Just Accepted
This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.
Use of Medicare-subsidised treatment services among people prescribed opioids for chronic non-cancer pain
Abstract
Objectives: Australians receive healthcare services subsidised by the Medicare national health insurance scheme, including through the Chronic Disease Management initiative supporting primary care management of chronic conditions. The use of such subsidised services by people with chronic non-cancer pain is unknown. This study examined Medicare-subsidised service use, including Chronic Disease Management items, allied health service use, and specialist attendances, among Australians prescribed opioids for chronic non-cancer pain.
Methods: Medicare Benefits Schedule claims data for the period 01/01/2012-31/12/2018 were linked to a longitudinal cohort of 1,206 adults prescribed opioids for chronic non-cancer pain. Service use was compared to the general population, to examine whether individuals with chronic non-cancer pain make greater use of such services, and factors (including demographics, socioeconomic status, pain scores and opioid treatment characteristics, physical and mental health scores) associated with service use were examined.
Results: Use of primary, allied health, and specialist services was high in comparison with the general population. Over three years, 928 participants (76.9%) received Chronic Disease Management items, mostly care plans (n=825, 68.4%). Private health insurance and living in a major city were associated with increased odds and rates of any specialist and pain medicine specialist attendances (private insurance and specialist attendances: adjusted odds ratio 4.29, 99.5% confidence interval 2.32-7.91; major city and pain specialist attendances: adjusted incident rate ratio 1.70, 99.5% confidence interval 1.12-2.56).
Conclusions: Australians prescribed opioids for chronic non-cancer pain have high use of subsidised primary, allied health, and specialist services. However, sociodemographic disparities were apparent, and there remains a need to improve specialist service accessibility for Australians who are uninsured and living in regional/remote areas. There is also a need to evaluate whether care delivered through current Medicare initiatives are meeting the needs of Australians with CNCP.
PU24012 Accepted 09 October 2024
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