Abstract
BackgroundThe number of people living with chronic health conditions is increasing in Australia. The Chronic Disease Management program was introduced to Medicare Benefits Schedule (MBS) to provide a more structured approach to managing patients with chronic conditions and complex care needs. The program supports General Practitioners (GP)s claiming for up to one general practice management plan (GPMP) and one team care arrangement (TCA) every year and the patient claiming for up to five private allied health visits. We describe the profile of participants who claimed for GPMPs and/or TCAs in Central and Eastern Sydney (CES) and explore if GPMPs and/or TCAs are associated with fewer emergency hospitalisations (EH)s or potentially preventable hospitalisations (PPH)s over the following 5 years.MethodsThis research used the CES Primary and Community Health Cohort/Linkage Resource (CES-P&CH) based on the 45 and Up Study to identify a community-dwelling population in the CES region. There were 30,645 participants recruited within the CES area at baseline. The CES-P&CH includes 45 and Up Study questionnaire data linked to MBS data for the period 2006–2014. It also includes data from the Admitted Patient Data Collection, Emergency Department Data Collection and Deaths Registry linked by the NSW Centre for Health Record Linkage.ResultsWithin a two-year health service utilisation baseline period 22% (5771) of CES participants had at least one claim for a GPMP and/or TCA. Having at least one claim for a GPMP and/or TCA was closely related to the socio-demographic and health needs of participants with higher EHs and PPHs in the 5 years that followed. However, after controlling for confounding factors such as socio-demographic need, health risk, health status and health care utilization no significant difference was found between having claimed for a GPMP and/or TCA during the two-year health service utilisation baseline period and EHs or PPHs in the subsequent 5 years.ConclusionsThe use of GPMPs and/or TCAs in the CES area appears well-targeted towards those with chronic and complex care needs. There was no evidence to suggest that the use of GPMPs and /or TCAs has prevented hospitalisations in the CES region.
Highlights
The number of people living with chronic health conditions is increasing in Australia
Use of general practice management and/or team care arrangements within the Central and Eastern Sydney (CES) cohort Within the two-year health service utilisation baseline service period, 22% of the CES cohort (5771 people) had at least one claim recorded for a general practice management plan (GPMP) and/or TCA
After controlling for confounding factors such as socio-demographic need, health risk, health status and health care utilization no significant difference was found between having claimed for a GPMP or TCA during the baseline service period and time to first emergency hospitalisations (EH) and/ or potentially preventable hospitalisations (PPH) in the subsequent 5 years
Summary
The number of people living with chronic health conditions is increasing in Australia. To recognise and facilitate the effort required by General practitioners (GP) in planning ongoing care and coordinating a treatment team, the Enhanced Primary Care package was introduced into the Medicare Benefits Schedule (MBS) in 1999 with specific item numbers for GPs to undertake care planning and coordinate team care arrangements for patient with a chronic condition or terminal medical condition [8] This scheme evolved into the Chronic Disease Management (CDM) program in 2005 and additional items have been added to support the inclusion of services provided by private allied health providers (2004) and nurse practitioners (2007) [9, 10]
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