PET - Plain English Taxonomy

HRF_601_1_1: Statistical Data - by State - NSW
Australian Business Number Institution Name
   
Reporting Period Scale Factor  
Quarterly Whole dollars to two decimal places
Reporting Consolidation
Health Benefits Fund
Part 1 Policies and insured persons
Single Family Single parent Couple 2+ persons no adults 3+ adults Total
(1) (2) (3) (4) (5) (6) (7)
1. Total hospital treatment (includes hospital treatment only and hospital treatment and general treatment combined)
1.1. Policies
1.1.1. Exclusionary policies              
1.1.1.1. Excess & co-payments
1.1.1.2. No excess & no co-payments
1.1.1.3. Total exclusionary policies
1.1.2. Non-exclusionary policies              
1.1.2.1. Excess & co-payments
1.1.2.2. No excess & no co-payments
1.1.2.3. Total non-exclusionary policies
1.2. Total policies
1.3. Insured persons
1.3.1. Exclusionary policies              
1.3.1.1. Excess & co-payments
1.3.1.2. No excess & no co-payments
1.3.1.3. Total exclusionary policies
1.3.2. Non-exclusionary policies              
1.3.2.1. Excess & co-payments
1.3.2.2. No excess & no co-payments
1.3.2.3. Total non-exclusionary policies
1.4. Total insured persons
2. Hospital treatment only
2.1. Policies
2.1.1. Exclusionary policies              
2.1.1.1. Excess & co-payments
2.1.1.2. No excess & no co-payments
2.1.1.3. Total exclusionary policies
2.1.2. Non-exclusionary policies              
2.1.2.1. Excess & co-payments
2.1.2.2. No excess & no co-payments
2.1.2.3. Total non-exclusionary policies
2.2. Total policies
2.3. Insured persons
2.3.1. Exclusionary policies              
2.3.1.1. Excess & co-payments
2.3.1.2. No excess & no co-payments
2.3.1.3. Total exclusionary policies
2.3.2. Non-exclusionary policies              
2.3.2.1. Excess & co-payments
2.3.2.2. No excess & no co-payments
2.3.2.3. Total non-exclusionary policies
2.4. Total insured persons
3. Hospital treatment and general treatment combined
3.1. Policies
3.1.1. Exclusionary policies              
3.1.1.1. Excess & co-payments
3.1.1.2. No excess & no co-payments
3.1.1.3. Total exclusionary policies
3.1.2. Non-exclusionary policies              
3.1.2.1. Excess & co-payments
3.1.2.2. No excess & no co-payments
3.1.2.3. Total non-exclusionary policies
3.2. Total policies
3.3. Insured persons
3.3.1. Exclusionary policies              
3.3.1.1. Excess & co-payments
3.3.1.2. No excess & no co-payments
3.3.1.3. Total exclusionary policies
3.3.2. Non-exclusionary policies              
3.3.2.1. Excess & co-payments
3.3.2.2. No excess & no co-payments
3.3.2.3. Total non-exclusionary policies
3.4. Total insured persons
4. General treatment ambulance only
4.1.1. Policies
4.1.2. Insured persons
5. Total general treatment only              
5.1.1. Policies
5.1.2. Insured persons
6. General treatment excluding hospital-substitute, CD MP and hospital-linked ambulance treatment              
6.1.1. Policies
6.1.2. Insured persons
7. Total general treatment              
7.1.1. Policies
7.1.2. Insured persons
Changes during the quarter
Hospital treatment only Hospital treatment and general treatment General treatment only
Policies Insured persons Policies Insured persons Policies Insured persons
(1) (2) (3) (4) (5) (6)
8. Start of quarter
9. New policies/persons
10. Transferring from another state
11. Transferring to another state
12.   Transferring from another fund
13. Transferring from another policy
14. Transferring to another policy
15. Discontinued
16. End of quarter
Part 2 Total benefits paid for hospital treatment and hospital-substitute treatment
Total benefits for hospital treatment and hospital-substitute treatment
Episodes Days Benefits paid
(1) (2) (3)
17. Day hospital
18. Public hospitals      
18.1. Day only
18.2. Overnight
19. Private hospitals      
19.1. Day only
19.2. Overnight
20. Hospital-substitute day only
21. Treatment greater than one day
22. Total
23. Nursing home type patients      
23.1. Public hospitals
23.2. Private hospitals
23.3. Total nursing home type patients
Number Benefits paid
(1) (2)
24. Medical benefits
25. Prostheses benefits
26. Total Chronic Disease Management Programs
  Benefits paid
27. Total benefits paid for general treatment
28. Ineligible hospital benefits
29. Total benefits paid for hospital treatment and general treatment
High Cost Claimants Pool
 
30. Number of HCCP claimants (current quarter)
31. Gross benefits for current and preceding 3 quarters (for current quarter HCCP claimants)
32. Net benefits for current and preceding 3 quarters for HCCP claimants - after ABP
33. Net benefits above threshold for current and preceding 3 quarters (for current quarter HCCP claimants)
34. Total benefits to be included in HCCP (current quarter)
Part 3 Hospital treatment by age category
Hospital treatment by age category
35. Males
Age group Insured persons Episodes Days Other HT benefits Medical benefits Prostheses benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7) (8)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
35.1. Total males
36. Females
Age group Insured persons Episodes Days Other HT benefits Medical benefits Prostheses benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7) (8)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
36.1. Total females
Part 4 Hospital-substitute treatment by age category
 
Hospital-substitute treatment by age category
37. Males
Age group Insured persons Episodes Days Other H-ST benefits Medical benefits Prostheses benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7) (8)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
37.1. Total males
38. Females
Age group Insured persons Episodes Days Other H-ST benefits Medical benefits Prostheses benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7) (8)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
38.1. Total females
Part 5 Chronic Disease Management Program by age category
Chronic Disease Management Program by age category
39. Males
Age group Insured persons Programs Eligible benefits Ineligible benefits Total benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
39.1. Total males
40. Females
Age group Insured persons Programs Eligible benefits Ineligible benefits Total benefits Fees excluding medicare benefit
(1) (2) (3) (4) (5) (6) (7)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
40.1. Total females
Part 6 General treatment excluding hospital-substitute, CDMP and hospital-linked ambulance treatment
General treatment by age category
41. Males
Age group Insured persons Services Benefits Fees charged
(1) (2) (3) (4) (5)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
41.1. Total males
42. Females
Age group Insured persons Services Benefits Fees charged
(1) (2) (3) (4) (5)
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+
42.1. Total females
Part 7 Total hospital treatment policies by type of cover
Total hospital treatment policies
43. Number of policies
  Full cover Reduced cover but no lifetime exclusions Reduced cover and some lifetime exclusions Some lifetime exclusions but no reduced cover Total
  (1) (2) (3) (4) (5)
43.1. Excess & co-payments          
NIL
<= $500/$1,000 (*)
> $500/$1,000 (*)
43.2. Total
(*) Excess <= $500 per policy covering only one person and excess <=$1,000 for all other policies  
(**) Excess > $500 per policy covering only one person and excess > $1,000 for all other policies
General treatment claims processing for the state (excluding hospital-substitute treatment and CDMP)
44. Percent of claims processed within five working days
National retention index - hospital treatment policy holders
45. Percent of policies existing two years or more that are still in force
Part 8 Benefits paid for Chronic Disease Management Programs
46. Benefits paid for CDMPs
CDMP deliverables Services Benefits Fees charged
(1) (2) (3) (4)
Planning
Coordination
Allied Health Services
Other  
46.1. Total CDMPs
47. Benefits paid by program type
Type of CDMP Programs Benefits Fees charged
(1) (2) (3) (4)
Risk factors for chronic disease
Cardiovascular
Diabetes
Mental Health
Other (specify)
47.1. Total by program type
Part 9 Benefits paid for general treatment (excluding hospital-substitute treatment and CDMP)
48. Type of treatment by service type
Service type Services Benefits Fees charged
(1) (2) (3) (4)
Accidental Death / Funeral Expenses
Acupuncture / Acupressure
Ambulance
Chiropractic
Community, Home, District Nursing
Dental
Dietetics
Domestic Assistance  
Ex gratia Payments
Preventative Health Products/Health Management Program
Hearing Aids and Audiology
Hypnotherapy
Maternity Services
Natural Therapies
Occupational Therapy
Optical
Orthoptics (Eye Therapy)
Osteopathic Services
Overseas
Pharmacy
Physiotherapy
Podiatry (Chiropody)
Prostheses, Aids and Appliances
Psych/Group Therapy
School
Sickness and Accident
Speech Therapy
Theatre Fees
Travel and Accommodation
48.1. Other (please specify)      
Description Services Benefits Fees charged
(1) (2) (3) (4)
48.2. Total general treatment
Part 10 Lifetime Health Cover
49. Number of adults with hospital cover
Certified age at entry Male Female Male LHC loading removed Female LHC loading removed LHC Loading %
(1) (2) (3) (4)
30 0%
31 2%
32 4%
33 6%
34 8%
35 10%
36 12%
37 14%
38 16%
39 18%
40 20%
41 22%
42 24%
43 26%
44 28%
45 30%
46 32%
47 34%
48 36%
49 38%
50 40%
51 42%
52 44%
53 46%
54 48%
55 50%
56 52%
57 54%
58 56%
59 58%
60 60%
61 62%
62 64%
63 66%
64 68%
65 70%
Total 0%
Part 11 Total hospital treatment medical services statistics
  Amount charged Medicare benefit Fund benefit Gap Number of services % of services Amount charged % of MBS
  (1) (2) (3) (4) (5) (6) (7)
50. No-gap agreement              
<= MBS fee
>MBS to 125% MBS fee
>125% to 150% MBS fee
>150% to 200% MBS fee
>200% MBS fee
50.1. Total no-gap agreement
51. Known gap agreement              
>MBS to 125% MBS fee
>125% to 150% MBS fee
>150% to 200% MBS fee
>200% MBS fee
51.1. Total known gap agreement
52. Total agreement
53. No agreement              
<= MBS fee
>MBS to 125% MBS fee
>125% to 150% MBS fee
>150% to 200% MBS fee
>200% MBS fee
54. Total no agreement
             
55. Grand total
55.1. Total services with no gap
55.2. Total services with no or known gap