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National Health Reform Act 2011, current compilation. 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What Primary Health Networks are. 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Local Hospital Networks. 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World Development Indicators, Hospital beds per 1,000 people, Australia. 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World Development Indicators, Physicians per 1,000 people, Australia. 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World Development Indicators, Nurses and midwives per 1,000 people, Australia. API snapshot retrieved 14 August 2026. https://api.worldbank.org/v2/country/AUS/indicator/SH.MED.NUMW.P3?format=json&per_page=100", "url": "https://api.worldbank.org/v2/country/AUS/indicator/SH.MED.NUMW.P3?format=json&per_page=100", "locator": { "locator_type": "json_fields", "fields": [ "indicator.id", "countryiso3code", "date", "value" ], "source_word_anchor": "SH.MED.NUMW.P3", "source_word_count": 1 }, "territory": "national comparable series", "period": "observations 2000 to 2022; API retrieved 2026-08-14", "evidence_mode_candidate": "observed", "verification_source_layer": "official", "source_version": { "response_sha256": "f7a39d6278503f0c839944af14e2062577e6df3383226dd1e9dd15bc02247f0c", "detected_media_type": "application/json", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:wdi-nurses-midwives", "display_source_id": "display-source:AUS:aa43a445b7d69e383bad0efc", "source_version_id": "display-source-version:dcdd4f570f1283aeaf0aa541" }, { "candidate_source_id": "country-improvement-source:AUS:ahpra-annual-report-2024-25", "title": "Ahpra and National Boards annual report 2024 to 2025", "citation": "Australian Health Practitioner Regulation Agency and National Boards. Annual Report 2024/25. 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The Australian health system. 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What Primary Health Networks are. 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Public hospitals. 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Local Hospital Networks. Current page checked 14 August 2026. https://www.publichospitalfunding.gov.au/local-hospital-networks", "url": "https://www.publichospitalfunding.gov.au/local-hospital-networks", "locator": { "locator_type": "web_section", "section": "Local Hospital Networks", "source_word_anchor": "Every Australian public hospital is part of an LHN", "source_word_count": 9 }, "territory": "state- and territory-recognized Local Hospital Networks", "period": "current page checked 2026-08-14", "evidence_mode_candidate": "reported", "verification_source_layer": "official", "source_version": { "response_sha256": "b1105cbeccac0ee9bf44f476141723e794eb5e1174728180a448b7000262e518", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:local-hospital-networks-2026", "display_source_id": "display-source:AUS:4933186aa9898c46f4eec91d", "source_version_id": "display-source-version:835af4c9ecdc0034c2cb9f18" }, { "candidate_source_id": "country-improvement-source:AUS:private-hospitals-2024", "title": "Private hospitals", "citation": "Australian Government Department of Health, Disability and Ageing. Private hospitals. Updated 1 November 2024. https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en", "url": "https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en", "locator": { "locator_type": "web_sections", "sections": [ "What a private hospital is", "How private hospitals are funded" ], "source_word_anchor": "owned and run by the private sector", "source_word_count": 7 }, "territory": "private hospitals across Australia", "period": "current official guidance updated 2024-11-01", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "9804e3dd242df48ccf9302df4a0cf1ad3810bced464d5b5f0429188652fa2007", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:private-hospitals-2024", "display_source_id": "display-source:AUS:aedaf06c4515419eb520a0b4", "source_version_id": "display-source-version:63c8a6ec44ccacb4882ad2ba" } ], "source_version": { "response_sha256": "7bbd3f8ab77447be8716c1d54821979077b7ea6cb129f3bb17aac5505360f516", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "display_source_ids": [ "display-source:AUS:b5eeae633eca8b04b9efed34", "display-source:AUS:d03884cabaea730d2fe5c160", "display-source:AUS:0671316057aada63d606c895", "display-source:AUS:4933186aa9898c46f4eec91d", "display-source:AUS:aedaf06c4515419eb520a0b4" ], "source_version_ids": [ "display-source-version:d116b84652b0494a7f157d07", "display-source-version:0cc175e94077020d26a40c29", "display-source-version:126e55f2b048eaa1ea8b97a2", "display-source-version:835af4c9ecdc0034c2cb9f18", "display-source-version:63c8a6ec44ccacb4882ad2ba" ], "display_claim_ids": [ "display-claim:75044d0abd376b3c0e41135b" ], "display_evidence_object_id": "display-claim:75044d0abd376b3c0e41135b", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:AUS:public-private:ownership-choice-and-contracts", "country_id": "AUS", "mapping_group": "delivery_and_referrals", "target_view": "public-private", "target_slot": "public-private-hospital-and-patient-status-architecture", "support_state": "candidate_supported", "mapping_basis": "declared_from_official_public_private_hospital_and_health-system-guidance", "source_projection_ids": [ "country-improvement-source:AUS:australian-health-system-2026", "country-improvement-source:AUS:public-hospitals-2024", "country-improvement-source:AUS:private-hospitals-2024", "country-improvement-source:AUS:nhra-2026-2031" ], "typed_fields": { "public_ownership": "public hospitals are recognized and managed within state and territory systems", "private_ownership": "private hospitals are privately owned and run, with state licensing and Commonwealth declaration", "contracted_public_care": "private or not-for-profit providers can operate or supply public hospital services under government contract", "public_patient_choice": "covered public care does not include choice of treating doctor", "private_patient_choice": "private status can permit doctor choice with insurer and patient payment consequences", "boundary": "funding source, patient status, operator and facility ownership are separate attributes" }, "analytical_objects": {}, "title": "Ownership, operator, funding and patient status do not form one public-private split", "statement": "State public-hospital systems coexist with privately owned hospitals and contracted public services. A private operator can deliver public care, and public or private patient status changes payment and doctor choice without necessarily changing facility ownership.", "citation": "Australian health system; public-hospital and private-hospital official guidance; National Health Reform Agreement 2026 to 2031.", "url": "https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en", "locator": "Private-hospital ownership and funding sections; public-hospital eligibility section; NHRA public-patient and contracted-provider provisions", "period": "current arrangement checked 2026-08-14", "territory": "national framework with state and payer variation", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "coverage_domains": [ "ownership", "decision_rights", "hospital_organization", "referral_design", "networks", "governance", "market_structure" ], "review_requirements": [ "Do not use a facility count, funding share or patient status as a proxy for delivery dominance." ], "source_references": [ { "candidate_source_id": "country-improvement-source:AUS:australian-health-system-2026", "title": "The Australian health system", "citation": "Australian Government Department of Health, Disability and Ageing. The Australian health system. Updated 27 May 2026. https://www.health.gov.au/topics/about-the-department/australian-health-system?language=en", "url": "https://www.health.gov.au/topics/about-the-department/australian-health-system?language=en", "locator": { "locator_type": "web_sections", "sections": [ "Australian Government responsibilities", "State, territory and local government responsibilities", "Shared responsibilities" ], "source_word_anchor": "Australia has both a public and a private health system", "source_word_count": 10 }, "territory": "Australia, with federal, state, territory and local responsibilities distinguished", "period": "current official description updated 2026-05-27", "evidence_mode_candidate": "reported", "verification_source_layer": "official", "source_version": { "response_sha256": "7bbd3f8ab77447be8716c1d54821979077b7ea6cb129f3bb17aac5505360f516", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:australian-health-system-2026", "display_source_id": "display-source:AUS:b5eeae633eca8b04b9efed34", "source_version_id": "display-source-version:d116b84652b0494a7f157d07" }, { "candidate_source_id": "country-improvement-source:AUS:public-hospitals-2024", "title": "Public hospitals", "citation": "Australian Government Department of Health, Disability and Ageing. Public hospitals. Updated 4 March 2024. https://www.health.gov.au/topics/hospital-care/about/public-hospitals?language=en", "url": "https://www.health.gov.au/topics/hospital-care/about/public-hospitals?language=en", "locator": { "locator_type": "web_sections", "sections": [ "What a public hospital is", "How we fund public hospitals", "Who can receive treatment" ], "source_word_anchor": "Public patients don't get to choose their doctor", "source_word_count": 8 }, "territory": "public hospitals across Australia", "period": "current official guidance updated 2024-03-04", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "9faf5050f311fc0418665a9bbdc667f9a4f44a2516c406bec4a609c744e864a8", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:public-hospitals-2024", "display_source_id": "display-source:AUS:0671316057aada63d606c895", "source_version_id": "display-source-version:126e55f2b048eaa1ea8b97a2" }, { "candidate_source_id": "country-improvement-source:AUS:private-hospitals-2024", "title": "Private hospitals", "citation": "Australian Government Department of Health, Disability and Ageing. Private hospitals. Updated 1 November 2024. https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en", "url": "https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en", "locator": { "locator_type": "web_sections", "sections": [ "What a private hospital is", "How private hospitals are funded" ], "source_word_anchor": "owned and run by the private sector", "source_word_count": 7 }, "territory": "private hospitals across Australia", "period": "current official guidance updated 2024-11-01", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "9804e3dd242df48ccf9302df4a0cf1ad3810bced464d5b5f0429188652fa2007", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:private-hospitals-2024", "display_source_id": "display-source:AUS:aedaf06c4515419eb520a0b4", "source_version_id": "display-source-version:63c8a6ec44ccacb4882ad2ba" }, { "candidate_source_id": "country-improvement-source:AUS:nhra-2026-2031", "title": "Addendum to the National Health Reform Agreement 2026 to 2031", "citation": "Commonwealth of Australia and the States and Territories. Addendum to the National Health Reform Agreement 2026 to 2031. Signed 27 February 2026. https://federalfinancialrelations.gov.au/sites/federalfinancialrelations.gov.au/files/2026-04/nhra-2026-31-addendum-consolidated.pdf", "url": "https://federalfinancialrelations.gov.au/sites/federalfinancialrelations.gov.au/files/2026-04/nhra-2026-31-addendum-consolidated.pdf", "locator": { "locator_type": "pdf_page_set_anchor", "physical_pdf_pages": [ 11, 12, 13, 14, 15, 115, 116, 117, 119, 120 ], "sections": [ "Clauses 19 to 29", "Schedule E" ], "source_word_anchor": "States are the stewards of the public hospital", "source_word_count": 8 }, "territory": "all Australian states and territories", "period": "effective 2026-07-01 to 2031-06-30", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "file_sha256": "918fe1b135db20098b33c890b6ccfff9b17a621de5244f80c78382838f632fb7", "response_sha256": "918fe1b135db20098b33c890b6ccfff9b17a621de5244f80c78382838f632fb7", "page_count": 196, "detected_media_type": "application/pdf", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:nhra-2026-2031", "display_source_id": "display-source:AUS:e56e799f2be0644bf849d2cf", "source_version_id": "display-source-version:d5e182ea2302f283d736a36b" } ], "source_version": { "response_sha256": "7bbd3f8ab77447be8716c1d54821979077b7ea6cb129f3bb17aac5505360f516", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "display_source_ids": [ "display-source:AUS:b5eeae633eca8b04b9efed34", "display-source:AUS:0671316057aada63d606c895", "display-source:AUS:aedaf06c4515419eb520a0b4", "display-source:AUS:e56e799f2be0644bf849d2cf" ], "source_version_ids": [ "display-source-version:d116b84652b0494a7f157d07", "display-source-version:126e55f2b048eaa1ea8b97a2", "display-source-version:63c8a6ec44ccacb4882ad2ba", "display-source-version:d5e182ea2302f283d736a36b" ], "display_claim_ids": [ "display-claim:9f80e26db227b49e7773ad45" ], "display_evidence_object_id": "display-claim:9f80e26db227b49e7773ad45", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:AUS:referrals:formal-choice-and-gatekeeping", "country_id": "AUS", "mapping_group": "delivery_and_referrals", "target_view": "referrals", "target_slot": "medicare-referral-choice-and-voluntary-enrolment", "support_state": "candidate_supported", "mapping_basis": "declared_from_services_australia_mymedicare_public_hospital_and_oecd_policy_sources", "source_projection_ids": [ "country-improvement-source:AUS:medicare-specialist-referrals-2025", "country-improvement-source:AUS:mymedicare-2026", "country-improvement-source:AUS:public-hospitals-2024", "country-improvement-source:AUS:oecd-gatekeeping-2026" ], "typed_fields": { "first_contact": "primary care is commonly the first service, but general-practice registration is voluntary", "specialist_referral": "valid referral is required for Medicare specialist reimbursement", "bypass": "specialist access without referral is possible but generally loses Medicare reimbursement", "specialist_choice": "an open referral allows the patient to choose where to present", "public_hospital_choice": "public patients do not choose the treating doctor", "exceptions_and_variation": "public outpatient, emergency, specialty and insurer pathways are not represented by one national rule" }, "analytical_objects": {}, "title": "Gatekeeping is primarily a reimbursement architecture with retained choice", "statement": "A referral normally enables Medicare specialist reimbursement, while an open referral can preserve provider choice. Seeing a specialist without referral is possible but generally loses the Medicare rebate. MyMedicare registration remains voluntary, and public-hospital patient status adds a separate choice rule.", "citation": "Services Australia specialist-referral guidance; MyMedicare official description; public-hospital guidance; OECD 2026 outpatient gatekeeping review.", "url": "https://www.servicesaustralia.gov.au/referrals-for-specialist-treatment?context=20", "locator": "Referral recipient and duration sections; MyMedicare voluntary-registration section; OECD physical page 11", "period": "current policy checked 2026-08-14", "territory": "Medicare and public-hospital pathways nationally, with jurisdiction and service variation", "evidence_mode_candidate": "formal", "verification_source_layer": "review_literature", "coverage_domains": [ "decision_rights", "primary_care", "referral_design", "observed_referral", "networks", "patient_flows", "governance", "market_structure", "authoritative_review" ], "review_requirements": [ "Do not call referral a universal legal bar or infer actual compliance from the reimbursement rule." ], "source_references": [ { "candidate_source_id": "country-improvement-source:AUS:medicare-specialist-referrals-2025", "title": "Referrals for specialist treatment", "citation": "Services Australia. Referrals for specialist treatment. Updated 15 August 2025. https://www.servicesaustralia.gov.au/referrals-for-specialist-treatment?context=20", "url": "https://www.servicesaustralia.gov.au/referrals-for-specialist-treatment?context=20", "locator": { "locator_type": "web_sections", "sections": [ "Referring patients", "Period of referral" ], "source_word_anchor": "Patients can choose where to present", "source_word_count": 6 }, "territory": "Medicare-subsidised specialist treatment", "period": "current guidance updated 2025-08-15", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "78f0ba95e899711ca814be87d905012da3d980c8df3a672025c37b39b51d09f1", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:medicare-specialist-referrals-2025", "display_source_id": "display-source:AUS:9872d50842e13b050f481dea", "source_version_id": "display-source-version:3474db6df1b449695ddd7f9a" }, { "candidate_source_id": "country-improvement-source:AUS:mymedicare-2026", "title": "About MyMedicare", "citation": "Australian Government Department of Health, Disability and Ageing. About MyMedicare. Updated 15 May 2026. https://www.health.gov.au/our-work/mymedicare/about?language=en", "url": "https://www.health.gov.au/our-work/mymedicare/about?language=en", "locator": { "locator_type": "web_section", "section": "What MyMedicare is", "source_word_anchor": "voluntary patient registration model", "source_word_count": 4 }, "territory": "participating general practices and eligible patients", "period": "current programme description updated 2026-05-15", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "b79ae77bb048c094ddc0d792b774694f1424bae0d763fbd78d1fce9456fbb6df", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:mymedicare-2026", "display_source_id": "display-source:AUS:c6deae2557422e2f41686ccc", "source_version_id": "display-source-version:19344bcacf9d7093c73fd812" }, { "candidate_source_id": "country-improvement-source:AUS:public-hospitals-2024", "title": "Public hospitals", "citation": "Australian Government Department of Health, Disability and Ageing. Public hospitals. Updated 4 March 2024. https://www.health.gov.au/topics/hospital-care/about/public-hospitals?language=en", "url": "https://www.health.gov.au/topics/hospital-care/about/public-hospitals?language=en", "locator": { "locator_type": "web_sections", "sections": [ "What a public hospital is", "How we fund public hospitals", "Who can receive treatment" ], "source_word_anchor": "Public patients don't get to choose their doctor", "source_word_count": 8 }, "territory": "public hospitals across Australia", "period": "current official guidance updated 2024-03-04", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "source_version": { "response_sha256": "9faf5050f311fc0418665a9bbdc667f9a4f44a2516c406bec4a609c744e864a8", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:public-hospitals-2024", "display_source_id": "display-source:AUS:0671316057aada63d606c895", "source_version_id": "display-source-version:126e55f2b048eaa1ea8b97a2" }, { "candidate_source_id": "country-improvement-source:AUS:oecd-gatekeeping-2026", "title": "Incentivising Patient Pathways in Outpatient Care", "citation": "Mueller M. Incentivising Patient Pathways in Outpatient Care: A Review of Gatekeeping and Cost-Sharing Policies Across the OECD. OECD Health Working Papers. 2026. https://www.oecd.org/content/dam/oecd/en/publications/reports/2026/05/incentivising-patient-pathways-in-outpatient-care_c6154148/349dcf1c-en.pdf", "url": "https://www.oecd.org/content/dam/oecd/en/publications/reports/2026/05/incentivising-patient-pathways-in-outpatient-care_c6154148/349dcf1c-en.pdf", "locator": { "locator_type": "pdf_page_anchor", "physical_pdf_pages": [ 11 ], "section": "Gatekeeping policies", "source_word_anchor": "not eligible for Medicare reimbursement", "source_word_count": 5 }, "territory": "Australia within an OECD comparative policy review", "period": "policy reviewed through 2026", "evidence_mode_candidate": "reported", "verification_source_layer": "review_literature", "source_version": { "file_sha256": "2ed7fdbd497606f221c11309aa38164fce9c0adbf61cf50930bb764228c9c7e5", "response_sha256": "2ed7fdbd497606f221c11309aa38164fce9c0adbf61cf50930bb764228c9c7e5", "page_count": 63, "detected_media_type": "application/pdf", "hash_verified": true, "retrieved_at": "2026-08-14" }, "source_projection_id": "country-improvement-source:AUS:oecd-gatekeeping-2026", "display_source_id": "display-source:AUS:87ec0dc37443f86ba4ac12c6", "source_version_id": "display-source-version:e27b9ec6a2549cbd0997ed97" } ], "source_version": { "response_sha256": "78f0ba95e899711ca814be87d905012da3d980c8df3a672025c37b39b51d09f1", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-14" }, "display_source_ids": [ "display-source:AUS:9872d50842e13b050f481dea", "display-source:AUS:c6deae2557422e2f41686ccc", "display-source:AUS:0671316057aada63d606c895", "display-source:AUS:87ec0dc37443f86ba4ac12c6" ], "source_version_ids": [ "display-source-version:3474db6df1b449695ddd7f9a", "display-source-version:19344bcacf9d7093c73fd812", "display-source-version:126e55f2b048eaa1ea8b97a2", "display-source-version:e27b9ec6a2549cbd0997ed97" ], "display_claim_ids": [ "display-claim:b6fb8b1b3e56d4c150393ff9" ], "display_evidence_object_id": "display-claim:b6fb8b1b3e56d4c150393ff9", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:AUS:referrals:observed-use-and-evidence-gap", "country_id": "AUS", "mapping_group": "delivery_and_referrals", "target_view": "referrals", "target_slot": "observed-service-use-without-false-pathway-linkage", "support_state": "candidate_supported", "mapping_basis": "declared_from_national_patient-experience-survey_and_bounded-integration-evaluation", "source_projection_ids": [ "country-improvement-source:AUS:abs-patient-experiences-2022-23", "country-improvement-source:AUS:health-care-homes-2024", "country-improvement-source:AUS:oecd-gatekeeping-2026" ], "typed_fields": { "gp_contact": "82.3 percent reported seeing a GP in the prior 12 months", "specialist_contact": "37.9 percent reported seeing a specialist", "emergency_contact": "15.2 percent reported an emergency-department visit", "hospital_admission": "12.6 percent reported admission", "preferred_gp_access": "36.3 percent could not see their preferred GP at least once", "evidence_gap": "national sources reviewed do not link these contacts into referral-completion or bypass trajectories", "trial_boundary": "Health Care Homes is a selected non-randomized intervention, not a national referral-rate estimate" }, "analytical_objects": {}, "title": "National use is measured, but complete referral trajectories are not", "statement": "National survey estimates describe separate GP, specialist, emergency and hospital contacts. 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These are separate self-reported service contacts, not a linked referral pathway.", "tags": [], "territory": "Australia, people aged 15 years and over in private dwellings", "title": "Patient Experiences 2022 to 2023", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2022-23" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Australian Government Department of Health, Disability and Ageing. Private hospitals. 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They can also contract with governments to deliver public hospital services.", "tags": [], "territory": "private hospitals across Australia", "title": "Private hospitals", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.au/topics/hospital-care/about/private-hospitals?language=en" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Australian Government Department of Health, Disability and Ageing. Public hospitals. 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Updated 15 August 2025. https://www.servicesaustralia.gov.au/referrals-for-specialist-treatment?context=20", "country_ids": [ "AUS" ], "coverage_domains": [ "decision_rights", "governance", "networks", "patient_flows", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Patients can choose where to present", "institution": "Services Australia", "locator": { "locator_type": "web_sections", "source_word_anchor": "Patients can choose where to present", "source_word_count": 6 }, "material_id": "material:786090cba4809bf31c55d738", "notes": [ "This is a Medicare billing rule, not proof of referral completion or a universal legal access ban." ], "origin": "country-evidence-improvement-sources", "period": "current guidance updated 2025-08-15", "publication_date": null, "publication_year": 2025, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "78f0ba95e899711ca814be87d905012da3d980c8df3a672025c37b39b51d09f1" }, "statement": "A valid referral supports Medicare specialist billing, but an open referral can leave the patient free to choose where to present. A GP referral normally lasts 12 months unless another period is specified.", "tags": [], "territory": "Medicare-subsidised specialist treatment", "title": "Referrals for specialist treatment", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.servicesaustralia.gov.au/referrals-for-specialist-treatment?context=20" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Tran DT, Falster MO, Pearse J, et al. The Australian Health Care Homes trial: quality of care and patient outcomes. A propensity score-matched cohort study. Medical Journal of Australia. 2024;220:372-378. https://www.mja.com.au/system/files/issues/220_07/mja252266.pdf", "country_ids": [ "AUS" ], "coverage_domains": [ "governance", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "not changes in most measures of hospital use", "institution": "Medical Journal of Australia", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "not changes in most measures of hospital use", "source_word_count": 8 }, "material_id": "material:5eab57f40f0e2f6afa773642", "notes": [ "Keep the non-randomized design, selected population and limited rollout visible." ], "origin": "country-evidence-improvement-sources", "period": "trial 2017-10-01 to 2021-06-30; published 2024", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "79eb7228962614e9509d9e7679347ef63ccdf61506055b9f29e46e4875131ac2", "page_count": 7, "response_sha256": "79eb7228962614e9509d9e7679347ef63ccdf61506055b9f29e46e4875131ac2" }, "statement": "The non-randomized Health Care Homes trial increased GP and allied-health use but did not reduce most hospital-use measures. 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Updated 27 May 2026. https://www.health.gov.au/topics/about-the-department/australian-health-system?language=en", "country_ids": [ "AUS" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Australia has both a public and a private health system", "institution": "Australian Government Department of Health, Disability and Ageing", "locator": { "locator_type": "web_sections", "source_word_anchor": "Australia has both a public and a private health system", "source_word_count": 10 }, "material_id": "material:5e5a185fd9b019f0b5cdde1e", "notes": [ "Do not collapse federal and state responsibilities into one national operator." ], "origin": "country-evidence-improvement-sources", "period": "current official description updated 2026-05-27", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "7bbd3f8ab77447be8716c1d54821979077b7ea6cb129f3bb17aac5505360f516" }, "statement": "Australia combines public and private systems. The Commonwealth leads Medicare benefits, medicines, private-insurance policy and much primary-care funding, while states and territories manage public hospitals, community services, ambulance services and facility oversight.", "tags": [], "territory": "Australia, with federal, state, territory and local responsibilities distinguished", "title": "The Australian health system", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.au/topics/about-the-department/australian-health-system?language=en" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Brown A, Dickinson H, Kelaher M, et al. Understanding corporate governance of healthcare quality: a comparative case study of eight Australian public hospitals. 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This observed variation prevents a single national claim about hospital-board autonomy or performance.", "tags": [], "territory": "eight public hospitals in Victoria and New South Wales", "title": "Understanding corporate governance of healthcare quality", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://link.springer.com/article/10.1186/s12913-019-4593-0" }, { "kind": "embedded_source_url", "source": "URL supplied in citation", "url": "https://doi.org/10.1186/s12913-019-4593-0" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Australian Government Department of Health, Disability and Ageing. What Primary Health Networks are. 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Their boards, clinical councils and community advisory committees inform decisions, but PHNs do not own or provide all primary care.", "tags": [], "territory": "31 regional Primary Health Network areas", "title": "What Primary Health Networks are", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.au/our-work/phn/what-PHNs-are?language=en" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Bank. World Development Indicators, Hospital beds per 1,000 people, Australia. 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This older all-sector series is suitable for international trend context, not a current domestic public-bed inventory.", "tags": [], "territory": "national comparable series", "title": "World Development Indicators: hospital beds", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://api.worldbank.org/v2/country/AUS/indicator/SH.MED.BEDS.ZS?format=json&per_page=100" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Bank. World Development Indicators, Nurses and midwives per 1,000 people, Australia. 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