澳大利亚医疗保健概述

澳大利亚的卫生系统以医疗保险制度为基础，这是一项全民健康保险计划.

医疗支出由国家税收提供资金(43%), 州和地区政府税收(28%), 患者自付费用(14%), 私人健康保险(8%)和事故赔偿计划(7%)[1].

Medicare is funded by the national 政府ernment through taxation revenue known as Medicare Levy (currently at 2% of taxable income). 大约45%[2] of the population also has private health insurance (PHI) and the national 政府ernment encourages residents to take PHI through additional levies and subsidies. Residents who do not have an appropriate level of PHI are charged an additional Medicare Levy Surcharge between 1-1.应纳税所得额的5%，根据年龄和收入. The national 政府ernment also charges a Lifetime Health Cover loading if a resident takes PHI later in life, 年龄在31岁以上的人每年要多交2%的个人健康保险保费. 较高的保费适用于最多10年的连续PHI保险. 作为额外的激励, residents with PHI are eligible for a Private Health Insurance Tax Rebate at the end of each financial year. 这是基于年龄和收入，在8.2% – 32.8%[3].

Healthcare policy and Medicare are managed nationally through the Department of Health and Aged Care. 医疗保健的提供主要由两级政府管理.

国家(联邦)政府管理初级保健的提供, 药品, 治疗用品和老年护理. 初级保健的管理下放给31个初级保健网络。, who co-ordinate and commission primary health services within their region to meet the needs of their population.

6个州和2个地区政府管理公立医院, 救护车, 公共牙科服务, 社区卫生, 住院精神健康服务和一些老年护理服务. 每个国家都有自己的医疗体系、法规和政策. All manage public hospitals and 社区卫生 services via some form of local hospital network (LHN).  Each LHN manages a single or cluster of public hospitals in a geographic area and is responsible for co-ordinating public hospital services and any associated 社区卫生 services in that region.

The state/territory 政府ernments are responsible for registering and licensing private hospitals and the health workforce. Any new or modified services must be approved and audited by the state/territory health department prior to commissioning. 国家政府负责药品的管理.

The 澳大利亚n Commission on Safety and Quality in Healthcare develops national safety and quality standards and clinical care standards for hospitals. Each state/territory 政府ernment decides which standards are mandatory for implementation in their jurisdiction, 哪些是通过认证程序进行测试的.

澳大利亚的医疗保健资金

所有居民都可以在医疗保险的公共卫生系统中获得免费医疗保健. The national 政府ernment sets the rates Medicare will pay for primary and specialist care under the Medical Benefits Scheme (MBS). 如果按公布的mbs费率收费, 医疗保险覆盖全科医生就诊的100%费用(称为“批量计费”)。, 公立医院护理, 门诊专家费用的85%. 如果全科医生或专科医生的收费高于抵押贷款支持证券, 病人必须用自付费用或私人健康保险来填补缺口, 取决于服务交付的位置.

Prescription medications are also subsidised to provide them at a discounted cost via the Pharmaceutical Benefits Scheme (PBS). 医疗保险不包括牙科检查或治疗的费用, 救护车服务, 私人专职保健(e.g. 门诊物理治疗, 职业治疗, 言语病理学, 足部医疗服务), 或眼镜或所有的家庭护理(通常需要共同支付).

All healthcare services provided in a public hospital are funded based on activity via diagnosis-related groups (DRG). 所有居民在公立医院免费接受治疗, 然而，病人不能选择自己的专科医生. 患者可以选择在他们选定的专科医生的私人机构接受治疗.

Specialist services performed in a private hospital are funded for 85% of the Medicare-set rate, 只要治疗被列在MBS上. 余下15%的专科诊疗费和住院费(如.g. 住宿, 剧院, nursing care and food) are paid by private health insurance and/or by the patient (co-payment, 超额或自筹资金). Private hospitals negotiate rates with private health funds to cover the hospital costs for privately insured patients. Each fund will negotiate rates and have their own requirements and performance indicators for reimbursement. 

Private hospitals may receive some funds from self-employed specialists (referred to as Visiting Medical Officers – VMOs) for use of consulting rooms and administrative services.  然而, vmo由医疗保险单独支付, the patient and/or private health fund and will also negotiate with private health funds separately for reimbursement.

对于院外服务，供资将取决于所提供的服务.  门诊专家咨询由联邦医疗保险资助，占MBS费率的85%. 精神卫生资金由国家和州/地区政府共享. 在私立医院提供住院服务时, the cost of the psychiatrist is funded by Medicare and the hospital costs must be covered by the patient and/or private health insurance.

作为门诊服务提供的联合医疗可能由医疗保险资助, 私人医疗保险或病人自筹资金, 这取决于服务，以及它是否在MBS上列出

Prescription medicines are subsidised by the national 政府ernment under the Pharmaceutical Benefits Scheme (PBS). The amount of subsidy depends on the medicine and most patients are required to make a co-payment for prescription medicines.  然而，并不是所有的处方药都在PBS上.

医疗服务提供者

Specialists in 澳大利亚 are typically either employed at public hospitals or are self-employed consultants. Doctors working in public hospitals are either paid a salary by the state/territory health department or a modified fee-for-service based on the MBS.

Some self-employed specialists will practice at a number of private hospitals and may also be contracted to deliver set hours at the public hospitals.

Specialists practicing in private hospitals (VMOs) must be accredited by each hospital’s Medical Advisory Committee to practise at that hospital.  VMO accreditation is reviewed every 3 years and requires the specialist to be registered with AHPRA (澳大利亚n Health Practitioner Regulation Agency), 持有适当的医疗责任保险，并定期进行同行评审.

[1] 2019- 2020年(卫生支出——澳大利亚卫生和福利研究所.政府.au)) 

[2] APRA 2022年6月 季度私人健康保险统计数据| APRA 

[3] ATO 2021-22 -医疗保险和私人健康保险(医疗保险和私人健康保险|澳大利亚税务局(ato.政府.au))

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The information in the ‘全国网赌正规平台的市场’ section of the Ramsay Group’s website is based on information obtained from external sources and is current as at 16 February 2023. Ramsay尚未独立核实本节中提供的信息. 这些信息是摘要形式的，并不一定是完整的.

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