Australia’s health system includes a complex mix of health professionals and service providers from a range of organisations—across all levels of government and the non-government sector. Collectively, they work to meet the health care needs of all Australians1.
The Australian Government in particular funds a range of subsidised health services and medicines through the Medicare Benefits Schedule (MBS), the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS); for example, appointments with general practitioners (GPs), diagnostic tests and the supply of subsidised prescription medicines.
Understanding patient experiences and interactions with the health system is critical to ensure that services delivered are appropriate and are meeting the needs of all Australians. High quality health care leads to better health outcomes, while access to well-coordinated and good quality health care is crucial to enhancing patients’ understanding, control and self-management of their illness2,3. Timely access to GPs and other health services as well as coordinated, patient centred care are essential components of a high quality health care system.
This publication presents findings from the second stage of the Coordination of Health Care Study (the Study) which links MBS and PBS data to the 2016 Survey of Health Care.
The first stage of the Study, the 2016 Survey of Health Care, collected information on respondents' experiences with a range of health care professionals (for example, GPs and specialists) and the broader health care system (for example, diagnostic tests, hospital admissions and emergency department visits).
The second stage of the Study provides an opportunity to understand patient experiences of coordinated care with health care providers in the context of their actual use of MBS subsidised services and PBS subsidised medicines.
The Coordination of Health Care Study is funded by the Australian Institute of Health and Welfare (AIHW) and is jointly conducted by the Australian Bureau of Statistics (ABS) and the AIHW. This publication was jointly prepared and released by the ABS and the AIHW.
|THE STUDY COHORT|
Results in this publication are based on a sample of around 18,000 Australians aged 45 years or over who had at least one GP visit between November 2014 and November 2015. This sample has been weighted to represent the 8.8 million people in Australia who had at least one GP visit in this period (the Study cohort).
These 18,000 Study participants consented to linking of their 2016 Survey of Health Care responses to information about the health services they used between 1 January 2014 and 30 June 2018 obtained from the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme.
All linkage is approved by appropriate ethics committees and follows strict confidentiality procedures to ensure Study participants’ personal information is protected.
This publication focusses on participants’ use of MBS services and PBS medicines in 2015-16 to coincide with the Survey of Health Care reference period of 2016.
There are a number of factors that should be considered when interpreting information presented in this publication.
Data presented relate to people who used MBS subsidised services or PBS subsidised medicines in 2015-16. People may obtain other health services from a range of providers not subsidised through these schemes, such as:
- state and territory government funded services (for example, salaried doctor arrangements)
- services provided to public patients in public hospitals
- some private sector health services, including some allied health services
- medicines supplied to clients of eligible remote area Aboriginal Health Services under the provisions of section 100 of the National Health Act 19534.
While people who used MBS services and PBS medicines may have also used these and other services, their use and experiences with these services are not captured in this Study.
Additionally, variation in the use of health services across geographies may reflect the different demographic characteristics of these areas (for example, their age structures) as well as other factors such as the availability of particular health services. It is important to note that while results presented in this publication may indicate relationships between use of health services and reported experiences of health care, these do not necessarily imply a cause and effect association.
Data on the use of medicines subsidised through the Repatriation Pharmaceutical Benefits Scheme will be added to the Study in early 2019. Further analysis, including for Primary Health Networks, will be undertaken by the Australian Institute of Health and Welfare in 2019.
The third stage of the Study will link state and territory hospital admissions and emergency department data to Survey of Health Care data. This will facilitate further exploration of the impact of coordination and continuity of care on health outcomes and health system usage.
1. Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16.
AUS 221. Canberra: AIHW
2. Bywood P, Jackson-Bowers E & Muecke S 2011. Initiatives to integrate primary and acute health care, including ambulatory care services. PHCRIS (Primary Health Care Research & Information Service) policy issue review. Adelaide: PHCRIS
3. Jeon Y, Kraus S, Jowsey T & Glasgow N 2010. The experience of living with chronic heart failure: a narrative review of qualitative studies. BMC Health Services Research 10:77
4. Australian Government Department of Health, 2014, ‘Aboriginal Health Services and the Pharmaceutical Benefits Scheme (PBS)’, viewed 13 November 2018, http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pbs-indigenous