Emergency departments the centre of cost-shifting

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A new report from the Australian Institute of Health and Welfare has again confirmed the substantial jump in the number of public hospital separations funded by private insurers.

The report, Private health insurance patients in Australian hospitals, 2006–07 to 2015–16: Australian hospital statistics, shows private health insurance-funded hospitalisations increased from 8.2 per cent of hospitalisations in 2006–07 to 13.9 per cent in 2015–16 - an average annual increase of 9.6 per cent.

At the same time, private health insurance-funded hospitalisations in private hospitals increased at an average annual rate of just 4.9 per cent.

"In 2006–07 about 1 in 7 private health insurance-funded hospitalisations occurred in public hospitals, increasing to about 1 in 5 in 2015–16," said AIHW spokesperson, Jenny Hargreaves.

The number of private health insurance-funded hospitalisations in public hospitals increased from 382,000 in 2006–07 to 872,000 in 2015–16.

Health minister Greg Hunt said the government remains "very concerned" about private health insurance being charged by public hospitals for treatments that should be free.

"This practice is driving up private health insurance premiums and is blowing out public hospital waiting lists," he said.

"I have raised this issue with my state and territory counterparts on numerous occasions, including at the recent Council of Australian Governments (COAG) Health Council meeting. All agreed to consider the issue of private patients in public hospitals further, but this new AIHW report shows this needs urgent action," added Mr Hunt.

The new data confirms the findings of a recent discussion paper published by the Department of Health.

The paper found that, if the number of private patients in the public sector had grown at the same rate as private patients in private hospitals since 2010-11, premiums in 2015-16 would have been about 2.5 per cent lower.

Health minister Greg Hunt recently said the "harvesting of private patients" by public hospitals was unacceptable because of the impact on waiting lists.

The increase was most stark for emergency admissions, which grew at an average annual rate of 11.7 per cent, but 20.3 per cent for same-day emergency admissions.

In a statement issued in response to the AIHW report, the Consumers Health Forum also expressed concern over the impact on public hospital waiting lists for uninsured patients.

While the report found private health insurance-funded patients generally experienced shorter median waiting times for elective surgery - 20 days on average compared to 42 days for public patients - only 5 per cent of elective surgery admissions funded by private health insurance took place in a public hospital.

"Between 2006–07 and 2015–16, medical care (that is, not involving surgical or other procedures) was the most common type of service provided for private health insurance-funded hospitalisations in public hospitals," says the report. "It accounted for an increasing proportion of private health insurance-funded hospitalisations in public hospitals over this period—rising from 67% to 73%."