Use and cost of Medicare Benefits Schedule and Pharmaceutical Benefits Scheme services following inpatient rehabilitation for acquired disability in Australia
Samantha J. Borg
A * , David N. Borg A , Michele M. Foster A , Ryan Bell A B , Jessica Bowley A and Timothy Geraghty A B
+ Author Affiliations
- Author Affiliations
A The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.
B Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, Qld, Australia.
* Correspondence to: s.borg@griffith.edu.au
Australian Health Review 47(2) 165-174 https://doi.org/10.1071/AH22118
Submitted: 14 May 2022 Accepted: 26 November 2022 Published: 22 December 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Objectives This study explored publicly funded health system and patient expenditure in the post-acute phase following discharge from inpatient acquired brain injury (ABI) or spinal cord injury (SCI) rehabilitation. The secondary aim was to explore sociodemographic and injury characteristics associated with high costs.
Methods This was a prospective cohort study. 153 patients (ABI: n = 85; SCI: n = 68) who consented to the use of their Medicare data were recruited between March 2017 and March 2018, at the point of discharge from ABI or SCI specialist rehabilitation units. The main outcome measure involved linkage of the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data for the 12 months following discharge from rehabilitation. Bayesian penalised regression was used to determine characteristics associated with high costs.
Results The median number of MBS items used in the 12 months after discharge was 33 (IQR: 21–52). General practitioners and allied health services were accessed by 100% and 41% of the cohort, respectively. The median MBS system cost (in Australian dollars) was $2006 (IQR: $162–$3090). Almost half (46%) of the participants had no MBS patient expenditure. The median PBS system cost was $541 (IQR: $62–$1574). For people with ABI, having a traumatic injury or one comorbidity was associated with lower PBS system costs by on average $119 and $134, respectively. We also found that hospitalisation in ABI was associated with higher PBS system costs, by on average $669.
Conclusion There was evidence of high and variable MBS and PBS costs, raising concerns about financial hardship. Future research should focus on identifying any unmet service and prescription needs in the post-acute rehabilitation phase for these populations.
Keywords: acquired brain injury, healthcare costs, Medicare Benefits Schedule, primary care, Pharmaceutical Benefits Scheme, rehabilitation, service use, spinal cord injury.
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