommodation and various levels of nursing and/or personal care). Residential services are mainly provided by the non-government sector, about half of which are operated by religious or charitable organisations. Community care (ranging from delivered meals, home help and transport to intensive coordinated care packages for people who otherwise would need residential care). Both public and non-government sector organisations provide community care services, under the Home and Community Care Program.6 For more information on the broad range of schemes available to in Australia, refer to the Aged Care Australia website via the link below. Aged Care Australia Mental health Mental Health is an issue that affects the lives of many Australians either directly or indirectly. It is estimated that 45% of Australians between the age of 16 and 85 years will experience a common mental-health related condition such as depression, anxiety or a substance use disorder in their lifetime.8 The mental health sector has been radically restructured over the last few decades, so that people with mental health problems are now generally treated while still a part of the community rather than in long-stay psychiatric hospitals. Mental health-related services are provided in Australia in a variety of ways: services provided by general practitioners services provided in emergency departments state and territory community mental health services ambulatory-equivalent admitted
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