Decade of Medicare: The contribution of private practice dietitians to chronic disease management and diabetes group services

Abstract

AbstractAimTo review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013.MethodsDietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t‐test was used to investigate the association of dietetics' individual service utilisation and workforce statistics.ResultsIndividual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302 910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle‐aged and older patients were common, with highest uptake by those aged 55–74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010.ConclusionsAs 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services.