Percentage of Patients With Out-Of-Pocket Costs for Non-Hospital Medicare Services
Identifying Attributes
Care Settings
Primary Care
Country
Australia
Publishing Organisation
Australian Institute of Health and Welfare (AIHW): Healthy community indicators
Type of Quality Indicator
Outcome
IOM Quality Dimension
Equity
Domain
Wait and System Planning / Access
Defining Attributes
Definition
Percentage of patients with out-of-pocket costs for non-hospital Medicare services.
Numerator
Number of patients whose annual out-of-pocket cost (fee charged minus benefit paid) for all eligible claims processed between 1 July 2016 and 30 June 2017 was greater than zero.
Denominator
Number of patients who claimed at least one non-hospital Medicare service processed between 1 July 2016 and 30 June 2017.
Exclusions
Services from the Child Dental Benefits Schedule. Patients were excluded if the sum of eligible services in the year was less than one, or if their annual out-of-pocket expenditure was equal to or less than zero.
Use of Risk Adjustment
No
Risk Adjustments
None
Stratifications
By Primary Health Network (PHN) and Statistical Areas Level 3 (SA3s).
Collection and Reporting Attributes
Type of Data Collection
Administrative data
Data Collection Methods
Medicare Benefits Schedule (MBS)
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No
Source and Reference Attributes
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025
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Date Modified 02 December 2025