Investing in big ideas: Utilisation and cost of Medicare Allied Health Services in Australia under the Chronic Disease Management Initiative in primary care

Cant, Robyn P. and Foster, Michele M. (2011) Investing in big ideas: Utilisation and cost of Medicare Allied Health Services in Australia under the Chronic Disease Management Initiative in primary care. Australian Health Review, 35 4: 468-474. doi:10.1071/AH10938

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Author Cant, Robyn P.
Foster, Michele M.
Title Investing in big ideas: Utilisation and cost of Medicare Allied Health Services in Australia under the Chronic Disease Management Initiative in primary care
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
0156-5788
Publication date 2011-01-01
Sub-type Article (original research)
DOI 10.1071/AH10938
Volume 35
Issue 4
Start page 468
End page 474
Total pages 7
Place of publication Collingwood, Vic., Australia
Publisher CSIRO Publishing
Language eng
Formatted abstract
Objective. To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives.
Methods. Statistics generated from national billing data from July 2005 to June 2009 were extracted from Medicare data and compared by profession, State or Territory and population.
Results. Most services grew over 4 years although nationally consistent service levels were not found for any allied health provider profession. On referral from GPs, podiatry, physiotherapy and dietetics provided most services (82%) in 2008–09. Professions had unique patterns of referral instanced by age range and sex of clientele. Wide variation was apparent in per capita utilisation of allied health services by State or Territory; some with far less than average national use and others with high use. Annual number of GP Management Plans or Team Care Arrangements was low (mean: ≤22 per GP in 2008–09), indicating low use of care planning.
Conclusion. Inequality of accessibility for patients was apparent. Five years into the program, a review of Medicare Allied Health CDM policy is warranted.
Implications. Research and evaluation is needed to identify whether the program is meeting the needs of GPs, allied health providers and chronic disease patients.
What is known about the topic? Since 2004, Medicare Chronic Disease Management program has offered Australian patients with chronic or complex disease access to 13 allied health professions via private clinics on referral from their general practitioner – with costs subsidised by Medicare. Little is known about the demographics of referred patients or which allied health services are utilised.
What does this paper add? We take a multidisciplinary perspective to describe program use and find wide variation by profession nationally. Per capita State and Territory data indicate inequality of accessibility. Podiatry, physiotherapy and dietetics provided 82% of all services in 2008–09. Referrals initiated by GPs via patient care plans are increasing, but at present referrals per each GP are low.
What are the implications for practitioners? More needs to be known about the dynamics that affect referral, the local accessibility of allied health providers and issues that affect uptake by patients.
Keyword Access
Dietetics
Physiotherapy
Podiatry
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Nursing, Midwifery and Social Work Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 13 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 20 Oct 2011, 23:22:33 EST by Dr Michele Foster on behalf of School of Social Work and Human Services