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RESEARCH ARTICLE
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Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia

Md Mijanur Rahman A # * , Shafkat Jahan B # , Bogda Koczwara C D , Mahesh Iddawela E , Raymond J. Chan F G , Elysia Thornton-Benko H I J , Gail Garvey B and Nicolas H. Hart F G K L M
+ Author Affiliations
- Author Affiliations

A The Daffodil Centre, University of Sydney and Cancer Council NSW, NSW, Australia.

B School of Public Health, Faculty of Medicine, The University of Queensland, Qld, Australia.

C Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia.

D Flinders Centre for Innovation in Cancer, Flinders Medical Centre, SA, Australia.

E Alfred Health & Latrobe Regional Hospital, Vic, Australia.

F Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, SA, Australia.

G Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Qld, Australia.

H School of Clinical Medicine, Faculty of Medicine, University of New South Wales, NSW, Australia.

I Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia.

J Bondi Road Doctors, Sydney, NSW, Australia.

K Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), NSW, Australia.

L Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.

M Institute for Health Research, University of Notre Dame Australia, WA, Australia.

* Correspondence to: m.m.rahman@sydney.edu.au
# These authors contributed equally to this paper

Australian Health Review https://doi.org/10.1071/AH24121
Submitted: 9 January 2024  Accepted: 10 September 2024  Published: 1 October 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigates Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors.

Methods

Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis.

Results

In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11–1.21) and TCA (OR: 1.12, 95% CI: 1.07–1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85–0.93). People with cancer living in remote areas were less likely to receive TCA (OR: 0.84, 95% CI: 0.80–0.88) or utilise allied health services (OR: 0.63, 95% CI: 0.60–0.67) than those in metropolitan areas.

Conclusion

Our findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer’s care needs are being met and ways to optimise the supportive care of these people.

Keywords: allied health, data linkage, general practice, oncology, people with cancer, Team Care Arrangements.

References

1  World Health Organization. Cancer. 2023. Available at https://www.who.int/news-room/fact-sheets/detail/cancer#:~:text=Cancer%20is%20a%20leading%20cause,and%20rectum%20and%20prostate%20cancers [accessed 3 April 2023].

2  Centre for Disease Control and Prevention. About Chronic Diseases. 2023. Available at https://www.cdc.gov/chronic-disease/?CDC_AAref_Val=https://www.cdc.gov/chronicdisease/about/index.htm [accessed 3 April 2023].

3  Australian Institute of Health and Welfare. Cancer Data in Australia. Australian Institute of Health and Welfare; 2023. Available at https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/about [accessed 25 November 2023].

4  Ramin C, Schaeffer ML, Zheng Z, et al. All-Cause and Cardiovascular Disease Mortality Among Breast Cancer Survivors in CLUE II, a Long-Standing Community-Based Cohort. J Natl Cancer Inst 2021; 113(2): 137-145.
| Crossref | Google Scholar | PubMed |

5  Fowler H, Belot A, Ellis L, et al. Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BMC Cancer 2020; 20(1): 2.
| Crossref | Google Scholar | PubMed |

6  Jiang C, Deng L, Karr MA, et al. Chronic comorbid conditions among adult cancer survivors in the United States: Results from the National Health Interview Survey, 2002-2018. Cancer 2022; 128(4): 828-838.
| Crossref | Google Scholar | PubMed |

7  Coulter A, Entwistle VA, Eccles A, Ryan S, Shepperd S, Perera R. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database Syst Rev 2015; 2015(3): CD010523.
| Crossref | Google Scholar | PubMed |

8  Welberry H, Barr ML, Comino EJ, Harris-Roxas BF, Harris E, Harris MF. Increasing use of general practice management and team care arrangements over time in New South Wales, Australia. Aust J Prim Health 2019; 25(2): 168-175.
| Crossref | Google Scholar | PubMed |

9  Australian Government Services Australia. Chronic disease GP Management Plans and Team Care Arrangements. 2023. Available at https://www.servicesaustralia.gov.au/mbs-billing-rules-for-chronic-disease-gp-management-plans-and-team-care-arrangements?context=20 [accessed 8 April 2023].

10  Australian Institute of Health and Welfare. Medicare-subsidised GP, allied health and specialist health care across local areas: 2019–20 to 2020–21. Canberra: Australian Institute of Health and Welfare; 2021.

11  Australian Institute of Health and Welfare. Use of Medicare chronic disease management items by patients with long-term health conditions. Canberra: Australian Institute of Health and Welfare; 2022.

12  Hamar GB, Rula EY, Wells A, Coberley C, Pope JE, Larkin S. Impact of a chronic disease management program on hospital admissions and readmissions in an Australian population with heart disease or diabetes. Popul Health Manag 2013; 16(2): 125-131.
| Crossref | Google Scholar | PubMed |

13  Wickramasinghe LK, Schattner P, Hibbert ME, Enticott JC, Georgeff MP, Russell GM. Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews. Med J Aust 2013; 199(4): 261-265.
| Crossref | Google Scholar | PubMed |

14  Coorey G, Campain A, Mulley J, et al. Utilisation of government-subsidised chronic disease management plans and cardiovascular care in Australian general practices. BMC Prim Care 2022; 23(1): 157.
| Crossref | Google Scholar | PubMed |

15  Barr ML, Welberry H, Comino EJ, et al. Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis. Prim Health Care Res Dev 2019; 20: e141.
| Crossref | Google Scholar | PubMed |

16  Perez-Concha O, Goldstein D, Harris MF, et al. Uptake of Team Care Arrangements for adults newly diagnosed with cancer. Aust J Prim Health 2023; 29(1): 20-29.
| Crossref | Google Scholar | PubMed |

17  Lindsay D, Bates N, Diaz A, Watt K, Callander E. Quantifying the hospital and emergency department costs for women diagnosed with breast cancer in Queensland. Support Care Cancer 2022; 30(3): 2141-2150.
| Crossref | Google Scholar | PubMed |

18  Lindsay D, Whiteman DC, Olsen CM, Gordon LG. Health care service use by people diagnosed with invasive melanoma in Queensland: a benefit incidence analysis. Med J Aust 2023; 219(9): 417-422.
| Crossref | Google Scholar | PubMed |

19  Callander E, Topp SM, Larkins S, Sabesan S, Bates N. Quantifying Queensland patients with cancer health service usage and costs: study protocol. BMJ Open 2017; 7(1): e014030.
| Crossref | Google Scholar | PubMed |

20  de Oliveira CM, Viater Tureck L, Alvares D, et al. Relationship between marital status and incidence of type 2 diabetes mellitus in a Brazilian rural population: The Baependi Heart Study. PLoS One 2020; 15(8): e0236869.
| Crossref | Google Scholar | PubMed |

21  Australian Institute of Health and Welfare. Chronic conditions and multimorbidity. Australian Institute of Health and Welfare; 2022.

22  Grattan Institute. Not so universal. How to reduce out-of-pocket healthcare payments. Grattan Institute; 2022.

23  Reay R, Kisely SR, Looi JCL. Better Access: substantial shift to telehealth for allied mental health services during COVID-19 in Australia. Aust Health Rev 2021; 45(6): 675-682.
| Crossref | Google Scholar | PubMed |

24  Cant RP, Foster MM. Investing in big ideas: utilisation and cost of Medicare Allied Health services in Australia under the Chronic Disease Management initiative in primary care. Aust Health Rev 2011; 35(4): 468-474.
| Crossref | Google Scholar | PubMed |

25  Vardy JL, Chan RJ, Koczwara B, et al. Clinical Oncology Society of Australia position statement on cancer survivorship care. Aust J Gen Pract 2019; 48(12): 833-836.
| Crossref | Google Scholar | PubMed |

26  Cormie P, Atkinson M, Bucci L, et al. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 2018; 209(4): 184-187.
| Crossref | Google Scholar | PubMed |