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Annual Report - Performance Indicators
Outcome Performance ReportMajor AchievementsOutcome SummaryPerformance IndicatorsFinancial Resources Summary

PERFORMANCE INDICATORS (EFFECTIVENESS INDICATORS)


The Department of Health and Ageing is responsible, and accountable, for contributing to the achievement of nine outcomes. Effectiveness indicators are used to measure the progress the Department is making in achieving our outcomes.

Listed below are the effectiveness indicators for Outcome 2 followed by a brief description of the Department's performance in meeting these targets.

Indicator 1. Client support for Medicare

Target:

High levels of client support.

Information source/reporting frequency:

Structured feedback through the HIC customer surveys.


As the service delivery agency for payment of entitlements under the MBS and PBS, the Health Insurance Commission (HIC) undertakes annual customer satisfaction research into its service delivery. The 2005 survey indicates a high level of support and attitudes toward the administration and delivery of services. Conducted with health practitioners, their practice managers, health consumers and pharmacists.

The medical practitioner and practice manager satisfaction with HIC's services has increased since 2004. Medical practitioner levels increased from 79 per cent to 85 per cent, while practice managers' satisfaction level remained constant at 90 per cent. Consumer and pharmacist satisfaction with the HIC's delivery of services continued to be stable with no significant difference for the past seven years, achieving 90 per cent and 85 per cent satisfaction respectively.

Indicator 2. Aboriginal and Torres Strait Islander access to Medicare

Target:

Increasing Aboriginal and Torres Strait Islander access to Medicare in accordance with need.

Information source/reporting frequency:

Medicare benefits claimed by Aboriginal and Torres Strait Islander Medical Services.

Enrolment and claims data through the voluntary Indigenous identifier.


To address the problems of access to the MBS by Aboriginal and Torres Strait Islander peoples, special arrangements were put in place in 1996 under sub-section 19(2) of the Health Insurance Act 1973 to allow Medicare benefits to be paid for services provided by medical practitioners working at Aboriginal Community Controlled Health Services (ACCHSs). Regular surveys are conducted by the HIC to gather information on the number of medical practitioners employed by ACCHSs. Based on information supplied by the ACCHSs and claims processed for 2003-04, it is estimated that approximately 466,000 services were provided at a cost to Medicare of $15.4 million.

In addition, State funded clinics in Queensland and the Northern Territory received Medicare payments of approximately $2.3 million, covering 64,000 services.

Since November 2002, Aboriginal and Torres Strait Islander peoples have been able to identify as Aboriginal or Torres Strait Islander on the Medicare database by means of a voluntary Indigenous identifier. At the end of June 2005, over 84,000 people were identified as Aboriginal or Torres Strait Islander.

Approximately 41,800 Aboriginal and Torres Strait Islander people were identified during 2004-05 this represents significant growth of 80 per cent since July 2004.

Indicator 3. Percentage of Medicare services that are direct billed with no gap charged

Target:

To monitor billing patterns through provision of regular reports.

Information source/reporting frequency:

Quarterly Medicare Statistics.


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The number of MBS services bulk-billed increased by 8.6 per cent during 2004-05. In 2004-05, 165,964 million services were provided at no cost to the patients across all types of medical services. The percentage of all services bulk-billed in 2004-05 increased by 2.7 percentage points to 70.2 per cent.

Indicator 4. Medicare Benefits Schedule outlays per capita in rural and remote areas compared with other areas

Target:

More equal distribution between localities.

Information source/reporting frequency:

Annual HIC data.


MBS outlays per capita continue to be lower in rural and remote areas, although the relationship to the national average has improved in recent years. In 1999-2000, MBS expenditure per person was $463.90 in capital cities, $444.12 in other metro centres, $350.52 in rural and remote areas, and $429.99 at the Australia level. In 2004-05, MBS expenditure per person was $512.48 in capital cities, $497.91 in other metro centres, $428.82 in rural and remote areas, and $487.62 at the national level.

Indicator 5. Number of persons per approved pharmacy in Australia and the number of persons per pharmacy in urban areas compared with those pharmacies in rural and remote areas

Target:

The ratio is similar for urban and rural and remote areas.

Information source/reporting frequency:

Annual HIC data.


The distribution of pharmacies across urban, rural and remote areas underlies access to the PBS. In 2004-05, there were on average 3,739 people per pharmacy in urban areas compared to 4,591 people per pharmacy in rural and remote areas.

Figure 2.2: Distribution of Australian Pharmacies by Urban and Rural Areas 2005

Distribution of Australian Pharmacies by Urban and Rural Areas 2005

Text description

Source: HIC data at 30 June 2005 and Census 2001 data.


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Indicator 6. Aboriginal and Torres Strait Islander access to Pharmaceutical Benefits Scheme medicines

Target:

Increasing Aboriginal and Torres Strait Islander access to the Pharmaceutical Benefits Scheme in remote area Aboriginal Medical Services in accordance with need.

Information source/reporting frequency:

Annual HIC data.


To address barriers in accessing the PBS by Aboriginal and Torres Strait Islander peoples in remote areas, special supply arrangements operate under the provisions of Section 100 of the National Health Act 1953. These arrangements provide clients of eligible remote area Aboriginal Health Services with PBS medicines at the time of medical consultation, without the need for a formal prescription form, and without charge. Clients of more than 170 health services across remote Australia now benefit from improved access to PBS medicines through these arrangements. Total expenditure for 2004-05 was $22.0 million representing an increase of 24 per cent over 2003-04 outlays.

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Indicator 7. Percentage of cost of Pharmaceutical Benefits Scheme prescriptions covered by the Government

Target:

To monitor changes in underlying drivers through the provision of regular reports.

Information source/reporting frequency:

Annual HIC data.


The percentage of the cost of PBS prescriptions covered by the Australian Government decreased from 84.2 per cent in 2003-04 to 83.6 per cent in 2004-05.

Indicator 8. Pharmaceutical Benefits Scheme outlays per capita in rural and remote areas compared with other areas

Target:

More equal distribution between localities.

Information source/reporting frequency:

Annual HIC data.


Over the past five years the expenditure by the Australian Government on PBS per person has increased in rural and remote areas more than other areas. PBS subsidies per capita for 2000-01 were $222.03,4 $246.44 and $218.07 in capital city, other metro centres and rural and remote areas respectively. The corresponding figures for 2004-05 were $255.58, $283.96 and $264.10.

Indicator 9. Overall growth rates in Medicare outlays, including Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and AHCA growth rates

Target:

To monitor growth rates in Medicare outlays through the provision of regular reports.

Information source/reporting frequency:

Budget papers.


In 2004-05, approximately $24.7 billion was spent on Outcome 2. This equates to approximately two-thirds of the total expenditure of the Health and Ageing Portfolio. In cash terms, the Australian Government's expenditure on the three main components of Medicare in 2004-05 was $24.0 billion, a real increase of 7 per cent on the previous year.

Outlays and growth rates for MBS, PBS and AHCAs are managed within the context of an agreement. These agreements allow for growth to occur at an agreed rate within the funding allocated.


Figure 2.3: Australian Government real outlays on PBS, MBS and AHCAs (constant 2004-05 dollars); 1991-92 to 2004-05


Figure 2.3: Australian Government real outlays on PBS, MBS and AHCAs (constant 2004-05 dollars); 1991-92 to 2004-05

Text description

Source: The Department of Health and Ageing and the Health Insurance Commission data


Notes
1. Outlays deflated using the non-farm Gross Domestic Product (GDP) implicit price deflator.
2. MBS refers to the Medicare Benefits Scheme.
3. PBS refers to the Pharmaceutical Benefits Scheme.
4. AHCAs refers to the Australian Health Care Agreements. Included are 2003-2008 AHCAs, 1998-2003 AHCAs, 1993-1998 Medicare Agreements and the 1988-1993 Medicare Agreements. Each Agreement contains a slightly different suite of programs. The 1998-2003 AHCAs includes funding to the states/territories under the National Health Development Fund. The 2003-2008 AHCAs includes funding to the states/territories under the Pathways Home program.
5. Outlays are on a cash basis from 1991-92 to 1998-99 and on an accrual basis from 1999-2000 to 2004-05.
6. The Department’s outcome and outputs structure commenced in 1999-2000 and the AHCA funding represented since then includes both outcome 2 and outcome 4 allocations. Outcome 4 contributes less than 2 per cent annually of total funding under the AHCAs.


Indicator 10. Australian Government expenses per capita on Medicare, both total and by Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and under the AHCAs

Target:

To monitor per capita expenses through the provision of regular reports.

Information source/reporting frequency:

Budget papers.


For the three components of Medicare, real growth in per capita expenditure was 5.7 per cent, rising from $1,123 per capita in 2003-04 to $1,187 in 2004-05. The per capita expenditure has increased by
35 per cent in real terms over the past ten years.

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Figure 2.4: Australian Government real per capita outlays on PBS, MBS and AHCAs (constant 2004-05 dollars); 1991-92 to 2004-05

 Australian Government real per capita outlays on PBS, MBS and AHCAs
Text description

Source: The Department of Health and Ageing and the Health Insurance Commission data


Notes
1. Outlays deflated using the non-farm Gross Domestic Product (GDP) implicit price deflator.
2. MBS refers to the Medicare Benefits Scheme.
3. PBS refers to the Pharmaceutical Benefits Scheme.
4. AHCAs refers to the Australian Health Care Agreements. Included are 2003-2008 AHCAs, AHCAs, 1993-1998 Medicare Agreements and the 1988-1993 Medicare Agreements. Each Agreement contains a slightly different suite of programs. The 1998-2003 AHCAs includes funding to the states/territories under the National Health Development Fund. The 2003-2008 AHCAs includes funding to the states/territories under the Pathways Home program.
5. Outlays are on a cash basis from 1991-92 to 1998-99 and on an accrual basis from 1999-2000 to 2004-05.
6. The Department’s outcome and outputs structure commenced in 1999-2000 and the AHCA funding represented since then includes both outcome 2 and outcome 4 allocations. Outcome 4 contributes less than 2 per cent annually of total funding under the AHCAs.



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Indicator 11. Trends in workforce changes due to medical indemnity costs

Target:

Workforce levels for highrisk specialty groups such as surgeons, obstetricians and procedural general practitioners do not decline due to medical indemnity costs.

Information source/reporting frequency:

Budget papers.

  • Medicare data on workforce figures;
  • utilisation of MBS items by high risk specialty groups;
  • utilisation of MBS specialty item numbers by general practitioners;
  • Premium Support Scheme, High Cost Claims Scheme and Incurred But Not Reported Indemnity Scheme expenditure data; and
  • premiums for high-risk specialties after premium support.

According to MBS utilisation of specialty numbers, there was no significant reduction in procedural general practitioners, obstetricians and neurosurgeons in 2004-05 compared with 2003-04. In addition, the Department is provided with medical indemnity premium data, which is then used by the Australian Government to track the effectiveness of the Government's medical indemnity framework and to improve the operation of medical indemnity schemes in the future. Premium data for 2004-05 will also be used for a report to be released by the Australian Competition and Consumer Commission.

PART 2: PERFORMANCE INFORMATION


Performance Information for Administered Items



Administered Item 1. Access through Medicare to cost effective medical services, medicines and acute health care for all Australians, including:
  • national insurance for medical services through the Medicare Benefits Schedule;
Target: Quantity: Medicare rebates will be provided for an estimated 237 million services.

Result: Target met.

Rebates were provided for an estimated 236.3 million services.

Target: Quantity: Medicare rebates will be provided for an estimated 11.8 services per capita.
Result: Target met. Rebates were provided for an estimated 11.6 services per capita.
  • alternative funding for General Practice;
Target: Quantity: The number of practices taking up the outcomes based elements of the Practice Incentives Program (such as diabetes, cervical screening and participation in activities approved by the National Prescribing Service).

Result: Increase on previous year.

The majority of general practices in Australia participate in the Practice Incentives Program (PIP). At May 2005, there were 4,681 practices (4,646 practices at May 2004) participating in the program, providing 80% of GP care provided to patients nationally. In the May 2005 payment quarter:

  • 26% of PIP practices participated in the Quality Prescribing Initiative;
  • 4,265 (91%) of PIP practices had agreed to participate in the Cervical Screening initiative. Of these practices, 3,103 (73%) practices achieved an outcomes payment for reaching the screening target for women patients in the practice aged 20 to 69 years; and
  • 4,202 (90%) of PIP practices had agreed to participate in the Diabetes Initiative. Of these practices 1,920 practices (46%) practices achieved an outcomes payment for providing an annual cycle of care to more than 20% of their patients.
  • development and support of medical services related to the Medicare Benefits Schedule;
Target: Quality: 100% of new medical services listed for funding under the Medicare Benefits Schedule have been assessed for evidence of safety, effectiveness and cost-effectiveness (see also Departmental Output Group 2).

Result: Target met.

All new medical services listed on the Medicare Benefits Schedule were assessed by the Medical Services Advisory Committee for safety, effectiveness and cost-effectiveness.

  • acces to subsidised medicines through the Pharmaceutical Benefits Scheme;
Target: Quantity: An estimated 173 million Pharmaceutical Benefits Scheme prescriptions will be supplied for general and concessional patients.

Result: Target met.

The number of prescriptions dispensed in 2004-05 subsidised under the Pharmaceutical Benefits Scheme was 170 million. This compared with 165 million in 2003-04.

Target: Quantity: An estimated 8.5 Pharmaceutical Benefits Scheme prescriptions per capita will be supplied.
Result: Target met. The average number of PBS scripts supplied per capita was 8.3 for 2004-05, compared with 8.2 for 2003-04.
Target: Efficiency: Cost of approved price increases to existing Pharmaceutical Benefits Scheme items compared with increases in previous years.
Result: Target met. Price increases as a result of Pharmaceutical Benefits Pricing Authority recommendations amounted to $9.8 million in 2004-05, compared with $4.8 million in 2003-04.


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  • development and support of services related to the Pharmaceutical Benefits Scheme;
Target: Quantity: Percentage of drugs listed on the Pharmaceutical Benefits Scheme which were subjected to evidence-based assessment of comparative effectiveness and cost.

Result: Target met.

In 2004-05, there were 661 drugs listed on the PBS of which 49% have been subjected to evidence-based assessment.

See Figure 2.5.

Target: Efficiency: Pharmacist remuneration as a proportion of Pharmaceutical Benefits Scheme outlays.
Result: Target met.

In 2004-05, the PBS pricing formula provided allowances for pharmacist dispensing fees and pharmacy retail mark ups representing 24.16% of all PBS outlays, compared to 24.5% in 2003-04.

The formula also provided 9.55% of PBS outlays as allowance for the wholesale distribution of PBS medicines. This allowance is also paid to pharmacists.




Figure 2.5: Percentage of PBS Drugs Subject to Cost Effectiveness Requirements

Percentage of PBS Drugs Subject to Cost Effectiveness Requirements
Text description

Source: The Department of Health and Ageing.

Quantity: Percentage of Pharmaceutical Benefits Scheme benefits paid for pharmaceuticals listed following evidence based assessment of comparative effectiveness and cost.

  • access to public hospital services for public patients;
Target: Quality: Performance levels for emergency department and elective surgery waiting times relative to performance standards.
Result: Slight improvement from 2002-03 (Table 2.1); and slight deterioration from 2002-03(Table 2.2). Figures on the waiting times for emergency departments and elective surgery are set out in Table 2.1 and Table 2.2 at the end of this chapter.
Target: Quantity: Number of public patient weighted separations per 1,000 weighted population.
Result: Increase on previous year. The number of public patient weighted separations per 1,000 weighted population for 2004-05 are currently unavailable. On the data currently available for 2003-04, a national average of 184.91 public patient separations per 1,000 weighted population was achieved.
  • access to private medical services through the implementation of the medical indemnity package;
Target: Quantity: Value of premium support payments made to Medical Indemnity Insurers.
Result: Not applicable. The value of premium support payments made to Medical Indemnity Insurers was $25.7 million.
Target: Quantity: Number of doctors receiving premium support payments.
Result: Increase on previous year. The number of doctors that received premium support payments in 2004-05 was 4,441. This is around four times as many as participated in the Medical Indemnity Subsidy Scheme in 2003-04.
Target: Quantity: Payments made to Medical Indemnity Insurers for claims made under the Incurred But Not Reported liabilities scheme.
Result: Not applicable. The value of payments made to Medical Indemnity Insurers for claims made under the Incurred But Not Reported liabilities scheme was $8.7 million compared to $5.2 million in the 8 months from 1 November 2003 to 30 June 2004.
Target: Quantity: Value and number of claims lodged under the High Cost Claims Scheme.
Result: Not applicable. The High Cost Claims Scheme has continued to accrue liabilities during 2004-05. The accrual of these liabilities has reduced costs across the medical indemnity industry and put downward pressure on medical indemnity premiums.
Target: Quantity: Payments made to Medical Indemnity Insurers for claims made under the Run-Off Cover Scheme.
Result: Not applicable. In 2004-05, the first full year after its implementation the Run-Off Cover Scheme accrued liabilities arising from potential claims. No claims were lodged by Medical Indemnity Insurers under the Run-Off Cover Scheme in 2004-05. However, the scheme will allow the payment of accrued claims once lodged by Medical Indemnity Insurers.


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  • affordable Medicare services (bulk billing incentives);
Target: Quantity: Percentage of GP attendances by concessional patients and children aged under 16 years where no gap fee is charged.
Result: No target number specified in 2003-04.

In 2004-05, the percentage of GP attendances by concessional patients and children under 16 where no gap fee is charged:

  • 84.3% of GP attendances (excluding practice nurse items); and
  • 84.8% of GP attendances (including practice nurse items).
Target: Quantity: Number of Medicare services claimed by GPs for bulk billing concessional/ child patients.
Result: No target number specified in 2003-04.

In 2004-05, the number of Medicare services claimed by GPs for bulk billing concessional/child patients:

  • 49.8 million GP attendances (excluding practice nurse items); and
  • 51.9 million GP attendances (including practice nurse items).
  • affordable Medicare services (safety nets); and

Target: Quantity: Number of families/individuals that are benefiting including:

  • concession card holders;
  • people covered by the Family Tax Benefit (A); and
  • other general population.
Result: Target met. 191,590 families and individuals have either received extended Medicare safety net benefits or will receive benefits when their claims have been substantiated.
Target: Quantity: Number of families registering for the MBS safety net including families of concession card holders.
Result: Increased from previous year. At 30 June 2005, a total of 3,898,855 families were registered for the Medicare safety net, compared with 2,956,733 registered families in 2003-04.
Target: Quantity: Average benefits provided.
Result: It was inappropriate for the safety net to have a separate benefit total as it is only a part of the total Medicare Benefit.
Target: Quantity: Total benefits provided.
Result: Increased from previous year. A total of $244 million was provided for Medicare Safety nets in 2004-05.
  • access to services.

Target: Quantity: Percentage of eligible practices participating in the practice nurse initiative.

Result: Increased from previous year. In May 2005, over 75% of eligible PIP practices in rural areas received support to employ a practice nurse or Aboriginal health worker. This is an increase of 2% from May 2004. In urban areas of workforce shortage, 49% of eligible practices received support to employ a practice nurse or allied health worker. This is an increase of 6% from May 2004.
Target: Quantity: Number of GPs participating in the PIP procedural loading initiative.
Result: Increased from previous year. In May 2005, a PIP procedural GP payment was made to 340 (291 in May 2004) practices for services provided by 761 procedural GPs. It is estimated that over 75% of procedural GPs are participating in this initiative. Payments of $3.2 million were made in 2003-04 and $3.3 million in 2004-05.
Target: Quantity: Number of aged care residents provided with a Comprehensive Medical Assessment on entry to an aged care home or where required.
Result: Target met. 24,471 residents were provided with a Comprehensive Medical Assessment in the programs first year.
Target: Quantity: Number of patients with Enhanced Primary Care plans who access allied health services and/or dental services under the new Medicare items.
Result: Target met. Over 85,000 patients benefited from access to the new rebates under Medicare for allied health or dental care services. Uptake for this new measure is still building. A delay in getting GPs, allied health providers and dentists involved was not unexpected.
Target: Quantity: Number of Aboriginal and Torres Strait Islander people who access two-yearly adult health checks.
Result: Target met. 7,759 Aboriginal and Torres Strait Islander adults have received a health check from May 2004 to May 2005. The monthly uptake rate has risen from 249 in May 2004 to a peak of 753 in March 2005.


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Performance Information for Departmental Outputs


Output Group 1. Policy advice, including:
  • development of 2005-06 Budget measures that contribute to the Government's health and fiscal objectives;
  • advice to the Minister on financing arrangements in health; and
  • consideration of possible improvements to the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme.

Target: Quality: A high level of satisfaction of the Ministers, Parliamentary Secretary and Ministers’ Offices with the relevance, quality and timeliness of policy advice.

Result: Target met. The Minister and Minister’s Office were satisfied with the relevance, quality and timeliness of policy advice, Question Time Briefs, Parliamentary Questions on Notice and briefings.
Target: Quality: Timely production of evidence-based policy research.
Result: Target met. Evidence-based policy research undertaken by the Department was produced in a timely manner, such as, policy research into the provision of rebates to assist with the management of home dialysis for patients with end-stage renal failure awaiting transplant.
Target: Quality: Opportunity for stakeholders to participate in policy and program development.
Result: Target met.

Stakeholders representing the health professions (including medical, pharmacy, nursing, dental, and optometry), medical and pharmaceutical manufacturing industries and consumers participate in policy and program development for the MBS, PBS and the National Medicines Policy.

In order for stakeholders to participate in the policy and program development of MBS changes, Medicare Benefit Consultative Committee meetings are held between representatives from the relevant professional groups, the Australian Medical Association, the Health Insurance Commission and the Department.

In 2004-05:

  • 7 Medicare Benefit Consultative Committee and 1 Optometrical Benefit Consultative Committee meetings were convened;
  • meetings and consultations with stakeholders were held; and
  • input to Senate inquiries on cancer and mental health was provided.

During 2004-05, the Medical Services Advisory Committee (MSAC) received 30 submissions and provided enhanced opportunities for stakeholder participation in the MSAC process.

The Australian Medical Association, Royal Australian College of General Practitioners, Rural Doctors Association of Australia and the Australian Divisions of General Practice have been involved in the progress of the Red Tape Review recommendations including the development of new Chronic Disease Management items, through the PIP and EPC Review Advisory Group and the Medicare Benefits Consultative Committee.


Output Group 2. Program management, including:
  • managing the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme estimates;
  • making payments to the States and Territories under the Australian Health Care Agreements;
  • financial management and reporting on Outcome 2;
  • managing partnership arrangements with the Health Insurance Commission for delivery of functions in relation to Outcome 2;
  • management of contracts to support policy development;
  • administration of grant programs;
  • successful implementation of Budget initiatives;

Target: Quality: Budget predictions are met and actual expenses vary less than 5% from budgeted expenses.

Result: Target met.

Actual expenses for Outcome 2 were $24,744 billion compared to a predicted $24,709 billion. Overall expenses were 0.14% from estimates.

Actual expenses vary less than 5% from budgeted expenses for PB Other Special Appropriation and Aids and Appliances Special Appropriation.

Target: Quality: 100% of payments are made accurately and in accordance with negotiated service standards.
Result: Target met. All payments required to be made in respect of the Department’s contractual obligations were made on time.
Target: Quantity: Approximately 37 grants, 79 consultancies/contracts and 160 funding agreements (including 8 AHCAs) administered.
Result: Target not met.

Total agreements administered in 2004-05:

  • 20 grants;
  • 56 consultancies/contracts; and
  • 155 funding agreements.
  • ongoing development and maintenance of the Medicare Benefits Schedule;
  • ongoing development and maintenance of the Pharmaceutical Benefits Scheme;

Target: Quality: All new listings included on the Schedule of Pharmaceutical Benefits have been assessed for evidence of safety, effectiveness and cost effectiveness.

Result: Target met. All listings for new drugs included on the PBS have been assessed for evidence of safety, effectiveness and cost effectiveness.
Target: Quality: All new medical services listed in the Medicare Benefits Schedule have been assessed for evidence of safety, effectiveness and cost effectiveness.
Result: Target met. All new medical services were listed on the MBS following assessment by the Medical Services Advisory Committee.
Target: Quality: Time taken to assess applications to the Medical Services Advisory Committee for public funding of new medical services.
Result: Increased from previous year.

The average time for all completed reviews increased slightly from 13 months in 2003-04 to 15.9 months in 2004-05. The increased average review time is attributable to the increased involvement by stakeholders in the assessment process in line with the outcomes of the Medical Services Advisory Committee Review.

Target: Quality: Time taken to process new submissions for listing on the Schedule of Pharmaceutical Benefits. In 2003-04 all submissions for listing a medicine on the Pharmaceutical Benefits Scheme received by the relevant close off time were processed and considered by the appropriate advisory committees within agreed timeframes.
Result: Target met.

All applications for listing a medicine on the PBS received by the due date were processed by the Department within the agreed timeframes (i.e. 17 weeks) from lodgement of the application to consideration by the Pharmaceutical Benefits Advisory Committee (PBAC). All positive PBAC recommendations were considered at the next Pharmaceutical Benefits Pricing Authority meeting, unless withdrawn by sponsors.

During 2004-05, the Pharmaceutical Benefits Advisory Committee received 129 submissions for new or varied PBS listings. This compares to 88 submissions in 2003-04.

Target: Quantity: Number of new listings on the Medicare Benefits Schedule. There were 56 new listings in 2003-04.
Result: Increase from previous year. There were 214 new MBS listings in 2004-05.
Target: Quantity: Item descriptions amended on the Medicare Benefits Schedule. There were 132 descriptions amended in 2003-04.
Result: Decrease from previous year. There were 109 item descriptions amended in 2004-05.

Target: Quantity: Number of new listings on the Pharmaceutical Benefits Scheme.

  • There were 18 new drugs (chemical entities) listed on the Schedule of Pharmaceutical Benefits in 2003-04.
  • There were 177 new forms and strengths (items) and 90 new brands listed on the Schedule of Pharmaceutical Benefits in 2003-04.
Result: Decrease in number of listings. There were 23 new drugs (chemical entities), 90 new forms and strengths (items) and 82 new products (brands) listed on the Schedule of Pharmaceutical Benefits in 2004-05.
Target: Quantity: Number of listings amended on the Pharmaceutical Benefits Scheme. There were 203 amendments to PBS listings (such as changes to eligibility rules and maximum quantities and repeats) included in the Schedule of Pharmaceutical Benefits in 2003-04.
Result: Decrease from the previous year. There were 150 amendments to already listed PBS drugs (such as changes to eligibility rules and maximum quantities and repeats) included in the Schedule of Pharmaceutical Benefits in 2004-05.


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  • development of information activities for 2004-05 include: consumer, evidence-based, education strategy regarding safe and correct use of medicines;

Target: Quality: Information campaigns conducted during the year are evaluated as being effective.

Result: Target met. Media profile of Medicare has been high as a result of new initiatives to extend and strengthen the program and community perception of Medicare as reported in the media appears positive. This positive community perception of Medicare would, therefore, suggest that the Department’s information campaigns have been effective.
Target: Quality: A high level of stakeholder satisfaction with the relevance, quality and timeliness of information and education services.
Result: Target met.

Stakeholders have indicated a high level of support and satisfaction with the timeliness, quality and relevance of information and education services. In particular, stakeholders have demonstrated a high level of enthusiasm to be involved in data collections which have as a result progressed in both scope and size. Stakeholder satisfaction was achieved through:

  • advice provided by the Department was delivered in a timely manner;
  • education and consultation campaigns are developed in close consultation with stakeholders; and
  • information campaigns conducted under Outcome 2 throughout 2004-05 was generally successful and stakeholders are satisfied with their relevance, quality and timeliness.
Target: Quantity: An estimated 35,000 calls to the Pharmaceutical Benefits Scheme information line.
Result: Decrease calls to PBS information line. 33,758 calls were received by the Pharmaceutical Benefits Scheme Information Line. Of these 33,725 (99.90%) were satisfied with the customer service provided, 20 (0.06%) were dissatisfied and 13 (0.04%) were abusive.
  • production of the Medicare Benefits Schedule (and supplements) covering more than 4,500 individual items; including the Optometrical Services Schedule and the Cleft Lip and Palate Schedules;
  • production of the Pharmaceutical Benefits Scheme schedule (and supplements) covering approximately 2,500 individual drug items;

Target: Quality: Production of Medicare Benefits Schedule Supplement by 1 May 2005.

Result: Target met. 52,000 copies of the MBS supplement were distributed to doctors, hospitals, health insurance funds, software developers and Health Insurance Commission offices.
Target: Quality: Three revisions of the Schedule of Pharmaceutical Benefits, produced by 1 August 2004, 1 December 2004 and 1 April 2005 respectively.
Result: Target met.

The Department prepared three issues of the Schedule of Pharmaceutical Benefits in August 2004, December 2004 and April 2005. 52,066 schedules were distributed on time.

  • continued implementation of public hospital funding arrangements, the Diagnostic Imaging and Pathology Agreements, and the Community Pharmacy Agreement;

Target: Quality: A high level of stakeholder satisfaction with the timely development and implementation of national strategies.

Result: Target met. Stakeholders are generally satisfied with the timely development and implementation of national strategies. Despite significant investment by the Department in stakeholder consultation during 2004-05, stakeholders did not express satisfaction with all strategies and implementation arrangements, especially where there are funding constraints. For example, the pharmaceutical industry generally opposed the reference pricing policies under the PBS, arguing that this suppresses the prices of some medicines. On the other hand, the medical profession welcomed the extended Medicare safety net to assist patients with out of pocket costs of private medical services. While it is unrealistic to expect stakeholder satisfaction with all policies and implementation strategies in this area, a high level was maintained.
  • production of the State of our Public Hospitals Report;
  • implementation of the 2003-08 Australian Health Care Agreements; and

Target: Quality: Production of the State of our Public Hospitals Report by 30 June 2005.

Result: Target met. Report completed and publicly released on 29 June 2005 in accordance with the requirements of the Australian Health Care Agreements (AHCAs) (Clause 4, Schedule C).
Target: Quality: All key milestones and results areas for 2004-05 specified in the AHCAs are implemented on time.
Result: Target met.

All key milestones for 2004-05 were implemented on time as specified in the AHCAs:

  • agreement to a new standardised system for determining recurrent health expenditure by 30 June 2005 (Clause 36);
  • agreement to new performance indicators on rehabilitation and geriatric evaluation and management services by 31 December 2004 (Schedule B, Clause 14); and
  • design of an approved outpatient care National Minimum Data Set completed in February 2005 and approved by the registration authority in March 2005 (Schedule C, Clause 6(g)).
  • implementation of the new package of Medical Indemnity measures announced on 17 December 2003.

Target: Quality: The Premium Support Scheme, United Medical Protection support arrangements, and the Run-Off Cover Scheme are operational in agreed timeframes.

Result: Target met. The Premium Support Scheme, the Run-off Cover Scheme and the United Medical Protection support arrangements were implemented within agreed timeframes.


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PERFORMANCE ASSESSMENT: EVALUATIONS AND REVIEWS


Evaluation/Review: Cervical Screening Incentives for General Practitioners Program.

Timeframe:

 

Related Performance Indicator:

URL/Web Address for published results:

Commencement date: August 2004.

End date: September 2004.

The number of practices taking up the outcomes based elements of the Practice Incentives Program (such as diabetes, cervical screening and participation in activities approved by the National Prescribing Service).

Not applicable.

Evaluation/Review: Home Medicines Review Program.

Timeframe:

Related Performance Indicator:

 

 

 

 

URL/Web Address for published results:

Commencement date: July 2004

End date: October 2004

Departmental Output Group 2.

  • development of information activities for 2004-05 include:
  • consumer, evidence-based, education strategy regarding safe and correct use of medicines;

A high level of stakeholder satisfaction with the relevance,quality and timeliness of information and education services.

Not applicable.

Evaluation/Review: Review of Competitive Neutrality in the Medical Indemnity Insurance Market.

Timeframe:

 

Related Performance Indicator:

URL/Web Address for published results:

Commencement date: 7 December 2004.

End date: 15 March 2005.

Indicator 11.

 

<www.health.gov.au/internet/wcms/publishing.nsf/Content/health-medicalindemnity-competitiveneutrality>.


Table 2.1 Australian Health Care Agreements: 2003-04 Performance - Emergency Department Waiting Time
Levels achieved (per cent)
  Resuscitation Emergency Urgent Semi-urgent Non-urgent
New South Wales 100 76 58 65 86

Victoria
100 88 83 75 89

Queensland
100 76 56 57 84
Western Australia 100 72 68 67 92

South Australia
94 65 49 54 85

Tasmania
96 67 61 61 92

Australian Capital Territory
100 69 64 58 77

Northern Territory
100 57 63 59 86

National average
99 77 64 65 87

Source: Data provided by the states and territories under the Australian Health Care Agreements (AHCA).

Notes:
Category 1 - patients need resuscitation and require treatment immediately (eg cardiac arrest);
Category 2 - patients are deemed to be ‘emergencies’ and require treatment within 10 minutes (eg chest pain);
Category 3 - patients are deemed to be ‘urgent’ and require treatment within 30 minutes (eg moderate trauma);
Category 4 - patients are defined as ‘semi-urgent’ and require treatment within 1 hours; and
Category 5 - patients are defined as ‘non-urgent’ and require treatment within 2 hours.



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Table 2.2 Australian Health Care Agreements: 2003-04 Performance - Elective Surgery Waiting Times


Levels achieved (per cent)
  Category 1 Category 2 Category 3
New South Wales 80 76 87

Victoria
100 80 93

Queensland
91 90 87
Western Australia 83 72 92

South Australia
82 81 93

Tasmania
64 51 61

Australian Capital Territory
98 52 71

Northern Territory
81 69 85

National average
85 80 89

Source: Data provided by the states and territories under the AHCAs.

Notes:
Category 1 - admission within 30 days desirable for a condition that has the potential to deteriorate quickly to the point it may become an emergency;
Category 2 - admission within 90 days desirable for a condition causing some pain, dysfunction or disability but which is not likely to deteriorate quickly;and
Category 3 - admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability, which is unlikely to deteriorate quickly and which does not have the potential to become an emergency (while no time frame is specified for category 3, ‘within 12 months’ is a widely used measure for this category).




Figure 2.2 Distribution of Australian Pharmacies by Urban and Rural Areas 2005

State / Territory
Number of pharmacies
Number of people per Pharmacy
  Urban Rural Urban Rural
NT 18 9 5,151 12,850
WA 402 84 3,583 4,871
QLD 780 172 3,631 4,773
SA 303 81 3,787 3,939
NSW 1,459 247 3,632 4,339
ACT 58 - 5,378

-

VIC 996 151 3,942 4,753
TAS 83 48 3,330

3,736

Australia 4,099 792 3,739 4,591

Urban = PhARIA 1

Rural = PhARIA 2-6




Return to figure 2.2


Figure 2.3 Australian Government real outlays on PBS, MBS and AHCA's
Financial year expenditure billion
1991-92 12.7 billion
1992-93 13.6 billion

1993-94

14.9 billion
1994-95 15.8 billion
1995-96 16.5 billion
1996-97 16.5 billion
1997-98 17.2 billion
1998-99 18.5 billion
1999-00 19.5 billion
2000-01 20.2 billion
2001-02 $21.1 billion
2002-03 $21.9 billion
2003-04 $22.5 billion
2004-05 $24.0 billion


Return to figure 2.3


Figure 2.4: Australian Government real per capita outlays on PBS, MBS and AHCAs (constant 2004-05 dollars); 1991-92 to 2004-05

Financial year expenditure
1991-92 $728
1992-93 $774

1993-94

$841
1994-95 $877
1995-96 $906
1996-97 $894
1997-98 $923
1998-99 $984
1999-00 $1,023
2000-01 $1,050
2001-02 $1,082
2002-03 $1,108
2003-04 $1,123
2004-05 $1,187


Return to figure 2.4


Figure 2.5 Percentage of PBS Drugs Subjected to Cost Effectivness Requirements

Financial year Percentage
1991-92 2
1992-93 4

1993-94

7
1994-95 14
1995-96 20
1996-97 27
1997-98 33
1998-99 36
1999-00 39
2000-01 40
2001-02 42
2002-03 44
2003-04 46
2004-05 49


Return to Figure 2.5


Produced by the Portfolio Strategies Division, Australian Government Department of Health and Ageing.
URL: http://www.health.gov.au/internet/annrpt/publishing.nsf/Content/performance-indicators-2
If you would like to know more or give us your comments contact: annrep@health.gov.au