Supply and demand – a health economic perspective on the Australian hospital and elective surgery crisis
Jeffrey C. L. Looi
A B * , Stephen Allison B C , Tarun Bastiampillai B C D , Stephen R. Kisely B E F and Stephen J. Robson G
A Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Garran, Canberra, ACT 2605, Australia.
B Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.
C College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
D Department of Psychiatry, Monash University, Wellington Road, Clayton, Vic., Australia.
E School of Medicine, The University of Queensland, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Qld, Australia.
F Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
G Department of Obstetrics and Gynaecology, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia.
Australian Health Review 47(4) 391-393 https://doi.org/10.1071/AH23048
Submitted: 16 March 2023 Accepted: 5 June 2023 Published: 21 June 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY).
Abstract
The COVID-19 pandemic has contributed to longstanding structural shortfalls in the supply of healthcare services in high-income countries, including Australia. These impacts are reflected in Australian public hospital key performance indicators for acute care, elective surgery and hospital exit block. The challenges occur in the context of increased demand following the suspension of a range of healthcare services during the pandemic. The main supply challenge is suitable numbers of skilled healthcare workers. Rebalancing of supply and demand in healthcare is challenging, but needs to be achieved.
Keywords: access block, COVID-19, exit block, health economics, healthcare demand, healthcare services, healthcare supply, healthcare workforce.
References
[1] ABS. COVID-19 Mortality by wave. Canberra, ACT, Australia: Australian Bureau of Statistics; 2023. Available at https://www. abs.gov.au/articles/covid-19-mortality-wave [12 June 2023][2] DITRDCA. Road Trauma Australia—Annual Summaries. Canberra, ACT, Australia: Department of Infrastructure, Transport, Regional Development, Communications and the Arts; 2023. Available at https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_annual_summaries [12 June 2023]
[3] COVID-19 Mortality Working Group. COVID-19 Mortality Working Group: Another month of high excess mortality in July 2022. Sydney, NSW, Australia: Actuaries Digital; 2022. Available at https://www.actuaries.digital/2022/11/04/covid-19-mortality-working-group-another-month-of-high-excess-mortality-in-july-2022/ [13 February 2023].
[4] Poon Y-SR, Lin YP, Griffiths P, et al. A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions. Hum Resour Health 2022; 20 70
| A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions.Crossref | GoogleScholarGoogle Scholar |
[5] Department of Health. National Medical Workforce Strategy 2021–2031. Canberra, ACT, Australia: Department of Health; 2022.
[6] Anonymous. Why health-care services are in chaos everywhere. London, UK: The Economist; 2023. Available at https://www.economist.com/finance-and-economics/2023/01/15/why-health-care-services-are-in-chaos-everywhere [1 February 2023].
[7] AMA. Australian public hospitals in logjam. Canberra, ACT, Australia: AMA; 2023. Available at https://www.ama.com.au/articles/australian-public-hospitals-logjam [1 February 2023].
[8] AMA. Hospital exit block: a symptom of a sick system. Canberra, ACT, Australia: AMA; 2023. Available at https://www.ama.com.au/articles/hospital-exit-block-symptom-sick-system [13 February 2023].
[9] Abbasi K. Sunak fiddles while the NHS burns. BMJ 2023; 380 p68
| Sunak fiddles while the NHS burns.Crossref | GoogleScholarGoogle Scholar |
[10] AMA. Addressing the elective surgery backlog. Canberra, ACT, Australia: AMA; 2023. Available at https://www.ama.com.au/articles/addressing-elective-surgery-backlog [1 February 2023].
[11] Amiet K, Robinson N. The post-pandemic spiral of our public hospitals. In: Amiet K, editor. The Front [podcast]. Sydney, NSW, Australia: The Australian; 2023. Available at https://www.theaustralian.com.au/nation/the-postpandemic-spiral-of-our-public-hospitals/audio/b7eba0a730de1a45e431efcd28036b52 [7 June 2023]
[12] AIHW. My Hospitals. Canberra, ACT, Australia: AIHW; 2023. Available at https://www.aihw.gov.au/reports-data/myhospitals [1 February 2023].
[13] AMA. Hospital performance failing as health system crumbles. Canberra, ACT, Australia: AMA; 2023. Available at https://www.ama.com.au/media/hospital-performance-failing-health-system-crumbles [1 February 2023].
[14] BMA. BMA warns of social care crisis as current system is ‘deeply flawed’ and in need of ‘urgent reform’. London, UK: BMA; 2022. Available at https://www.bma.org.uk/bma-media-centre/bma-warns-of-social-care-crisis-as-current-system-is-deeply-flawed-and-in-need-of-urgent-reform [13 february 2023].
[15] National Skills Commission. Care workforce labour market survey. Canberra, ACT, Australia: National Skills Commission; 2021.
[16] AMA. Medicare media ahead of Strengthening Medicare Taskforce report. Canberra, ACT, Australia: AMA; 2023. Available at https://www.ama.com.au/ama-rounds/27-january-2023/articles/medicare-media-ahead-strengthening-medicare-taskforce-report [1 February 2023].
[17] Skinner C. Health workforce: not normal, not safe, but it can be fixed. Sydney, NSW, Australia: MJA Insight+; 2022. Available at https://insightplus.mja.com.au/2022/11/health-workforce-not-normal-not-safe-but-it-can-be-fixed/ [10 May 2023].
[18] National Skills Commission. 2022 Skills Priority List Key Findings Report. Canberra, ACT, Australia: National Skills Commission; 2022. Available at https://www.nationalskillscommission.gov.au/sites/default/files/2022-10/2022%20SPL%20Key%20Findings%20Report%20-%206%20October%202022_0.pdf [10 May 2023].
[19] AAMC. AAMC Report Reinforces Mounting Physician Shortage. Washington, DC, USA: AAMC; 2021. Available at https://www.aamc.org/news-insights/press-releases/aamc-report-reinforces-mounting-physician-shortage [1 February 2023].
[20] Shanafelt TD, West CP, Dyrbye LN, et al. Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic. Mayo Clin Proc 2022; 97 2248–58.
| Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic.Crossref | GoogleScholarGoogle Scholar |
[21] McFadzean IJ, Edwards M, Davies F, et al. Realist analysis of whether emergency departments with primary care services generate ‘provider-induced demand’. BMC Emerg Med 2022; 22 155
| Realist analysis of whether emergency departments with primary care services generate ‘provider-induced demand’.Crossref | GoogleScholarGoogle Scholar |
[22] Department of Health. Australian Government partnership with private health sector secures 30,000 hospital beds and 105,000 nurses and staff, to help fight COVID-19 pandemic. Canberra, ACT, Australia: Department of Health; 2020. Available at https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/australian-government-partnership-with-private-health-sector-secures-30000-hospital-beds-and-105000-nurses-and-staff-to-help-fight-covid-19-pandemic [10 May 2023].
[23] Spiliakos A. Tragedy of the Commons: What It Is and 5 Examples. Boston, MA, USA: Harvard Business School; 2019. Available at https://online.hbs.edu/blog/post/tragedy-of-the-commons-impact-on-sustainability-issues [13 February 2023].
