eHealth – Government Services Report 2022

Impact of COVID-19 on Healthcare sector data

COVID-19 may affect the data in this report in several ways. This includes actual performance (i.e. the impact of COVID-19 on service delivery in 2020 and 2021, which is reflected in the data results), and data collection and processing (c i.e. the capacity of the data providers to undertake the data collection and process the results for inclusion in the report).

Pandemic plans and social distancing restrictions introduced in 2020 and 2021 are likely to have had an impact on the healthcare sector. Any impacts specific to the service areas covered in this report are noted in sections 10, 11, 12 and 13. For health sector overview indicators, mortality data by cause of death now identifies COVID-19 deaths separately.

Main objectives of services in the sector

Health sector services are concerned with the promotion, restoration and maintenance of a healthy society with the aim that Australians are born and remain healthy. They involve the prevention of disease, the promotion of health, the detection and treatment of disease and injury, and the rehabilitation and palliative care of people who suffer from disease and injury.

Services included in the sector

  • Primary and community health
    Includes general medicine, pharmaceutical services, dentistry, paramedical services, maternal and child health, alcohol and drug treatment and other services.
  • Ambulance services
    Includes the response and treatment of medical emergencies outside the hospital.
  • Public hospitals
    Includes care provided to admitted and non-admitted patients, including acute and non-acute care and mental health services.
  • Mental health services
    Includes MBS-funded mental health services provided by primary and community health providers, specialist state and territory government mental health services and non-governmental services providing community support.
  • Other major areas of government involvement in health care delivery not covered in the sections on health, or elsewhere in the report, include public health programs, other than those for mental health, and the financing of medical specialists.

Detailed information on the equity, effectiveness and efficiency of service delivery and achievement of outcomes for primary and community health, ambulance, public hospital and mental health services is contained in the service-specific sections.

To note: Data tables are referenced by table xA.1, xA.2, etc., where x refers to the section or overview. For example, Table EA.1 references Data Table 1 for this sector overview.

Public expenditure in the sector

Total Australian government, state and territory recurrent expenditure on health services was estimated at $122.2 billion for the most recent year for which data is available, or approximately 40.6% of government expenditure total services covered by this report. Public hospitals were the largest contributor ($76.7 billion (in 2019-20), Table 12A.1), followed by primary and community health ($41.1 billion (in 2019-20), Table 10A.1) and ambulance services ($4.4 billion (in 2020-21), Table 11A.10). Spending on mental health services was $10.4 billion in 2019-20 (Table 13A.1); however, as much of this expenditure is already accounted for in public hospitals and primary community health expenditure, it is not included in total health expenditure to avoid double counting.

When local government and health care spending outside the scope of this report is added, government spending in 2019-20 was estimated at $142.6 billion.

Flow in the sector

Health services in Australia are delivered by a variety of government and non-government providers in a range of service settings that do not have a clearly defined pathway (Figure E.1). The most common entry points into the healthcare system in Australia are primarily through primary and community health services. Ambulance services and public hospital emergency departments can also be first points of contact. Some patients may then progress through the system to become non-admitted or admitted inpatients (including specialist mental health care) or specialist medical patients. Often a number of cycles of care through various points in the system are required to treat a condition. Finally, some patients will need rehabilitation provided by hospitals or primary and community health services.

Figure E.1 Client flow through the Australian health system

Sector indicators

Four sectoral indicators of governments’ goal that Australians are born and stay healthy are reported. The main risk factors affecting the results of these indicators include overweight/obesity, smoking and risky alcohol consumption (data on these risk factors are available in tables EA.3, EA.7 and EA.9).

Babies born with low birth weight

In 2019, 5.2% of babies born in Australia had low birth weight (Table EA.1). The proportion of low birth weight babies born to Aboriginal and Torres Strait Islander mothers was more than double that of babies born to non-Aboriginal mothers (Figure E.2). Data on the baby’s Aboriginal status are available in Table EA.1.

Some potentially preventable diseases

The potentially preventable diseases selected relate to diseases that could have been prevented through the provision of health interventions and the early management of diseases. Diseases covered in this report include certain cancers, heart attacks and type 2 diabetes.

Nationally in 2018 (excluding the Northwest Territories), the age-standardized rate of new cases for selected cancers was highest for female breast cancer (127.0 per 100,000 women), followed by melanoma, bowel cancer and lung cancer (53.8, 52.9 and 42.6 per 100,000 population respectively) and the lowest for cervical cancer (7.2 per 100,000 women) (Table EA.11). More recent data for 2019 is available for three jurisdictions (Victoria, WA and SA) in Table EA.11.

Nationally, the age-standardized rate of heart attacks (acute coronary events) was 289.0 cases per 100,000 people in 2019 (Table EA.14). The national rate has declined every year over the 10 years included in this report. The rate for women is less than half the rate for men.

Nationally in 2011-2012 (the only year for which data is available), about 4.3% of adults had type 2 diabetes, with rates higher among men than women (Table EA .23).

Life expectancy

The average life expectancy at birth during the period 1901-1910 was 55.2 years for males and 58.8 years for females. It has increased steadily in each decade since, reaching 81.2 years for men and 85.3 years for women in 2018-2020 (Table EA.29). The life expectancy of Aboriginal and Torres Strait Islander men is considerably lower than that of other people with a life expectancy at birth of 71.6 years for Aboriginal and Torres Strait Islander males and 75.6 years for Aboriginal and Torres Strait Islander women born between 2015 and 2017. During the same period, life expectancy at birth for non-Aboriginal males was 80.2 years and that of non-Aboriginal females was 83 .4 years (Table EA.30 (global estimates)).

Mortality rates

The national age-standardized death rate, measured as deaths per 100,000 people, was 488.7 in 2020, down from 2019 (Figure E.3). Consistent with life expectancy data, mortality rates are higher for Aboriginals and Torres Strait Islanders than for non-Aboriginals (Table EA.32).

Perinatal and children

Mortality data are reported separately for children for perinatal deaths (fetal deaths [still births] and neonatal deaths [death of an infant within 28 days of birth]), infant deaths (children aged 0

There were 8.4 perinatal deaths per 1,000 births (Table EA.41) in 2020, of which about 70% were fetal deaths and the rest neonatal deaths (Tables EA.39–41).

Over the past 10 years, the annual infant mortality rate in Australia has varied from an average of 3.1 deaths per 1000 live births (2018 and 2016) to 3.8 deaths per 1000 live births (2011). In 2020, the rate was 3.2 deaths per 1000 live births (Table EA.33). Australia’s combined infant and child mortality rate (3-year average) has declined over time, from 98.9 deaths per 100,000 population in 2009-2011 to 73.1 deaths per 100,000 population in 2018-2020 ( table EA.35).

Causes and Prevention

The most common causes of death among all Australians in 2020 were cancers and diseases of the circulatory system (including heart disease, heart attack and stroke), although rates for both have fallen significantly since 2009 (Table EA.37). Data by Aboriginal status are available in Table EA.38.

Many deaths are potentially preventable with individualized care and/or can be treated through existing primary or hospital care. Nationally, there were 97.4 potentially preventable deaths per 100,000 people in 2020 – the lowest rate for 10 years of data included in this report (Table EA.26). The rate of potentially preventable deaths in 2016-20 for Aboriginal and Torres Strait Islander people was more than three times that of other people, but similar to the total population, the lowest rate over 10 years of data in this report (Table EA. 27).

Download data tables

These data tables relate to the entire sector. Data specific to individual service areas can be found in the data tables under the relevant service area.

  1. AIHW health expenditure database; Australian Bureau of Statistics, Taxation revenue, Australia, 2019–20 (AIHW custom report). Locate footnote 1 above
  2. Australian Bureau of Statistics (ABS) 2010, Deaths Australia 2009, ABS website. Locate footnote 2 above

Ashley C. Reynolds