Expenditure on admitted patient palliative care
Box 1: Admitted patient palliative care
According to the Independent Health and Aged Care Pricing Authority (IHACPA), admitted palliative care is a form of subacute care in which the primary clinical purpose or treatment goal is optimisation of the quality of life of a patient with an active and advanced life-limiting illness. The patient will have complex physical, psychosocial or spiritual needs.
Palliative care is always:
- delivered under the management of or informed by a clinician with specialised expertise in palliative care
- evidenced by an individualised multidisciplinary assessment and management plan which is documented in the patient’s medical record. The plan must consider the physical, psychological, emotional, social and spiritual needs of the patient, as well as include negotiated goals (IHACPA 2024).
Further information on how admitted patient palliative care is identified through the National Hospital Cost Data Collection can be found in Technical information: Data sources – May release.
In 2021–22 (Figure 1):
- 261 public hospitals reported admitted patient palliative care data to the IHACPA, with a hospital cost of $532.5 million on admitted palliative care. This represents 17% of all subacute care cost ($3.1 billion) and 1.1% of total cost ($48.6 billion) in these hospitals (Table 1).
- The types of costs (line item) linked to salaries and wages accounted for 67% of all admitted patient palliative care cost. In salaries and wages streams, nursing accounted for the biggest share (51%), followed by medical and allied health (19% and 8.6%, respectively).
- For costs by hospital function (cost centre), 9 in 10 (89%) admitted patient palliative care costs were for clinical, followed by allied health and pharmacy (5.3% and 2.4%, respectively).
- When combining costs by hospital function and types of costs (cost bucket), wards accounted for the biggest share (61%) of all admitted patient palliative care cost – 34% for ward nursing, 15% for ward medical and 13% for ward supplies.
Between 2017–18 and 2021–22 (Figure 1):
- The number of hospitals reporting admitted patient palliative care data to the IHACPA declined by 18% between 2018–19 and 2019–20 (276 to 225). It then increased by 16% (to 261) in the following 2 years to 2021–22 – with a larger annual increase in 2020–21 compared to 2021–22 (15% and 0.8% increase, respectively). Meanwhile, the total number of hospitals reporting data to the IHACPA increased each year between 2017–18 and 2021–22 (453 to 667), with an average annual increase at 10%.
- Broadly consistent with the pattern observed for the number of hospitals reporting admitted patient palliative care data, the total expenditure on this care declined by 4.6% between 2018–19 and 2019–20 ($462.4 million to $441.3 million, or a 5.8% decline from $497.4 million to $468.4 million after adjusting for inflation). It then increased by 21% (to $532.5 million) in the following 2 years to 2021–22 (a 14% increase after adjusting for inflation) – the annual increase rate was similar in 2020–21 and 2021–22 (around 10%, or 6%–7% after adjusting for inflation).
Figure 1: Expenditure on admitted patient palliative care in public hospitals
Figure 1.1: This interactive bar graph shows expenditure on admitted patient palliative care in public hospitals, by selected characteristics in 2021–22.
Figure 1.2: This line graph presents number of public hospitals and expenditure on admitted palliative care in these hospitals between 2017–18 and 2021–22.
Reference
IHACPA (Independent Health and Aged Care Pricing Authority) (2024) Subacute and non-acute care, IHACPA, Australian Government, accessed 15 February 2024.