For national reporting of the Admitted patient episode of care-patient election status data element the following mapping occurs:
Code 1 Public is mapped to code 1 Public.
Code 2 Private shared is mapped to code 2 Private.
Code 3 Private single is mapped to code 2 Private.
Hospital Based Corporate Information System (HBCIS):
This data element is derived from the second digit of the Episode of admitted patient care-account class data element:
P is code 1 (Public)
R is code 2 (Private single)
S is code 3 (Private shared)
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Ineligible for Medicare
A patient who is ineligible for Medicare does not have access to hospital treatment 'free of charge'.
Queensland public hospitals are to provide Medicare ineligible patients with a choice to be treated as a public or private patient. Different fees apply depending on the option chosen. Refer to the Queensland Health Fees and Charges Register.
A patient who is compensable (e.g. entitled to receive compensation for their hospital treatment) does not have access to hospital treatment 'free of charge'. However, they do have the right to elect to be treated either by a hospital nominated doctor ("public") or by a doctor of their choice ("private").
Compensable patient charges will be raised on behalf of the patient either directly or indirectly through bulk-funding arrangements for their public hospital care, regardless of public or private chargeable status.
If a compensable patient has elected to be treated privately they will be responsible for all charges if the compensation claim is rejected or the insurer does not provide prior approval of the private status.
Department of Veterans' Affairs (DVA)
A patient who holds a Gold or White Repatriation Health Care Card can choose to use or not to use the benefits of their entitlement card. All eligible DVA patients who elect to have the DVA fund their hospitalisation, will also need to decide on whether they wish to have a public or private doctor manage their treatment. It is recognised that not all public hospitals have access to private doctors, hence account class codes are available that recognise a veteran's choice of doctor.
Reciprocal Health Care Agreements (RHCA)
The Australian Government has signed RHCA with the governments of the United Kingdom, Republic of Ireland, New Zealand, Sweden, the Netherlands, Belgium, Finland, Norway, Slovenia, Malta and Italy which entitles the patient to public hospital services 'free of charge' for 'essential' medical treatment while visiting Australia. A patient relying on a RHCA to cover the cost of their hospital stay must elect to be a public patient. Conditions such as period of cover vary between the different Agreements. For more information see the Department of Human Services website.
If a patient from a country with a RHCA with Australia, elects to be treated by a doctor of their choice i.e. a private patient, then they are ineligible for Medicare and do not have a right to access hospital care 'free of charge'. They will be coded as private ineligible patient regardless of whether the treatment was for 'essential' medical treatment or not.