Expenditure by condition

Introduction

This section summarises the results for Queensland in the Australian Institute of Health and Welfare’s (AIHW) estimates of health system spending by Australian Burden of Disease Study (ABDS) groups and specific diseases and injuries.¹ Understanding how health spending is distributed across the main disease groups and conditions driving health burden can highlight areas that may need increased resources as the population ages, and opportunities to reduce health burden by increasing resources for specific conditions including through prevention efforts.

Because estimates were based on health system expenditure, tangible costs incurred outside the health system, such as residential aged care facilities, workplaces, research, and judicial systems, are not included. Intangible costs such as lost productivity or reduced quality of life are also not included in these figures. Preventive health spending through public and community health programs is also not included due to difficulty allocating such spending to specific conditions. Such spending is typically less than 5% of total health expenditure.

Disease group expenditure

In 2022–23, an estimated $34.669 billion could be attributed to specific diseases and injuries in Queensland.¹ The comparative national figure was $172.350 billion.

In Queensland, by broad area:

• $22.808 billion (65.8%) was for hospital services
• $8.860 billion (25.6%) was for primary health care
• $3.002 billion (8.7%) was referred medical services.

Of the ABDS disease groups, cancer and other neoplasms had the highest estimated spending in 2022–23 ($4.021 billion, or 11.6% of total allocated spending) followed by cardiovascular diseases ($3.345 billion; 9.6%) and musculoskeletal disorders $3.345 billion; 9.1%) (Figure 1).

Figure 1 shows the breakdown of ABDS disease groups by area of services. Each shade of colours represents broad areas of services, where green is for hospitals, blue is for primary health care, and yellow is referred medical services.

Figure 1: Queensland allocated recurrent spending by disease group, 2022–23

Treatment of risk factors and Well care

In the most recent release of the Health system spending on disease and injury in Australia report, AIHW includes Treatment of risk factors and Well care as burden of disease groups.¹ Treatment of risk factors includes categories such as treatment of hypertension, treatment of obesity, tobacco intervention and treatment of hyperlipidaemia, and Well care includes social services, well person (such as routine examinations), counselling services, family planning, donor, pregnancy and post-partum care, and well dental (such as routine check-ups and cleaning).

In Queensland in 2022–23, $607 million was spent on treatment of risk factors, which was 1.8% of the total disease spending. The proportion was similar to the national spending (1.7%; $2.872 billion). Treatment of hypertension was the largest contributor to this group ($386 million), followed by treatment of obesity ($211 million) and tobacco intervention ($11 million).

For Well care, $2.230 billion was spent in 2022–23 in Queensland and the proportion of total spending for Well care was lower than national (6.4% and 7.7% respectively). Of Well care spending, 40.0% was spent on well dental ($891 million), followed by pregnancy and postpartum care ($870 million) and well person ($306 million).

Spending by sex and age

The prevalence of diseases are strongly related to age and sex, and examining relationships by sex and age group provides further insights into the differences in spending patterns for diseases. Note that due to data unavailability, analyses by age and sex excludes spending for oral disorders.

For males, cancer and other neoplasms had the highest estimated spending ($2.170 billion; 13.9% of total allocated spending) followed by cardiovascular diseases ($1.947 billion; 12.4%) and musculoskeletal disorders ($1.424 billion; 9.1%). For females, they were cancer and other neoplasms ($1.783 billion; 10.4%), musculoskeletal disorders ($1.689 billion; 9.9%) and cardiovascular diseases ($1.391 billion; 8.1%).

Adults 70 to 74 years had the highest estimated spending ($3.236 billion), followed by 75 to 79 years ($3.165 billion) and 65 to 69 years ($2.936 billion). For 70 to 74 years, cancer and other neoplasms had the highest estimated spending ($596 million), followed by cardiovascular diseases ($471 million) (Figure 2).

Figure 2: Queensland disease group allocated spending, 2022–23

Specific condition expenditure

Considering spending due to specific conditions, the three largest in terms of estimated spending were falls ($982 million), back pain and problems ($848 million) and osteoarthritis ($812 million) (Figure 3). All of these conditions are more prevalent in older age groups, where 47.5%, 31.0% and 50.9% of the total disease spending were for adults 70 years and older for falls, back pain and problems, and osteoarthritis, respectively.

Figure 3: Top 20 conditions for Queensland allocated spending, 2022–23

Changes over time

Over the last decade from 2013–14 to 2022–23, estimated disease expenditure in Queensland has increased from $24.948 billion to $34.669 billion (in constant prices). Public hospital admitted patient service remained the largest area of spending for diseases and injury for the last decade with $12.912 billion in 2022–23, followed by private hospital services ($6.594 billion) and pharmaceutical benefits scheme (PBS) ($4.168 billion) (Figure 4). The pattern in Queensland was similar for Australia overall.

• Spending for public hospital admissions has steadily increased—from $8.466 billion in 2013–14 to $12.912 billion in 2022–23 (in constant prices). While the spending for other hospital services (private hospital services, public hospital emergency department and outpatient services) have also increased, the level of increases were lower.
• In 2021–22, nationally, spending on pathology services surpassed medical imaging, before reducing in 2022–23. In Queensland, however, spending on pathology services have stayed lower than medical imaging spending since 2013–14.

Figure 4: Trend of disease spending by area (constant prices), Queensland

In 2022–23, the disease group that attracted the most disease expenditure was cancer and other neoplasms ($4.021 billion), followed by cardiovascular diseases ($3.345 billion) and musculoskeletal disorders ($3.141 billion). In 2013–14 (in constant prices), the top 3 were cancer and other neoplasms ($2.363 billion), musculoskeletal disorders ($2.346 billion) and cardiovascular diseases ($2.336 billion).¹ Changes in spending are due to many factors such as population growth and ageing, changes in health care treatment and cost, and changes to lifestyles and environments.

• For cancer and neoplasms, the estimated spending for public hospital admission was $744 million in 2013–14 and $1.432 billion in 2022–23. For PBS, they were $495 million in 2013–14 and $990 million in 2022–23, respectively. Spending on specialist services for cancer and neoplasms have also increased substantially from $130 million in 2013–14 to $256 million in 2022–23 (in constant prices).
• Similarly to the national trend, there was a spike in the spending for infectious diseases, in particular for public hospital outpatient and pathology services from 2019–20 to 2021–22, impacted by the COVID-19 pandemic. Spending on infectious diseases in public hospital admitted patient also saw a substantial increase in 2020–21.
• Spending on falls saw a large increase during the period—an increase from $689 million to $982 million. Spending on Type 2 diabetes has also increased—from $348 million to $556 million. For both diseases, the largest increases were observed in public hospital admissions.

Additional information

Data and statistics

Additional information are available on the Australian Institute of Health and Welfare website.

For expenditure by ABDS disease groups and conditions:

• Health system spending on disease and injury in Australia, 2022-23
• Health system spending per case of disease and for certain risk factors

For area of expenditure:

• Health expenditure

For spending on COVID-19 is available from:

• Health system spending on the response to COVID-19 in Australia 2019-20 to 2022-23