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RESEARCH ARTICLE
Contents Vol 49(2)

The trend of once-off versus follow-up Medicare-reimbursed psychiatric consultations and increased telehealth availability: an interrupted time series analysis

Luke Sy-Cherng Woon https://orcid.org/0000-0002-8216-0694 A B * , Tarun Bastiampillai C D E and Jeffrey C. L. Looi https://orcid.org/0000-0003-3351-6911 A C
+ Author Affiliations
- Author Affiliations

A School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia.

B Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia.

C Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis, Canberra, ACT, Australia.

D College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

E Department of Psychiatry, Monash University, Clayton, Vic, Australia.

* Correspondence to: luke.woon@anu.edu.au

Australian Health Review 49, AH25011 https://doi.org/10.1071/AH25011
Submitted: 21 January 2025  Accepted: 9 March 2025  Published: 1 April 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

The Australian Medicare Benefits Schedule (MBS) telehealth items were expanded in March 2020 and consolidated in January 2022. We aim to describe the trend of the ratio of MBS psychiatric video items for once-off assessments to follow-up sessions and examine the effect of telehealth consolidation.

Methods

Psychiatric once-off item to follow-up item ratios in face-to-face (F2F) and video modes were computed from state and territory-level monthly Medicare data (January 2016–December 2023). We performed a multilevel interrupted times series analysis (ITSA) of once-off video consultations with telehealth consolidation as the intervention, followed by subgroup analyses by age groups. Finally, in the young adult group (25–44 years), we performed a multiple-group ITSA comparing video once-off to follow-up ratios between genders.

Results

The once-off to follow-up ratio for video items after telehealth consolidation greatly increased compared with F2F items, with rapid growth in once-off assessments. Sustained high video once-off assessment usage occurred in the youth (15–24 years) and young adult (25–44 years) groups, while other age groups showed declines following the initial rise. The male group showed a greater initial increase in the video once-off to follow-up ratio among young adults but the ratio continued to rise only in the female group.

Conclusions

The evolving trends of reimbursed telepsychiatry consultations require further examination given their potential implications concerning service quality, health equity, health attitudes and behaviours, and healthcare costs.

Keywords: follow-up care, health policies, mental health services, private practice, remote consultation, services utilisation, telepsychiatry, videoconferencing.

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