Evaluating primary care expenditure in Australia: the Primary Care Spend (PC Spend) model

Objectives To assess the distribution of health care expenditure (public and private) for primary care and primary health care as proportions of overall health care funding. Study design The Primary Care Spend model; estimated distribution of expenditure for three tiers of primary care services by provider and function. Setting Primary Care Spend model applied to Australian health expenditure, public and private, 2020–21, from a health sector perspective, as recorded by the Australian Institute of Health and Welfare. Main outcome measures Proportions of all health care spending for essential community and primary health care functions (tier A), comprehensive primary care (services delivered in general practices and family physician clinics; tier B), and enhanced primary care services (long-term holistic patient care; tier C). Results In 2020–21, 33.2% of health spending in Australia was classified as primary health care spending (tier A), 6.0% as comprehensive primary care services (tier B), and 0.8% as long term holistic patient care services (tier C). Conclusions The application of the Primary Care Spend model to Australian data provides a more nuanced analysis of expenditure for primary health care than routine health expenditure reports. Its output could be used to inform targets for spending on different tiers, types, and locations of primary care, especially comprehensive and other high value primary care services, and to monitor progress toward these targets.