Expenditure on palliative care
This chapter provides information related to expenditure on palliative care, sourced from the National Hospital Cost Data Collection (NHCDC), Medicare Benefits Schedule (MBS), and Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS). It is a new chapter that brings together all the expenditure data currently reported in Palliative care services in Australia into one chapter to improve the accessibility of this information.
Note that the expenditure reported in this chapter does not include all palliative care expenditure due to data availability. Further information about how the expenditure on palliative care is identified through these available data sets is provided in Technical information: Data sources – May release.
The information in this chapter was last updated in May 2024.
Key points
In 2021–22:
- 261 public hospitals reported admitted patient palliative care data to the Independent Health and Aged Care Pricing Authority, with a total hospital cost of $532.5 million on admitted palliative care.
- 181 public hospitals reported non-admitted patient palliative care data to the Independent Health and Aged Care Pricing Authority, with a total hospital cost of $154.2 million on non-admitted palliative care.
In 2022–23:
- The benefits paid for Medicare-subsidised palliative medicine attendance and case conference services provided by palliative medicine physicians or specialists was $5.4 million, at an average of $390 per patient.
- The Australian Government spent $36.6 million on palliative care-related medications from the Palliative Care Schedule, at an average of $81 per patient.
- Pain relief prescriptions comprised 87% ($31.7 million) of the expenditure on palliative care-related medications, followed by prescriptions for gastrointestinal symptoms and neurological symptoms (7.9% and 3.4%, respectively).
| Key concept | Description |
|---|---|
Cost bucket | According to National Hospital Cost Data Collection (NHCDC), cost buckets represent different combinations of the line items and costs centres and can be considered as cost pools within the hospital. |
Cost centre | According to National Hospital Cost Data Collection (NHCDC), cost centres represent departmental cost, objects within a hospital that relate to a particular function of the hospital – for example, the hospital operating room. |
Line item | According to National Hospital Cost Data Collection (NHCDC), line items represent types of costs (for example, salaries and wages or goods and services) incurred by hospitals which are reported on in the general ledgers of hospitals. |
Palliative care-related prescriptions | Palliative care-related prescriptions are defined as medications listed in Palliative Care Schedule under the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS). Information on prescription medicines has been sourced from the processing of the PBS and RPBS. It refers to medications prescribed by approved prescribers and subsequently dispensed by approved suppliers (community pharmacies or eligible hospital pharmacies). Consequently, it is a count of medications dispensed, rather than a count of prescriptions written by clinicians. |
Palliative medicine | Palliative medicine is defined as the specialist care of people with terminal illnesses and chronic health conditions in community, hospital, and hospice settings. Palliative medicine physicians work collaboratively with a multidisciplinary team of health professionals to provide end-of-life care, provide relief from pain and symptoms of illness, and optimise the quality of life for a patient. Palliative medicine treats the physical aspects of illness, but also integrates psychological and spiritual facets of patient care. |
Palliative medicine physician/ specialist | Medical practitioner who, to be eligible for payment of Medicare Benefits Schedule (MBS) subsidies for palliative care services, must be a Fellow of the Royal Australasian College of Physicians who has completed the College training program in palliative medicine, or a Fellow of the Australasian Chapter of Palliative Medicine, or a Fellow of both. |
Patient co-payment | Under the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS), the cost of prescription medicines is subsidised by the Commonwealth government. Patients are classified as either general or concessional and are required to pay a patient co-payment towards the cost of their prescription, according to their entitlement. As of 1 January 2023, the co-payment was $30.00 (general) and $7.30 (concessional, including repatriation). |
Specialist attendance | A specialist attendance usually requires a referral from a general practitioner. A specialist attendance is a referred patient-doctor encounter (with Medicare funding benefits), such as a visit, consultation, and attendance (including a telehealth) with a medical practitioner who has been recognised as a specialist or consultant physician for the purposes of Medicare benefits. |
Subsidised prescription | A Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) prescription is subsidised when the dispensed price of a medication exceeds the patient co-payment. The PBS and RPBS covers the difference between the full cost of the medication and the patient co-payment. |
Under co-payment prescription | A prescription priced below the co-payment as defined in the National Health Act 1953. A Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) prescription is classified as under co-payment when the dispensed price of the prescription does not exceed the patient co-payment, and the patient pays the full cost of the medication. |