Medical | Explain the difference between public hospitals and private hospitals in Australia: How to choose the right hospital and doctor according to the condition?

Release your eyes, put on headphones, and listen~!
There are both public and private medical systems in Australia, and patients need to choose where to seek medical treatment based on their own circumstances. (Sanja Gjenero: www.sxc.hu)

In Australia, the news of online crowdfunding for several patients to receive treatment by the famous neurosurgeon Zhang Zhengxian has caused a lot of noise and aroused heated discussions in the community about where to go for medical treatment.

Key point

  • Patients in Australia can choose to seek medical treatment in public hospitals in other states or territories.The premise is to pass the strict audit of the agency

  • Since public hospitals can quickly organize multi-department joint diagnosis and treatment forces,In critical emergency situations, public hospitals may be a better choice

  • Public hospitals are responsible for training tasks, so patients can hardly appoint doctors

So, do Australian patients have no chance to receive high-quality medical services in public hospitals in a timely manner, as reported on the Internet, and spend a lot of money to receive all necessary treatments in private hospitals? A large hospital with a good reputation must cure all diseases, while a small hospital hidden in the world is a "quack doctor"?

In response to these issues that everyone is concerned about, the Australian Broadcasting Corporation ABC Chinese interviewed Dr. Xu Ruwei, an industry insider.

Xu Ruwei of Melbourne is a senior general surgeon who also works in many public and private hospitals including La Trobe Hospital and Knox Private Hospital.

Public hospital or private hospital

Both public and private hospitals in Australia have existed for a long time,In quantityThe difference is not great. According to statistics, from 2013 to 2014, the whole countryThere are 747 public hospitals and 612 private hospitals.

InSources of funds, Public hospitals mainlyFunded by the federal and state governments.据澳大利亚健康福利研究所《2016年澳大利亚卫生统计》报告(Australia’s Health 2016),2013-2014年,公立医院联邦拨款占37%,州以及领地政府拨款占54%。

OnOperationIn the above, the federal government is responsible for funding public hospitals, and the state government is responsible for fund allocation, personnel management, and reporting the use of funds to the federal government every year.

There are two types of private hospitals, one is run by the churchNon-profitHospital, the other isNature of profitHospitals, accounting for about 6 of the total0%.

Many people think that going to public hospitals does not cost money, but the service is not very good, while going to private hospitals is expensive and the service is good. So, is this really the case?

"On the whole, in terms of the degree of treatment, the difference between public hospitals and private hospitalsLittle difference in quality.Dr. Xu said."

He said,The advantages of public hospitals are usually large-scale and well-equipped, and comprehensive departments are the biggest advantages of public hospitals.For example, the largest public hospitals in Victoria, such as Monash Medical Centre and Royal Melbourne Hospital, contain almost all departments. such,The departments in the same system will cooperate more conveniently.

As for private hospitals, they vary in size.In the Greater Melbourne area, companies such as Epworth Healthcare and Cabrini HealthLarge non-profit private medical institutions have no disadvantages compared with public hospitals.

As for the long-term criticism, the long-termWaiting time for public hospital visits, Dr. Xu’s explanation is,Public hospitals admit many patients, and the state funding is limited, so they cannot provide services to everyone at any time.

Dr. Xu suggested,Patients can decide whether to go to a public hospital or a private hospital based on their condition.

He said that if you have common diseases or require elective surgery, such as common gallbladder and hernia surgery in general surgery, joint replacement in orthopedics, and elective surgery such as childbirth or obstetric surgery, it is more efficient to go to private hospitals. .

If you suffer from a common disease or require elective surgery, it is more efficient to go to a private hospital. (ABC News: Dan Cox)

Generally speaking,There are three advantages to seeing a doctor in a private hospital:Choose your own doctor; choose your own time; the specialist himself is responsible for the entire treatment process.

According to information on the Australian Institute of Health and Welfare (Australian Institute of Health and Welfare) website, elective surgery is divided into three categories in Australia. Among them, the waiting time for type 30 elective surgery is the shortest, and the recommended waiting period is 90 days; the recommended waiting period for type 365 elective surgery is XNUMX days; as for the third type of elective surgery, because it is a non-critical operation, the waiting period is the longest, and the recommended waiting time is For XNUMX days.The clinician will classify each patient who needs surgery according to the patient's condition and inform the approximate waiting time.

therefore,The patient can make a choice based on the waiting period for his elective surgery. If the surgery to be accepted isThree types of elective surgery,If you don’t want to wait too long, you might consider going to a private hospital.

Dr. Xu emphasized that although the waiting time for seeing common diseases in public hospitals is long,However, it is better to go to a public hospital in time for a critical emergency.For example, gastric perforation, cerebral hemorrhage, etc.Life threateningMost patients will be sent to public hospitals for emergency treatment. AgainSevere traumaFor example, large private hospitals have trauma specialists, but the trauma departments of larger public hospitals can handle such emergencies.

In addition, he also stated,It may be better to go to a public hospital for treatment of rare diseases, because the treatment of such diseases requires the cooperation of multiple departments, and large public hospitals have advantages in this regard.

There have been media reports that private hospitals in Australia are only willing to treat short-term patients. In response to this statement, Dr. Xu said,Public hospitals have a large investment, and the state is responsible for the admission and treatment of patients, so they can be treated for a long time as needed. It can take as long as it takes.

As for private hospitals, treatment plans are generally determined based on the recommendations of specialists.In this way, sometimes it is necessary to know the burden of the hospital after admitting the patient.

Is it feasible to seek medical treatment in another place?

Under normal circumstances, patients will not seek treatment. But inIf local medical resources are unable to provide treatment for the patient, or it is difficult to treat, the patient can also go to other states or territories for medical treatment.

"There is no problem in going to public hospitals across states or territories, especiallyTreat acute diseases,"Doctor Xu said.

For example, a patient living at the border of Victoria and NSW who needs to undergo gastroscopy or colonoscopy can apply directly to a public hospital in a neighboring state. After that, the internal management organization of the hospital conducts an audit to understand the patient's condition, long-term residence and other information, and verifies whether the medical institution of the patient's residence can conduct relevant examinations and treatments to make a final decision.

"You must have sufficient reasons to convince the hospital to prove that your request to seek treatment in a neighboring state or territory is reasonable," Dr. Xu emphasized.

He went on to say that if patients who want to go to public hospitals in other states or territories are suffering fromchronic, It’s more difficult to fulfill your wish, because the states and territoriesPublic hospitals must first give local residents priority treatment.

"But once that hospital puts you in its own treatment system, it shouldn't charge any more," he said.

For patients who intend to be treated in other places, it is necessary to pay attention to the provisions of the state or territory health agency for financial assistance to patients seeking medical treatment in other places.For example, the health agency in Canberra clearly stated that if certain patients cannot be treated in the Capital Territory, the government will provide eligible persons with part of the cost of treatment in public medical institutions in other states or territories. Download the application form from the website of the Ministry of Health of the Capital Territory and fill it out.

If you want to go to a public hospital in an out-of-state or territory to seek treatment from a private medical system doctor, the procedure is different.

For example, Dr. Zhang Zhengxian said in the "Today" program on Channel XNUMX,If patients outside of NSW ask him for surgery in the public healthcare system, they need to be coordinated by the Centre of Excellence in NSW.But so far the center has not successfully coordinated to ask Dr. Zhang to perform an operation in a public hospital.

Don't look at the "face value", but choose the doctor that suits you

After some patients come to Australia, they will consult around to find out which hospital has high-tech medical staff.The misunderstanding that some patients from China often have is that if the hospital is big and beautiful, the level of doctors is certainly not low.

in fact, Australian doctors are not fixed in a medical institution for consultations, but mobile consultations.There is little difference in the treatment of common and frequently-occurring diseases.

"A very important concept is that Australian doctors areIndependent occupationIndividuals,Often not hired by a hospital. Doctors are not controlled by the hospital, so they have the right to choose how to work and how to work," said Dr. Xu.

Taking himself as an example, he further explained, “For example, after receiving surgical training, I can choose to do surgery that I am good at and like to do.”

"Each of us has a relatively professional training, so I sometimes transfer patients referred by general practitioners to more suitable doctors instead of handling all diseases myself," said Dr. Xu.

"Whether it is a public hospital or a private hospital, every doctor has his own expertise."

Dr. Xu said,You cannot use the "Appearance Association" point of view when you seek medical treatment in Australia, but only look at the "face value" of the hospital, because all hospitals must have nationally recognized qualifications.

For example, he said, Box Hill Hospital and Peter MacCallum cancer centers both seem to be large in scale and beautiful in appearance.However, the medical conditions and the level of doctors are similar to those of the same level hospitals.

"of course,The state should support some special specialties.For example, we will refer trauma patients with slightly severe trauma to the two largest trauma centers in Melbourne-Alfred Hospital (Alfred Hospital) or Royal Melbourne Hospital, rather than Monash Medical, which seems to be very large Center," Dr. Xu explained.

of courseThis is not to say that the medical level of some hospitals is not as good as other hospitals, because all doctors in Australia have undergone very strict and sufficient training before they can work.Doctor’s qualifications are determined byRoyal College of SurgeonsAnd the definition and control of various professional associations.

Dr. Xu said that taking general surgery as an example, general surgeons working in any general hospital can treat large-scale diseases such as gallbladder disease, thyroid disease or gastrointestinal disease.

Who will treat me for surgery?

Some patients said that when they went to public hospitals, many of the doctors who consulted and operated on them were fledgling young people, but when they went to private hospitals, all they met were highly skilled and experienced doctors. So, why is there such a difference?

Dr. Xu said,One big difference between public hospitals and private hospitals is the training.Public hospitals are responsible forThe training of future doctors at all levels throughout the country, but private hospitals do not have these tasks.

"This means that you can hardly designate a doctor in a public hospital," Dr. Xu said.

In Australia, whether it is a private hospital or a public hospital, surgeons must undergo extremely strict training before they can work. (Pixabay, CC0)

For example,The doctor who performs the operation on the patient may not be the patient, the specialist just puts it on the waiting list for the operation.If the scale of the medical system is larger and there are more hospitals under it, if it is not for a very special condition, the less likely it is for outpatient specialists to perform operations on their own specific patients.

"Because of the training issue,So many operations in public hospitals are done by trained people."Dr. Xu said, "Of course, this kind of operation is also done under close supervision and guidance, so the risk is not high. "

Dr. Xu addedIf you use private medical insurance, patients will have more choices.For example, when a patient who needs an operation seeks a specific specialist doctor for consultation in a specialist clinic or private clinic, and indicates that he is willing to use private medical insurance, then the patient's surgery is performed by the specialist himself. If a patient does not have private medical insurance and chooses to perform an operation in a public hospital, the doctor who finally completes the operation may not be the specialist doctor himself, but may be other specialists or trained doctors under the guidance of specialists.

It is worth mentioning that since Australian doctors not only do not take full-time consultations, but they can also hold two positions in public hospitals and private hospitals. Therefore, they will meet experienced doctors and receive excellent medical services in public hospitals.

Dr. Xu specifically pointed out that in some cases, outpatient specialists will directly refer patients who need surgery to a hospital that specializes in such operations. For example, patients in Victoria who need a heart and lung transplant will be transferred to the state's designated hospital-Alfred Hospital, and patients who need a liver transplant will be transferred to another general public hospital-Austin Hospital ( Austin Hospital).

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