NSB102_Health System_mod 2 lecture_2023.pdf

NSB 102 Professional Practice and Cultural Safety Module 2: Lecture The Australian Health Care System Dr Audra de Witt  Acknowledgement of Traditional Owners In keeping with the spirit of Reconciliation, we acknowledge the Traditional Owners – the Jagera and the Turrbal peoples...

NSB 102 Professional Practice and Cultural Safety Module 2: Lecture The Australian Health Care System Dr Audra de Witt  Acknowledgement of Traditional Owners In keeping with the spirit of Reconciliation, we acknowledge the Traditional Owners – the Jagera and the Turrbal peoples of the land where QUT now stands and recognise these places have always been places of teaching and learning. We pay our respects to their Elders past and present, and acknowledge the important role Aboriginal and Torres Strait Islander peoples continue to play within the QUT community www.reconciliation.qut.edu.au QUT  The Australian Health Care System Overview of the Australian Health Care System (primary, secondary, tertiary) Health Care Settings, Private and Public health Government and their Roles 1 Health Care Funding Policies and National Health Priorities Health Care Performance Framework 2 Australian Health Care System Challenges The Health Workforce 3 Two Models of Health Care  An Introduction to Health Care in Australia One of the best health care systems in the world (“quality, safe & affordable health care”) Complex system = multiple services /programs. Wide range of health professionals & from various organisations – e.g. Federal, State/territory, Government, non-Government sector Together deliver health care to Australians Various settings e.g. public, private hospitals, primary health care (PHC) services (e.g. GPs, allied health services) & referred services (incl specialists, imaging, pathology) Range of health care – eg. health promotion (public health messages – e.g. encourage daily exercise, healthy lifestyles), preventative (e.g. breast screening programs, immunisation), cure (eg treatment of diseases) and palliative (end-of-life or supportive care) Source: Australian Department of Health and Aged Care: https://www.health.gov.au/about-us/the-australian-health-system. AIHW: https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf.  Primary, Secondary and Tertiary Health Care Many providers in health Primary Based within the community setting GP, dentist, nurse, pharmacist, allied health professional Commonly first point of contact with the health care system (non emergency) Secondary Can be in hospitals, clinics or community settings Specialist doctor (e.g. oncologist, psychiatrist) or other health professional e.g. pathology, radiology Tertiary Highly specialised care mostly provided in hospitals as in-patient e.g. surgery, complex medical care Can be referred from primary or secondary professional &/or direct entry via hospital emergency, or hospital transfer Source: https://www.health.qld.gov.au/__data/assets/pdf_file/0021/714243/5.-Health-system.PDF  Public and Private Health Care in Australia Public Health Private Health Public hospital system = equitable, Private health care – out of pocket accessible health care H/Insurance 2 types – hospital cover Free or low cost health care for Austn, only &/or ‘extras’ non-medical services NZ citizens & countries with reciprocal e.g. dental, physiotherapy, optical – agreements (Medicare - MBS) not Medicare covered. Can have one Pharmaceutical Benefits Scheme or both (PBS) – some subsidies for cheaper Govt provides means-tested rebate to prescription medicines help with insurance cost Source: https://www.health.gov.au/about-us/the-australian-health-system Who is responsible for providing Healthcare? The main players Private Sector (for profit) Not-For- State Govt Profit Healthcare Health Dept Federal in & Other Govt Australia Agencies Source: https://www.aihw.gov.au/reports/australias-health/health-system-overview Australia’s Health Care System: Main Roles of Government Federal States & Territories Local Leads devt of national policies Funds/manages public hospitals Delivers community & home- Funding e.g. Medicare & Regulation & licensing – e.g. based health & support services Pharmaceutical Benefits private hospitals, regulates Environmental health services Scheme (PBS), states/ products with health impacts – (e.g. waste disposal) territories hospitals, population- tobacco & alcohol Public health activities (e.g to wide services, health & medical Delivers community-based & promote physical & mental research) preventative services (eg wellbeing e.g. provision of bike Regulates medicines & medical cancer screen, immunisation), paths, green spaces devices ambulance services Regulates private health Implements setting-based insurance measures e.g. smoke free laws Sources: (Biggs and Cook 2018; Department of Health 2019; Duckett and Willcox 2015) in https://www.aihw.gov.au/reports/australias-health/health-system-overview & https://www.aihw.gov.au/reports/australias-health/health-promotion  Australian Health Care System: Shared government responsibilities in Health 3 Levels of Government Federal  Health professional education and training  Health workforce regulations  Food and safety standards  Improve quality and safety of health care  Funding programs and services State Local Source: (Biggs and Cook 2018; Department of Health 2019; Duckett and Willcox 2015) inhttps://www.aihw.gov.au/reports/australias-health/health-system-overview  Total health spending in Australia across health services 2019-20 % (estimates) 2019-20 Health Expenditure Just to give you an overall idea of breakdown in spending in different areas. Other services, 16% 41% hospitals = $83.5b 33% PHC = $66.9b Referred medical Hospitals, 41% services, 10% Other services here also includes research and capital spending PHC, 33% Source: https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure International comparison – health funding Source: https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure  Main causes of death in Australia We consider these figures (how many people died and causes of death) as it gives an overall picture of the health of a population Source: https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf.aspx Overview of Australia’s health 2022 Source:https://www.youtube.com/watch?v=sR-RHA-QXrM  National Health Priority Areas (NHPA) Focusses attention and policy on diseases that contribute most to burden of illness in community  Arthritis & musculoskeletal conditions (2002)  Asthma (1999)  Cancer control (1996)  Cardiovascular health (1996)  Covid-19 (2020)  Dementia (2012)  Diabetes (1997)  Injury prevention (1996)  Mental health (1996)  Obesity (2008) https://www.countrysaphn.com.au/community/national-health-priority- areas/https://www.emerge.org.au/post-infection-disease-australias-10th-national-health-priority-area  The Australian Health Performance Framework Source: https://www.aihw.gov.au/reports-data/australias-health-performance/learn-more-about-the-framework  What is quality of care? (WHO) Source: https://www.youtube.com/watch?v=erei6SZjcck  Australian Health Care System Challenges examples HCS Challenges Making better use of Ageing population ↑ Chronic diseases ↑ costs of medical emerging technologies research & innovations & health data Source: https://www.health.gov.au/about-us/the-australian-health-system  The Health workforce in Australia More than 642,000 health professionals working in Australian in 2020 (registered with the Australian Health Practitioner Regulation Agency) including: Australian health workforce increased by 21% between 2015 and 2020 Source: https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf.aspx  Overview of Two Models of Health We will look at this in more detail in coming weeks Biomedical Model Treats and cures diseases - can be seen as a ‘bandaid’ approach Does not aim to prevent diseases before it happens Model views body as a machine – can be fixed when broken down Social Model Realization that personal behaviours, environment, up-bring, social, cultural factors influence health Need to address the social determinants of heath in addition to physical health Acts to reduce health inequalities, empower people, improve access to health care, involves collaboration across services/sectors Source: Khan R, Haider Qureshi MS (2018) Critical Analysis of Various Models of Health in the Context of Smoking. Int J Pub Health Safe 3: 145.  References AIHW (2022). Health system overview. https://www.aihw.gov.au/reports/australias-health/health-system-overview AIHW (2022). Health expenditure. https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure AIHW: Australia’s health 2022 video summary [Video]. YouTube. https://www.youtube.com/watch?v=sR-RHA-QXrM AIHW. The Australian Health Performance Framework. (2017). https://www.aihw.gov.au/reports-data/australias-health-performance/learn-more-about-the- framework AIHW: The Health Workforce. (2022). https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf.aspx Australian Institute of Health and Welfare (2022). Australia’s health 2022: in brief, catalogue number AUS 241. Australia’s health series number 18, AIHW, Australian Government https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf.aspx Australian Institute of Health and Welfare. (2022). Australia’s health 2022: data insights (series number 18). AIHW, Australian Government. Australian Department of Health and Aged Care: https://www.health.gov.au/about-us/the-australian-health-system. AIHW: https://www.aihw.gov.au/getmedia/c6c5dda9-4020-43b0-8ed6-a567cd660eaa/aihw-aus-421.pdf. Australia’s National Health Priority areas. https://www.countrysaphn.com.au/community/national-health-priority-areas/https://www.emerge.org.au/post- infection-disease-australias-10th-national-health-priority-area Biggs and Cook 2018; Department of Health 2019; Duckett and Willcox 2015 in https://www.aihw.gov.au/reports/australias-health/health-system-overview & https://www.aihw.gov.au/reports/australias-health/health-promotion Commonwealth of Australia. The Australian Health System. https://www.health.gov.au/about-us/the-australian-health-system Khan. R, Haider Qureshi. M.S (2018). Critical Analysis of Various Models of Health in the Context of Smoking. Int J Pub Health Safe 3:145. Queensland Health (2019). Health System. https://www.health.qld.gov.au/__data/assets/pdf_file/0021/714243/5.-Health-system.PDF Scriven, A., Ewles. L., Simnett. I., Parish. R. (2010). Promoting health: A practical guide (6th ed.). Edinburgh: Bailliere Tindall Elsevier. WHO: What is quality of care? [Video]. YouTube. https://www.youtube.com/watch?v=erei6SZjcck