Increasing use of general practice management and team care arrangements over time in New South Wales, Australia
Heidi Welberry A , Margo Linn Barr A B , Elizabeth J. Comino A , Ben F. Harris-Roxas A , Elizabeth Harris A and Mark Fort Harris AA Centre for Primary Health Care and Equity, Faculty of Medicine, Level 3, AGSM Building, University of New South Wales, Sydney, NSW 2052, Australia.
B Corresponding author. Email: margo.barr@unsw.edu.au.
Australian Journal of Primary Health 25(2) 168-175 https://doi.org/10.1071/PY18113
Submitted: 31 July 2018 Accepted: 14 December 2018 Published: 12 March 2019
Abstract
The number of older people living with chronic health conditions is increasing in Australia. The Chronic Disease Management (CDM) items program was introduced to the Medicare Benefits Schedule (MBS) to encourage a more structured approach to managing patients with chronic conditions. Initial uptake was slow and recent research has suggested that uptake is decreasing. This paper examines: person MBS CDM claims in NSW between 2006 and 2014 — using baseline survey data (2006–09) from the Sax Institute’s 45 and Up Study linked to MBS and Death Registry data (2006–14) — and MBS CDM claims per 100 000 population — using billing data sourced from the Medicare Australia Statistics website — to systematically examine any changes in uptake using a time-series analysis. After age adjustment, claims for initial plans increased from 11.3% in 2006 to 22.4% in 2014. Increases were also seen for allied health service claims (from 4.1% in 2006 to 20.8% in 2014) and for plan reviews (from 5.9% in 2006 to 16.0% in 2014). These increases were consistent with the MBS summary claims data. There is evidence that these plans are appropriately targeting those in most need; however, there is limited evidence of their effect. Claims for plan reviews, although increasing, are suboptimal and may indicate poor continuity of care.
Additional keywords: allied health, care plan, chronic disease, plan reviews.
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