Academic journal article Australian Health Review

Construction of the Australian Inpatient Export Database (AIED)

Academic journal article Australian Health Review

Construction of the Australian Inpatient Export Database (AIED)

Article excerpt

Abstract

Objective: To establish a database of exports by Australian acute health care institutions for the period in which exports were first promoted.

Method: Hospital morbidity data for patients resident overseas (Group A) and Medicare ineligible patients resident in Australia (Group B) were sought for the period 1983-84 to 1995-96 from each state and territory health department. Private hospital permission was obtained for the release of identifiable private hospital data.

Results: Data were coalesced into a relational database covering the period 1987-88 to 1995-96. Coding variations between and within jurisdictions over time necessitated the development of a consistent coding mechanism. Group A and Group B patients gave rise to at least 77 568 separations over the period 1987-88 to 1995-96. Of these separations 58418 (75.3%) should have generated export income and another 10 158 separations (13.1%) were likely to have generated export income. Definite export separations not for dialysis number 52 573, and these form the AIED.

Conclusion: An Australian database of inpatient exports, the AIED, encompassing public and private hospital data has been established for the period 1987-88 to 1995-96. The problems encountered in the course of this study emphasise the desirability of maintaining an adequately resourced national repository for health statistics.

Aust Health Rev 2007: 31(4): 546-556

What is known about the topic?

To date there is little known about the extent and characteristics of health service exports and the institutions that undertake this activity, in Australia and internationally.

What does this paper add?

This paper describes the establishment of, and provides some initial data from, the Australian Inpatient Export Database (AIED). The AIED encompasses hospital morbidity separation data for overseas patients treated in acute care facilities, private and public hospitals and free-standing day surgeries for the period 1987-88 to 1995-96. The AIED is the only known longitudinal database of inpatient exports in the world.

What are the implications for practitioners?

This paper identifies the strengths and limitations of the AIED for use by health management and policy practitioners. From the database it has been ascertained that over the period 1987-88 to 1995-96 there were a minimum of 52 573 separations that should have generated export income.

BETWEEN 1980 and the early 1990s international trade in commercial services grew from around 15% to 20% of total international trade, a level which it currently maintains.1,2 During this period, and in line with the increasing realisation of the role of services exports in trade performance, the export potential of health services began to be acknowledged, explored and promoted in a number of countries including the United Kingdom,3,4 Cuba4 and Australia. More recently, consideration of the export potential of the health services sector has been enhanced by the introduction of the General Agreement on Trade in Services (GATS).5 The GATS, which came into effect in 1995, commits member governments to negotiate on specific issues on trade in services, including health services, and enter into successive rounds of negotiations to progressively liberalise trade.6 There are limited quantitative data on the nature and extent of trade and investments in the health sector, the lack of which is problematic.7,8,9

This article details the establishment of the Australian Inpatient Export Database (AIED), a national longitudinal database of non-dialysis separations for overseas patients treated in acute care facilities, hospitals and free-standing day surgeries in Australia during the period 1987-88 to 1995-96. The time period 1987-88 to 1995-96 was chosen given the availability of comprehensive data across the states and territories and the period's association with the tenure of the Hawke/Keating Labor Ministries (March 1983 to March 1996). …

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