Utilisation of Private Hospital Insurance Benefits – PHIAC June 2011

Hospital accommodation benefits paid by private health insurers for episodes in freestanding day surgeries in the year ending June 2011 equaled $625 per bed day and $625 per episode. Hospital accommodation benefits paid for public hospitals during the same time period equaled $322 per bed day, and $1,370 per episode. For private hospitals, benefits paid equaled $901 per bed day, or $2,499 per episode. Overall, the average benefit paid per bed day for a privately insured patient was $1,074, or $2,936 per episode.

Selected statistics from the PHIAC Quarterly June 2011 data report  presented in this publication on private health insurance utilisation are presented below.

For the year ending 30 June 2011:

• Of each hospital episode, an average of $2,051 per episode was accounted for by accommodation costs, $468 was accounted for by medical service costs, and $417 per episode was accounted for by prostheses services.

• The total private health insurance benefits paid per insured person was $1,108. For hospital benefits paid per insured person, the figure was $960.
• The average length of stay for a public hospital episode was 4.3 days, and for a private hospital episode, 2.8 days. Overall, the average length of stay for an episode in any hospital was 2.7 days.
• The average length of stay for an overnight public hospital episode was 6.82 days. For an overnight private hospital episode, the average length of stay was 5.24 days.
• There were 49 free-standing day surgery bed days utilised during the year ending June 2011 per 1,000 insured persons, with 209 public bed days and 636 private bed days for the same period. Overall, 894 hospital bed days were used per 1,000 insured persons during the period.
• The average benefit paid for an allied health service was $46, with the average cost per service at $95. The benefits paid by private health insurers for allied health services represented 49% of the costs of these services.
• The average benefit paid per dental service was $56, with $63 being paid per optical service, $29 per physiotherapy service, $34 per podiatry service, and $25 per chiropractic service.

The Full Report is available to member health funds only. Please contact us if you require further information.

Tags: benefits, health cover, hospital services, June 2011, private health insurance, services, utilisation,