Private hos­pi­tals see pal­lia­tive care mar­ket, but need funds

The Weekend Australian - Travel - - Health -

From Health cover the best en­vi­ron­ment for peo­ple who were reach­ing the end of their life.

‘‘ So we set about find­ing an ap­pro­pri­ate site. Our cen­tre has been pur­pose-built to serve the needs of pal­lia­tive care pa­tients. It can be used by any­one who has private health in­sur­ance. It is 100 per cent pri­vately funded, it doesn’t re­ceive any state or fed­eral fund­ing.’’

Ben­nett says about 40 per cent of pa­tients are re­ferred from Cabrini Health’s acute hos­pi­tals, 40 per cent from the home-based ser­vice, and the re­main­ing 20 per cent come ‘‘ from a wide variety of places, in­clud­ing pub­lic hos­pi­tals and com­mu­nity ser­vices.’’

‘‘ We are not sure why other private health providers are not pro­vid­ing this ser­vice. They are fi­nan­cially vi­able ser­vices. Run­ning an in­pa­tient pal­lia­tive-care bed is about the same cost as run­ning an acute-care bed, and it’s a lot more com­fort­able for pa­tients than be­ing in a pub­lic hospi­tal.’’

The Aus­tralian Private Hos­pi­tals As­so­ci­a­tion ex­ec­u­tive di­rec­tor Michael Roff says about 40 of the as­so­ci­a­tion’s 290 mem­ber hos­pi­tals — ex­clud­ing day surg­eries — of­fer pal­lia­tive care.

‘‘ It’s likely to be more, be­cause the ma­jor Catholic hospi­tal groups, for ex­am­ple, are not mem­bers and a num­ber of them would pro­vide pal­lia­tive care ser­vices. There is quite a range of private hos­pi­tals in size and own­er­ship that pro­vide pal­lia­tive ser­vices.’’

Roff says the short­age of pal­lia­tive care spe­cial­ists could limit the level of pal­lia­tive­care ser­vices of­fered in hos­pi­tals. ‘‘ Pal­lia­tive care is just one of a num­ber of spe­cial­ties that is suf­fer­ing from work­force short­ages across both the pub­lic and private sec­tors.’’

He says some health funds, how­ever, are re­luc­tant to cover pal­lia­tive care be­cause there is no way to ac­cu­rately pre­dict the cost. ‘‘ The funds would of­fer some level of ben­e­fit for pal­lia­tive care treat­ment, but in some cases it may just cover ac­com­mo­da­tion and med­i­cal ser­vices costs, and not nec­es­sar­ily cover things like non-PBS listed drugs.

‘‘ There may be some level of pa­tient co­pay­ment that is re­quired. The mes­sage I’ve got back from the health funds is that they don’t nec­es­sar­ily like the open-ended na­ture of the treat­ment. It ob­vi­ously has an end-point that could vary greatly from pa­tient to pa­tient from a cou­ple of weeks to months.

‘‘ That’s some­thing I guess they find dif­fi­cult to plan for in terms of their ben­e­fit out­lays,’’ Roff said.

Aus­tralian Health In­sur­ance As­so­ci­a­tion chief ex­ec­u­tive of­fi­cer Michael Ar­mitage said the re­cent changes to health in­sur­ance could make it eas­ier for pa­tients with private cover to ac­cess pal­lia­tive care.

‘‘ The re­cent leg­is­la­tion re­moved re­stric­tions on the tim­ing of ser­vices such as pal­lia­tive care. When peo­ple joined be­fore, there were lim­its to when they could start ac­cess­ing their cover. Now there aren’t the same re­stric­tions, and we think that will lead to sig­nif­i­cant changes.’’

How­ever, Ar­mitage warns that pal­lia­tive care, like all other ser­vices, would have to be fi­nan­cially vi­able.

‘‘ The re­al­ity is that a health fund has to bal­ance all the in­ter­ests of ev­ery mem­ber, and one of those in­ter­ests is fi­nan­cial.’’

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