PET - Plain English Taxonomy

HRF_601_1_2: Statistical Data - by State - VIC
Effective date: 1 January 2024

Australian Business Number	Institution Name

Reporting Period	Scale Factor
Quarterly	Whole dollars to two decimal places
Reporting Consolidation
Health Benefits Fund

Part 1 Policies and insured persons

	Single	Family	Single parent	Couple	2+ persons no adults	3+ adults	Total
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
1. Total hospital treatment (includes hospital treatment only and hospital treatment and general treatment combined)
1.1. Policies
1.1.1. Exclusionary policies
1.1.1.1. Excess & co-payments	OI12444	OI12445	OI12446	OI12447	OI12448	OI12449	OI12450
1.1.1.2. No excess & no co-payments	OI12451	OI12452	OI12453	OI12454	OI12455	OI12456	OI12457
1.1.1.3. Total exclusionary policies	OI12458	OI12459	OI12460	OI12461	OI12462	OI12463	OI12464
1.1.2. Non-exclusionary policies
1.1.2.1. Excess & co-payments	OI12465	OI12466	OI12467	OI12468	OI12469	OI12470	OI12471
1.1.2.2. No excess & no co-payments	OI12472	OI12473	OI12474	OI12475	OI12476	OI12477	OI12478
1.1.2.3. Total non-exclusionary policies	OI12479	OI12480	OI12481	OI12482	OI12483	OI12484	OI12485
1.2. Total policies	OI12486	OI12487	OI12488	OI12489	OI12490	OI12491	OI12492
1.3. Insured persons
1.3.1. Exclusionary policies
1.3.1.1. Excess & co-payments	OI12493	OI12494	OI12495	OI12496	OI12497	OI12498	OI12499
1.3.1.2. No excess & no co-payments	OI12500	OI12501	OI12502	OI12503	OI12504	OI12505	OI12506
1.3.1.3. Total exclusionary policies	OI12507	OI12508	OI12509	OI12510	OI12511	OI12512	OI12513
1.3.2. Non-exclusionary policies
1.3.2.1. Excess & co-payments	OI12514	OI12515	OI12516	OI12517	OI12518	OI12519	OI12520
1.3.2.2. No excess & no co-payments	OI12521	OI12522	OI12523	OI12524	OI12525	OI12526	OI12527
1.3.2.3. Total non-exclusionary policies	OI12528	OI12529	OI12530	OI12531	OI12532	OI12533	OI12534
1.4. Total insured persons	OI12535	OI12536	OI12537	OI12538	OI12539	OI12540	OI12541
2. Hospital treatment only
2.1. Policies
2.1.1. Exclusionary policies
2.1.1.1. Excess & co-payments	OI12542	OI12543	OI12544	OI12545	OI12546	OI12547	OI12548
2.1.1.2. No excess & no co-payments	OI12549	OI12550	OI12551	OI12552	OI12553	OI12554	OI12555
2.1.1.3. Total exclusionary policies	OI12556	OI12557	OI12558	OI12559	OI12560	OI12561	OI12562
2.1.2. Non-exclusionary policies
2.1.2.1. Excess & co-payments	OI12563	OI12564	OI12565	OI12566	OI12567	OI12568	OI12569
2.1.2.2. No excess & no co-payments	OI12570	OI12571	OI12572	OI12573	OI12574	OI12575	OI12576
2.1.2.3. Total non-exclusionary policies	OI12577	OI12578	OI12579	OI12580	OI12581	OI12582	OI12583
2.2. Total policies	OI12584	OI12585	OI12586	OI12587	OI12588	OI12589	OI12590
2.3. Insured persons
2.3.1. Exclusionary policies
2.3.1.1. Excess & co-payments	OI12591	OI12592	OI12593	OI12594	OI12595	OI12596	OI12597
2.3.1.2. No excess & no co-payments	OI12598	OI12599	OI12600	OI12601	OI12602	OI12603	OI12604
2.3.1.3. Total exclusionary policies	OI12605	OI12606	OI12607	OI12608	OI12609	OI12610	OI12611
2.3.2. Non-exclusionary policies
2.3.2.1. Excess & co-payments	OI12612	OI12613	OI12614	OI12615	OI12616	OI12617	OI12618
2.3.2.2. No excess & no co-payments	OI12619	OI12620	OI12621	OI12622	OI12623	OI12624	OI12625
2.3.2.3. Total non-exclusionary policies	OI12626	OI12627	OI12628	OI12629	OI12630	OI12631	OI12632
2.4. Total insured persons	OI12633	OI12634	OI12635	OI12636	OI12637	OI12638	OI12639
3. Hospital treatment and general treatment combined
3.1. Policies
3.1.1. Exclusionary policies
3.1.1.1. Excess & co-payments	OI12640	OI12641	OI12642	OI12643	OI12644	OI12645	OI12646
3.1.1.2. No excess & no co-payments	OI12647	OI12648	OI12649	OI12650	OI12651	OI12652	OI12653
3.1.1.3. Total exclusionary policies	OI12654	OI12655	OI12656	OI12657	OI12658	OI12659	OI12660
3.1.2. Non-exclusionary policies
3.1.2.1. Excess & co-payments	OI12661	OI12662	OI12663	OI12664	OI12665	OI12666	OI12667
3.1.2.2. No excess & no co-payments	OI12668	OI12669	OI12670	OI12671	OI12672	OI12673	OI12674
3.1.2.3. Total non-exclusionary policies	OI12675	OI12676	OI12677	OI12678	OI12679	OI12680	OI12681
3.2. Total policies	OI12682	OI12683	OI12684	OI12685	OI12686	OI12687	OI12688
3.3. Insured persons
3.3.1. Exclusionary policies
3.3.1.1. Excess & co-payments	OI12689	OI12690	OI12691	OI12692	OI12693	OI12694	OI12695
3.3.1.2. No excess & no co-payments	OI12696	OI12697	OI12698	OI12699	OI12700	OI12701	OI12702
3.3.1.3. Total exclusionary policies	OI12703	OI12704	OI12705	OI12706	OI12707	OI12708	OI12709
3.3.2. Non-exclusionary policies
3.3.2.1. Excess & co-payments	OI12710	OI12711	OI12712	OI12713	OI12714	OI12715	OI12716
3.3.2.2. No excess & no co-payments	OI12717	OI12718	OI12719	OI12720	OI12721	OI12722	OI12723
3.3.2.3. Total non-exclusionary policies	OI12724	OI12725	OI12726	OI12727	OI12728	OI12729	OI12730
3.4. Total insured persons	OI12731	OI12732	OI12733	OI12734	OI12735	OI12736	OI12737
4. General treatment ambulance only
4.1.1. Policies	OI12738	OI12739	OI12740	OI12741	OI12742	OI12743	OI12744
4.1.2. Insured persons	OI12745	OI12746	OI12747	OI12748	OI12749	OI12750	OI12751
5. Total general treatment only
5.1.1. Policies	OI12752	OI12753	OI12754	OI12755	OI12756	OI12757	OI12758
5.1.2. Insured persons	OI12759	OI12760	OI12761	OI12762	OI12763	OI12764	OI12765
6. General treatment excluding hospital-substitute, CDMP and hospital-linked ambulance treatment
6.1.1. Policies	OI12766	OI12767	OI12768	OI12769	OI12770	OI12771	OI12772
6.1.2. Insured persons	OI12773	OI12774	OI12775	OI12776	OI12777	OI12778	OI12779
7. Total general treatment
7.1.1. Policies	OI12780	OI12781	OI12782	OI12783	OI12784	OI12785	OI12786
7.1.2. Insured persons	OI12787	OI12788	OI12789	OI12790	OI12791	OI12792	OI12793

Changes during the quarter

	Hospital treatment only		Hospital treatment and general treatment		General treatment only
	Policies	Insured persons	Policies	Insured persons	Policies	Insured persons
	(1)	(2)	(3)	(4)	(5)	(6)
8. Start of quarter	OI12794	OI12795	OI12796	OI12797	OI12798	OI12799
9. New policies/persons	OI12800	OI12801	OI12802	OI12803	OI12804	OI12805
10. Transferring from another state	OI12806	OI12807	OI12808	OI12809	OI12810	OI12811
11. Transferring to another state	OI12812	OI12813	OI12814	OI12815	OI12816	OI12817
12. Transferring from another fund	OI12818	OI12819	OI12820	OI12821	OI12822	OI12823
13. Transferring from another policy	OI12824	OI12825	OI12826	OI12827	OI12828	OI12829
14. Transferring to another policy	OI12830	OI12831	OI12832	OI12833	OI12834	OI12835
15. Discontinued	OI12836	OI12837	OI12838	OI12839	OI12840	OI12841
16. End of quarter	OI12842	OI12843	OI12844	OI12845	OI12846	OI12847

Part 2 Total benefits paid for hospital treatment and hospital-substitute treatment

Total benefits for hospital treatment and hospital-substitute treatment

	Episodes	Days	Benefits paid
	(1)	(2)	(3)
17. Day hospital	OI12848	OI12849	OI12850
18. Public hospitals
18.1. Day only	OI12851	OI12852	OI12853
18.2. Overnight	OI12854	OI12855	OI12856
19. Private hospitals
19.1. Day only	OI12857	OI12858	OI12859
19.2. Overnight	OI12860	OI12861	OI12862
20. Hospital-substitute day only	OI12863	OI12864	OI12865
21. Treatment greater than one day	OI12866	OI12867	OI12868
22. Total	OI12869	OI12870	OI12871
23. Nursing home type patients
23.1. Public hospitals	OI12872	OI12873	OI12874
23.2. Private hospitals	OI12875	OI12876	OI12877
23.3. Total nursing home type patients	OI12878	OI12879	OI12880

	Number	Benefits paid
	(1)	(2)
24. Medical benefits	OI12881	OI12882
25. Medical devices or human tissue products benefits	OI12883	OI12884
26. Total Chronic Disease Management Programs	OI12885	OI12886

	Benefits paid
27. Total benefits paid for general treatment	OI12887
28. Ineligible hospital benefits	OI12888
29. Total benefits paid for hospital treatment and general treatment	OI12889

High Cost Claimants Pool

30. Number of HCCP claimants (current quarter)	OI12890
31. Gross benefits for current and preceding 3 quarters (for current quarter HCCP claimants)	OI12891
32. Net benefits for current and preceding 3 quarters for HCCP claimants - after ABP	OI12892
33. Net benefits above threshold for current and preceding 3 quarters (for current quarter HCCP claimants)	OI12893
34. Total benefits to be included in HCCP (current quarter)	OI12894

Part 3 Hospital treatment by age category

Hospital treatment by age category

35. Males

Age group	Insured persons	Episodes	Days	Other HT benefits	Medical benefits	Medical devices or human tissue products benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
OI12896	OI12897	OI12898	OI12899	PL18168	PL18169	PL18170	PL18171
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

35.1. Total males	OI12900	OI12901	OI12902	PL18172	PL18173	PL18174	PL18175

36. Females

Age group	Insured persons	Episodes	Days	Other HT benefits	Medical benefits	Medical devices or human tissue products benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
OI12903	OI12904	OI12905	OI12906	PL18176	PL18177	PL18178	PL18179
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

36.1. Total females	OI12907	OI12908	OI12909	PL18180	PL18181	PL18182	PL18183

Part 4 Hospital-substitute treatment by age category

Hospital-substitute treatment by age category

37. Males

Age group	Insured persons	Episodes	Days	Other H-ST benefits	Medical benefits	Medical devices or human tissue products benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
OI12910	OI12911	OI12912	OI12913	PL18184	PL18185	PL18186	PL18187
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

37.1. Total males	OI12914	OI12915	OI12916	PL18188	PL18189	PL18190	PL18191

38. Females

Age group	Insured persons	Episodes	Days	Other H-ST benefits	Medical benefits	Medical devices or human tissue products benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
OI12917	OI12918	OI12919	OI12920	PL18192	PL18193	PL18194	PL18195
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

38.1. Total females	OI12921	OI12922	OI12923	PL18196	PL18197	PL18198	PL18199

Part 5 Chronic Disease Management Program by age category

Chronic Disease Management Program by age category

39. Males

Age group	Insured persons	Programs	Eligible benefits	Ineligible benefits	Total benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)
OI12924	OI12925	OI12926	PL18200	PL18201	PL18202	PL18203
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

39.1. Total males	OI12927	OI12928	PL18204	PL18205	PL18206	PL18207

40. Females

Age group	Insured persons	Programs	Eligible benefits	Ineligible benefits	Total benefits	Fees excluding medicare benefit
(1)	(2)	(3)	(4)	(5)	(6)	(7)
OI12929	OI12930	OI12931	PL18208	PL18209	PL18210	PL18211
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

40.1. Total females	OI12932	OI12933	PL18212	PL18213	PL18214	PL18215

Part 6 General treatment excluding hospital-substitute, CDMP and hospital-linked ambulance treatment

General treatment by age category

41. Males

Age group	Insured persons	Services	Benefits	Fees charged
(1)	(2)	(3)	(4)	(5)
OI12934	OI12935	OI12936	PL18216	PL18217
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

41.1. Total males	OI12937	OI12938	PL18218	PL18219

42. Females

Age group	Insured persons	Services	Benefits	Fees charged
(1)	(2)	(3)	(4)	(5)
OI12939	OI12940	OI12941	PL18220	PL18221
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95+

42.1. Total females	OI12942	OI12943	PL18222	PL18223

Part 7 Total hospital treatment policies by type of cover

Total hospital treatment policies

43. Number of policies

	Full cover	Reduced cover but no lifetime exclusions	Reduced cover and some lifetime exclusions	Some lifetime exclusions but no reduced cover	Total
	(1)	(2)	(3)	(4)	(5)
43.1. Excess & co-payments
NIL	OI14136	OI14137	OI14138	OI14139	OI14140
<= $500/$1,000 (*)	OI14141	OI14142	OI14143	OI14144	OI14145
> $500/$1,000 (**)	OI14146	OI14147	OI14148	OI14149	OI14150
43.2. Total	OI12950	OI12951	OI12952	OI12953	OI12954

(*) Excess <= $500 per policy covering only one person and excess <=$1,000 for all other policies
(**) Excess > $500 per policy covering only one person and excess > $1,000 for all other policies


General treatment claims processing for the state (excluding hospital-substitute treatment and CDMP)

44. Percent of claims processed within five working days	OI12955

National retention index - hospital treatment policy holders

45. Percent of policies existing two years or more that are still in force	OI12956

Part 8 Benefits paid for Chronic Disease Management Programs

46. Benefits paid for CDMPs

CDMP deliverables	Services	Benefits	Fees charged
(1)	(2)	(3)	(4)
OI12957	OI14179	OI12959	OI12960
Planning
Coordination
Allied Health Services
Other

46.1. Total CDMPs	OI14180	OI12962	OI12963

47. Benefits paid by program type

Type of CDMP	Programs	Benefits	Fees charged
(1)	(2)	(3)	(4)
OI12964	OI14181	OI12966	OI12967
Risk factors for chronic disease
Cardiovascular
Diabetes
Mental Health
Other (specify)

47.1. Total by program type	OI14182	OI12969	OI12970

Part 9 Benefits paid for general treatment (excluding hospital-substitute treatment and CDMP)

48. Type of treatment by service type

Service type	Services	Benefits	Fees charged
(1)	(2)	(3)	(4)
OI12971	OI12972	OI12973	OI12974
Accidental Death / Funeral Expenses
Acupuncture / Acupressure
Ambulance
Chiropractic
Community, Home, District Nursing
Dental
Dietetics
Domestic Assistance
Ex gratia Payments
Preventative Health Products/Health Management Program
Hearing Aids and Audiology
Hypnotherapy
Maternity Services
Natural Therapies
Occupational Therapy
Optical
Orthoptics (Eye Therapy)
Osteopathic Services
Overseas
Pharmacy
Physiotherapy
Podiatry (Chiropody)
Medical devices or human tissue products, Aids and Appliances
Psych/Group Therapy
School
Sickness and Accident
Speech Therapy
Theatre Fees
Travel and Accommodation

48.1. Other (please specify)
Description	Services	Benefits	Fees charged
(1)	(2)	(3)	(4)
OI12975	OI12976	OI12977	OI12978

48.2. Total general treatment	OI12979	OI12980	OI12981

Part 10 Lifetime Health Cover

49. Number of adults with hospital cover

Certified age at entry	Male	Female	Male LHC loading removed	Female LHC loading removed	LHC Loading %
	(1)	(2)	(3)	(4)
30	OI13207	OI13208	OI13209	OI13210	0%
31	OI13211	OI13212	OI13213	OI13214	2%
32	OI14000	OI14001	OI14002	OI14003	4%
33	OI14004	OI14005	OI14006	OI14007	6%
34	OI14008	OI14009	OI14010	OI14011	8%
35	OI14012	OI14013	OI14014	OI14015	10%
36	OI14016	OI14017	OI14018	OI14019	12%
37	OI14020	OI14021	OI14022	OI14023	14%
38	OI14024	OI14025	OI14026	OI14027	16%
39	OI14028	OI14029	OI14030	OI14031	18%
40	OI14032	OI14033	OI14034	OI14035	20%
41	OI14036	OI14037	OI14038	OI14039	22%
42	OI14040	OI14041	OI14042	OI14043	24%
43	OI14044	OI14045	OI14046	OI14047	26%
44	OI14048	OI14049	OI14050	OI14051	28%
45	OI14052	OI14053	OI14054	OI14055	30%
46	OI14056	OI14057	OI14058	OI14059	32%
47	OI14060	OI14061	OI14062	OI14063	34%
48	OI14064	OI14065	OI14066	OI14067	36%
49	OI14068	OI14069	OI14070	OI14071	38%
50	OI14072	OI14073	OI14074	OI14075	40%
51	OI14076	OI14077	OI14078	OI14079	42%
52	OI14080	OI14081	OI14082	OI14083	44%
53	OI14084	OI14085	OI14086	OI14087	46%
54	OI14088	OI14089	OI14090	OI14091	48%
55	OI14092	OI14093	OI14094	OI14095	50%
56	OI14096	OI14097	OI14098	OI14099	52%
57	OI14100	OI14101	OI14102	OI14103	54%
58	OI14104	OI14105	OI14106	OI14107	56%
59	OI14108	OI14109	OI14110	OI14111	58%
60	OI14112	OI14113	OI14114	OI14115	60%
61	OI14116	OI14117	OI14118	OI14119	62%
62	OI14120	OI14121	OI14122	OI14123	64%
63	OI14124	OI14125	OI14126	OI14127	66%
64	OI14128	OI14129	OI14130	OI14131	68%
65	OI14132	OI14133	OI14134	OI14135	70%
Total	OI12988	OI12989	OI12990	OI12991	0%

Part 11 Total hospital treatment medical services statistics

	Amount charged	Medicare benefit	Fund benefit	Gap	Number of services	% of services	Amount charged % of MBS
	(1)	(2)	(3)	(4)	(5)	(6)	(7)
50. No-gap agreement
<= MBS fee	PL18837	PL18838	PL18839	PL18840	OI14151	OI14152	PL18841
>MBS to 125% MBS fee	PL18842	PL18843	PL18844	PL18845	OI14153	OI14154	PL18846
>125% to 150% MBS fee	PL18847	PL18848	PL18849	PL18850	OI14155	OI14156	PL18851
>150% to 200% MBS fee	PL18852	PL18853	PL18854	PL18855	OI14157	OI14158	PL18856
>200% MBS fee	PL18857	PL18858	PL18859	PL18860	OI14159	OI14160	PL18861
50.1. Total no-gap agreement	PL18229	PL18230	PL18231	PL18232	OI12996	OI12997	PL18233

51. Known gap agreement
>MBS to 125% MBS fee	PL18862	PL18863	PL18864	PL18865	OI14161	OI14162	PL18866
>125% to 150% MBS fee	PL18867	PL18868	PL18869	PL18870	OI14163	OI14164	PL18871
>150% to 200% MBS fee	PL18872	PL18873	PL18874	PL18875	OI14165	OI14166	PL18876
>200% MBS fee	PL18877	PL18878	PL18879	PL18880	OI14167	OI14168	PL18881
51.1. Total known gap agreement	PL18239	PL18240	PL18241	PL18242	OI13001	OI13002	PL18243
52. Total agreement	PL18244	PL18245	PL18246	PL18247	OI13003	OI13004	PL18248

53. No agreement
<= MBS fee	PL18882	PL18883	PL18884	PL18885	OI14169	OI14170	PL18886
>MBS to 125% MBS fee	PL18887	PL18888	PL18889	PL18890	OI14171	OI14172	PL18891
>125% to 150% MBS fee	PL18892	PL18893	PL18894	PL18895	OI14173	OI14174	PL18896
>150% to 200% MBS fee	PL18897	PL18898	PL18899	PL18900	OI14175	OI14176	PL18901
>200% MBS fee	PL18902	PL18903	PL18904	PL18905	OI14177	OI14178	PL18906
54. Total no agreement	PL18254	PL18255	PL18256	PL18257	OI13008	OI13009	PL18258

55. Grand total	PL18259	PL18260	PL18261	PL18262	OI13010	OI13011	PL18263
55.1. Total services with no gap	PL18264	PL18265	PL18266	PL18267	OI13012	OI13013	PL18268
55.2. Total services with no or known gap	PL18269	PL18270	PL18271	PL18272	OI13014	OI13015	PL18273