Medicare Benefits Schedule Data Research Articles

Utilization and associated factors of TPMT testing among Australian adults receiving thiopurines: A national retrospective data-linkage study.

Thiopurine drugs are metabolized by thiopurine methyltransferase (TPMT) and low TPMT activity can result in severe adverse drug reactions. Therefore, TPMT testing is recommended for individuals receiving thiopurines to reduce the risk of toxicity. The objectives of this study were to assess the rate of TPMT testing among individuals receiving thiopurines and explore factors associated with undergoing TPMT testing in Australia. This retrospective cohort study utilized administrative data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), and the 2021 Census, accessed via the Person Level Integrated Data Asset (PLIDA) at the Australian Bureau of Statistics (ABS) DataLab. Individuals receiving thiopurines aged 18 years or above were identified using PBS data and exposure to TPMT testing was determined using MBS data. Multivariate logistic regression was performed to identify factors associated with TPMT testing. A total of 62,574 prevalent thiopurine users were identified between 2020 and 2022. Of these, 20,327 (32.5%) underwent TPMT testing (2011-2022). The most significant factor associated with TPMT testing was having at least one thiopurine medication prescribed by a medical specialist (adjusted odds ratio [aOR] 2.12, 95% confidence interval [CI] 2.02-2.22), compared to having medication solely prescribed by primary care physicians (PCPs). Other significant factors associated with TPMT testing included speaking a non-English language at home (aOR 1.29, 95% CI 1.22-1.36), having no chronic health conditions (aOR 1.18, 95% CI 1.13-1.24), not requiring assistance with core activities (aOR 1.16, 95% CI 1.08-1.23), and having a higher educational attainment (aOR 1.11, 95% CI 1.06-1.11). Compared to living in major cities, individuals living in remote areas were significantly less likely to undergo testing (aOR 0.49, 95% CI 0.39-0.60). Our study highlights the low utilization of TPMT testing in Australia and suggests the need for targeted interventions to address disparities and improve TPMT testing.

The Relationship Between Diet Quality and 21-Year Cumulative Health Care Costs Among Australian Women: A Longitudinal Cohort Study

BackgroundThe relationships between diet quality and health care costs have not been explored beyond 15 years. ObjectiveTo investigate relationships between both baseline diet quality and change in diet quality over time with cumulative data on health care claims and costs over 21 years among Australian women. DesignThis is a secondary analysis of data from a cohort study, the Australian Longitudinal Study on Women’s Health. Participants/SettingData for women born between 1946 and 1951 included diet quality data at baseline (2001, n = 8228), change in diet quality (2001–2013, n = 6553), and cumulative administrative health care data (2001–2021). Main OutcomesDiet quality was assessed using the Australian Recommended Food Score (ARFS) and the Fruit and Vegetable Variety Score. Twenty-one–year cumulative Medicare Benefits Schedule data (number of claims; total charges [$USD]), Australia’s universal health care coverage, were reported by baseline ARFS quintile and category of diet quality change (“diet quality worsened” [ARFS decrease ≤ –4 points], “remained stable” [–3 ≤ change in ARFS ≤ 3 points] or “improved” [ARFS increase ≥ 4 points]). Statistical AnalysisLinear regression analyses were conducted and adjusted for socioeconomic, health, and lifestyle factors. ResultsHigher baseline vegetable ARFS were correlated with fewer 21-year cumulative Medicare claims (β = –4.9, 95% CI, –7.3, –2.4) and charges (β = –$214; 95% CI, –$341; –$88). Baseline higher dairy scores were correlated with higher Medicare claims (β = 17.2; 95% CI, 11.1, 23.3) and charges (β = $762; 95% CI, $448, $1076). Compared with women whose diet quality score remained stable, those whose diet quality worsened over time made significantly more claims and higher charges; median (Q1, Q3) 413 (277, 588) claims, $17 868 ($11 037, $27 808) cumulative charges, compared with 387 (259, 559) claims, and $16 953 ($10 033, $26 604) cumulative charges. Change in total ARFS and ARFS subscales were predictors of 21-year cumulative health care claims. For each 1-point increase in ARFS over time, 1.2 fewer health care claims were made (95% CI, 0.3–2.2). Increasing vegetable and dairy ARFS scores were correlated with significantly fewer claims. ConclusionsBaseline greater variety of vegetables was correlated with fewer 21-year health care claims and costs. Worsening diet quality over time was correlated with greater cumulative health care claims and costs. Consideration of dietary quality and variety in national policy is suggested to potentially reduce national health care claims and costs.

Temporal trends in medication and service use patterns for mental health issues among men with prostate cancer.

Prostate cancer can significantly impact mental wellbeing, creating uncertainty and morbidity. This study described patterns of psychotropic medication and mental health service use, as a proxy measure for mental health problems, 5years before and 5years after prostate cancer diagnosis. Population-based registry data were linked with Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data for all prostate cancer patients diagnosed in South Australia between 2012 and 2020 (n=13,693). We estimated the proportion and rates of psychotropic medication and mental health service use before and after diagnosis. Multivariable adjusted interrupted time series analyses (ITSA) were conducted to uncover temporal patterns. Fifteen percent of men commenced psychotropic medications and 6.4% sought out mental health services for the first time after diagnosis. Psychotropic medication use rose from 34.5% 5years before to 40.3% 5years after diagnosis, including an increase in use of antidepressants (from 20.7% to 26.0%) and anxiolytics (from 11.3% to 12.8%). Mental health service use increased from 10.2% to 12.1%, with the increase mostly being general practice mental health visits (from 7.8% to 10.6%). Multivariable ITSA indicated a significant rise in medication and service utilisation immediately before and in the first 2years following prostate cancer diagnosis. There is a clear increase in psychotropic medication use and mental health service use around the time of prostate cancer diagnosis. Mental health outcomes of men with prostate cancer may be improved with early mental health screening, particularly during the diagnosis process, to enable early intervention.

Preliminary results from the Australian Genetics of Bipolar Disorder Study: A nation-wide cohort.

The Australian Genetics of Bipolar Disorder Study is a nation-wide cohort of adults living with bipolar disorder. The study aims to detect the relationships between genetic risk, symptom severity, and the lifetime prevalence of bipolar disorder, treatment response and medication side effects, and patterns and costs of health care usage. A total of 6682 participants (68.3% female; aged 44.8 ± 13.6 years [range = 18-90]) were recruited in three waves: a nation-wide media campaign, a mail-out based on prescriptions for lithium carbonate and through the Australian Genetics of Depression Study. Participants completed a self-report questionnaire. A total of 4706 (70%) participants provided a saliva sample and were genotyped and 5506 (82%) consented to record linkage of their Pharmaceutical and Medicare Benefits Schedule data. Most participants were living with bipolar I disorder (n = 4068) while 1622 participants were living with bipolar II disorder and 992 with sub-threshold bipolar disorder. The mean age of bipolar disorder diagnosis was 32.7 ± 11.6 years but was younger in bipolar I (p = 2.0E-26) and females (p = 5.7E-23). Excluding depression with onset prior to bipolar disorder diagnosis, 64.5% of participants reported one or more co-occurring psychiatric disorders: most commonly generalised anxiety disorder (43.5%) and posttraumatic stress disorder (20.7%). Adverse drug reactions were common and resulted in discontinuation rates ranging from 33.4% for lithium to 63.0% for carbamazepine. Our findings highlight the high rate of comorbidities and adverse drug reactions among adults living with bipolar disorder in the general Australian population. Future genomic analyses focus on identifying genetic variants influencing pharmacotherapy treatment response and side effects.

Australian surgical revision rate for benign prostatic obstruction.

To evaluate the rate of revision surgery following commonly performed procedures for benign prostatic hyperplasia (BPH) is hyperplasia of both glandular and stromal components of prostate especially in periurethral transitional gland, using real-world data from Medicare Australia. Prospection is a Healthcare Data Analytics firm that has negotiated access with the Medicare Benefits Schedule (MBS) to provide longitudinal data on the use of specific procedural item codes. We identified patients over the age of 40 years who had undergone primary transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP) or photoselective vaporization of the prostate (PVP) between 2005 and 2010 using MBS item numbers 37203, 37207 and 36854, respectively. Using longitudinal MBS data, primary outcomes included need for revision surgery at 5-years follow-up (2015). The release of these data was approved by Medicare Australia upon application. Data analysis was conducted using chi-squared tests and statistical significance was defined at P < 0.05. The distribution of primary surgical procedures performed between 2005 and 2010 was: TURP 5579 (90%), TUIP 345 (6%) and PVP 258 (4%). TURP was also the most prevalent procedure for treatment of lower urinary tract symptoms in men with BPH requiring revision surgery (75%). At 5-year follow-up the rate of revision surgery for TURP (573/5579), TUIP (47/345) and PVP (30/258) was 10.3%, 13.6% and 11.6%, respectively. The difference was not statistically significant (P= 0.12). There was no significant change (P = 0.59) observed over the years in number of men requiring revision surgery. This study indicates that TURP and PVP have a similar durability after 5 years of follow-up.

Evaluating an audit and feedback intervention for reducing overuse of pathology test requesting by Australian general practitioners: protocol for a factorial cluster randomised controlled trial

IntroductionConsistent evidence shows pathology services are overused worldwide and that about one-third of testing is unnecessary. Audit and feedback (AF) is effective for improving care but few trials evaluating AF...

The impact of cross-jurisdictional patient flows on ascertainment of hospitalisations and cardiac procedures for ST-segment-elevation myocardial infarction in an Australian population.

The patient journey for residents of New South Wales (NSW) Australia with ST-elevation myocardial infarction (STEMI) often involves transfer between hospitals and these can include stays in hospitals in other jurisdictions. To estimate the change in enumeration of STEMI hospitalisations and time to subsequent cardiac procedures for NSW residents using cross-jurisdictional linkage of administrative health data. Records for NSW residents aged 20 years and over admitted to hospitals in NSW and four adjacent jurisdictions (Australian Capital Territory, Queensland, South Australia, and Victoria) between 1 July 2013 and 30 June 2018 with a principal diagnosis of STEMI were linked with records of the Australian Government Medicare Benefits Schedule (MBS). The number of STEMI hospitalisations, and rates of angiography, percutaneous coronary intervention and coronary artery bypass graft were compared for residents of different local health districts within NSW with and without inclusion of cross-jurisdictional data. Inclusion of cross-jurisdictional hospital and MBS data increased the enumeration of STEMI hospitalisations for NSW residents by 8% (from 15,420 to 16,659) and procedure rates from 85.6% to 88.2%. For NSW residents who lived adjacent to a jurisdictional border, hospitalisation counts increased by up to 210% and procedure rates by up to 70 percentage points. Cross-jurisdictional linked hospital data is essential to understand patient journeys of NSW residents who live in border areas and to evaluate adherence to treatment guidelines for STEMI. MBS data are useful where hospital data are not available and for procedures that may be conducted in out-patient settings.

Examining the pharmacological and psychological treatment of child and adolescent ADHD in Australia: Protocol for a retrospective cohort study using linked national registry data

IntroductionAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which affects 5% of children globally. In Australia, it is estimated that 4.1% of children and adolescents have ADHD. While research...

Healthcare Costs Before and After Diagnosis of Cancer of Unknown Primary Versus Ovarian Cancer in Australia.

Little is known about the healthcare resource usage and costs for patients with cancer of unknown primary (CUP). The aim of this study was to describe and quantify healthcare resource use and costs in Australia, 6 months prior to and after a diagnosis of CUP, and compare to those of women with ovarian cancer. Individual-level data combining baseline surveys, clinical records and Medicare Benefits Schedule (MBS) claim records were analysed for 149 patients with CUP and 480 patients with ovarian cancer from two prospective cohort studies. MBS data were aggregated for the period 6 months prior to diagnosis date and 6 months after diagnosis. Data included doctor consultations, pathology, diagnostics, therapeutic procedures, imaging, allied health and medicines. Generalised linear models were used to evaluate the cost differences between CUP and ovarian cancer using gamma family and log link functions. Models were adjusted for age, employment, marital status, surgery, chemotherapy and number of comorbidities. The mean healthcare costs in the 6 months prior to diagnosis of CUP were Australian (AU) $3903 versus AU$1327 for ovarian cancer (adjusted cost ratio 2.94, 95% confidence interval [CI] 2.08-4.15). Mean healthcare costs 6 months post-diagnosis were higher for patients with CUP versus ovarian cancer (AU$20,339 vs AU$13,819, adjusted cost ratio 1.47, 95% CI 1.13-1.92). Higher costs for patients with CUP were driven by imaging (AU$1937 vs AU$1387), procedures (AU$5403 vs AU$2702) and prescribed medicines for all conditions (AU$10,111 vs AU$6717). Pre-diagnosis costs for patients with CUP are nearly triple those for ovarian cancer. Six months after diagnosis, healthcare costs for CUP remained higher than for ovarian cancer due to imaging, procedures and medicines.

Trends in mental health service utilisation by Australia's older population.

To examine the incidence, trends, and differences between age groups and sex in Medicare Benefits Schedule (MBS)-subsidised mental health service utilisation by older Australians over the past 10 years. A cross-sectional cohort study between 1 July 2009 and 30 June 2019 was conducted using publicly available MBS data for older individuals aged ≥65 years. Age- and sex-standardised yearly incidence rates of psychological therapy (MBS M06), GP mental health treatments (MBS A20), focussed psychological strategy (MBS M07), and psychiatric attendances (MBS A08) and incidence rate ratios (IRR) estimated using Poisson regression were calculated. Overall, the rate of utilisation of primary care mental health services by the older population increased over the study period, with psychological therapy claims increasing the greatest from 14.4/1000 older persons in 2009/10 to 38.5/1000 in 2018/19 (IRR 1.11, 95% CI 1.09-1.13), followed by GP mental health treatments increasing from 43.7/1000 (95% CI 43.4-43.9) in 2009/10 to 81.0/1000 (95% CI 80.7-81.3) in 2018/19 (IRR 1.07/year, 95% CI 1.06-1.09). Females aged 65-74 years had the highest use of GP mental health treatments at 123.8/1000 compared to 63.6/1000 in males in 2018/2019. While utilisation of mental health services by the older population in Australia has increased over the study period, it is important that policymakers and service providers continue to support access and use of these services, which may facilitate well-being and quality of life in the older population.

PD13-01 THE CONTINUING IMPACT OF THE COVID-19 PANDEMIC ON PROSTATE CANCER MANAGEMENT: A POPULATION BASED ANALYSIS

You have accessJournal of UrologyCME1 May 2022PD13-01 THE CONTINUING IMPACT OF THE COVID-19 PANDEMIC ON PROSTATE CANCER MANAGEMENT: A POPULATION BASED ANALYSIS Marlon Perera, Nathan Papa, and Matthew Roberts Marlon PereraMarlon Perera More articles by this author , Nathan PapaNathan Papa More articles by this author , and Matthew RobertsMatthew Roberts More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002545.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since early 2020, the global pandemic caused by COVID-19 has resulted in considerable healthcare related and economic impacts. To mitigate health impact to the wider population, restrictions on non-essential services were imposed. Australia performed favourably compared to other developed countries, largely due to these state-initiated transient ‘lock-downs’ to control local outbreaks. Recommendations to limit non-urgent urologic care were formulated to optimise patient safety and many of these were adopted in Australia. We aimed to extend this analysis to observe the trend in PSA tests, biopsies, and radical prostatectomies in the first 18 months of the pandemic, from January 2020 through to mid-2021, and compare these to the previous ten years. METHODS: Medicare Benefits Schedule data was extracted per state and per month from January 2010 to June 2021 for PSA tests, prostate biopsies, and radical prostatectomies. Each item was plotted as a two-year trend, with the count of tests/procedures expressed as a ratio to the first January count of that two-year period. Data on the number of covid cases per day to 30th June 2021, as a 7-day average. RESULTS: A sharp fall in PSA tests among all states was seen in April 2020 as the first wave of COVID-19 cases were detected and lockdown measures initiated. Test numbers rebounded quickly but remained slightly below the long-term trend (Figure 1, green line). For biopsy procedures, a decline from the expected trend began in March/April 2020 but generally remained below trend for the remainder of the year for most states within Australia. The observed deviation for radical prostatectomies commenced later than biopsies, with an apparent two- or three-month lag. In comparison to the longer-term average trend, from Jan 2020 to Jun 2021 it is estimated that there were 15% fewer PSA tests, 16% fewer biopsies and 17% fewer prostatectomies in Australia. CONCLUSIONS: The consequence of periodic lockdowns in response to COVID19 on patterns of care on stage at presentation and oncological outcomes is unknown but should be measured. As vaccination rates rise globally, it is expected that strict COVID-19 mitigation measures will not be required, therefore limiting the consequent impact on prostate cancer management contained. Source of Funding: Marlon Perera is sponsored by the Australian-America Fulbright Commission administered through a 2021-2022 Fulbright Future Scholarship funded by The Kinghorn Foundation © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e251 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marlon Perera More articles by this author Nathan Papa More articles by this author Matthew Roberts More articles by this author Expand All Advertisement PDF DownloadLoading ...

The continuing impacts of the COVID‐19 pandemic on diagnosis and surgical prostate cancer management: a population‐based analysis

The continuing impacts of the <scp>COVID</scp>‐19 pandemic on diagnosis and surgical prostate cancer management: a population‐based analysis

Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care.

To summarise and comment upon research regarding the service delivery impact of the introduction of COVID-19 pandemic Medicare Benefits Schedule (MBS) psychiatrist telehealth services in Australia in 2020-2021. Type of program or service: Privately-billed, MBS-reimbursed, face-to-face and telehealth consultations with a specialist psychiatrist during the first year of the COVID-19 pandemic. This paper draws on analyses of previously published papers. MBS-item-consultation data were extracted for video, telephone and face-to-face consultations with a psychiatrist for April-September 2020 in Victoria, and compared to face-to-face consultations in the same period of 2019 and for all of Australia. We also extracted MBS-item-consultation data for all of Australia from April 2020-April 2021, and compared this to face-to-face consultations for April 2018-April 2019. Although face-to-face consultations with psychiatrists waned following nationwide lockdowns, the introduction of MBS billing items for video and telephone telehealth meant that overall consultations were 13% higher in April 2020-April 2021, compared to the pre-pandemic year prior. A lockdown restricted to Victoria was associated with a 19% increase in consultations from April-September 2020, compared to the corresponding period in 2019. Telehealth has been an integral component of Australia's relatively successful mental health response to COVID-19. The public availability of MBS data makes it possible to accurately assess change in psychiatric practice. The Australian Federal Government subsidises MBS telepsychiatry care by a patient rebate per consultation, illustrating that government-subsidised services can rapidly provide additional care. Rapid and substantial provision of telepsychiatry in Australia indicates that it may be a useful substitute or adjunct to face-to-face care during future pandemics and natural disasters.

Medicare reimbursed telehealth exercise physiology services were underutilised through the coronavirus (COVID-19) pandemic: an ecological study.

Objectives To describe the quantity and cost of in-person and telehealth exercise physiology (EP) reimbursed under the Medicare Benefits Schedule (MBS) in Australia before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods This study uses publicly available MBS data to describe EP services (in-person and telehealth) reimbursed by Medicare between January 2020 and December 2021. Data were extracted at state and national levels. Results Despite a reduction in quantity and cost in quartile (Q) 2 2020 (41% reduction), MBS-reimbursed EP services have remained relatively constant at a national level through the 2-year observation period. Service claims averaged 88 555 per quarter in 2020 and 95 015 in 2021. The proportion of telehealth consultations relative to total quarterly claims for EP was <1% in Q1 2020, 6.0% in Q2 2020, 2.4% in Q3 2020 and 1.7% in Q4 2020. This dropped to an average of 1.4% across 2021 (Q1-Q4). States undergoing lockdown periods reported decreased service rates relative to February 2020 (i.e. pre-lockdown). EP services were associated with a Medicare expenditure of AUD17.9M in 2020 (telehealth = 2.4% of total) and AUD19.7M (telehealth = 1.5% of total) in 2021. Conclusions Quantity and cost of MBS-reimbursed EP services remained relatively constant throughout the height of service disruption due to COVID-19 (2020/21). Telehealth uptake during this time has been minimal for EP.

Specialist consultation activity and costs in Australia: Before and after the introduction of COVID-19 telehealth funding

This study describes and analyses the Medicare Benefits Schedule (MBS) activity and cost data for specialist consultations in Australia, as a result of the coronavirus disease 2019 (COVID-19) pandemic. To achieve this, activity and cost data for MBS specialist consultations conducted from March 2019 to February 2021 were analysed month-to-month. MBS data for in-person, videoconference and telephone consultations were compared before and after the introduction of COVID-19 MBS telehealth funding in March 2020. The total number of MBS specialist consultations claimed per month did not differ significantly before and after the onset of COVID-19 (p = 0.717), demonstrating telehealth substitution of in-person care. After the introduction of COVID-19 telehealth funding, the average number of monthly telehealth consultations increased (p < 0.0001), representing an average of 19% of monthly consultations. A higher proportion of consultations were provided by telephone when compared to services delivered by video. Patient-end services did not increase after the onset of COVID-19, signifying a divergence from the historical service delivery model. Overall, MBS costs for specialist consultations did not vary significantly after introducing COVID-19 telehealth funding (p = 0.589). Telehealth consultations dramatically increased during COVID-19 and patients continued to receive specialist care. After the onset of COVID-19, the cost per telehealth specialist consultation was reduced, resulting in increased cost efficiency to the MBS.

Annual trends in diabetes screening and management in Australia: A secondary analysis of Medicare Benefits Schedule data.

The increasing incidence of type 2 diabetes (T2D) is a major Australian andworldwide health concern. The aim of this study was to examine trends in T2D pathology testing by Australian doctors, with a focus on screening and early identification. A secondary analysis was conducted of publicly available data for eight pathology tests, accessed from the nationally funded Medicare Benefits Schedule (MBS). Descriptive statistics were used to analyse the annual trends, according to age and sex, for the calendar years 2010-19. Over the 10 years, screening rates for T2D had doubled while glycated haemoglobin (HbA1c) tests for management remained constant. At the end of 2014, the MBS introduced HbA1c screening tests. By 2019, the HbA1c screening rates were three times higher than glucose tolerance tests, which had halved. A strong adoption of the national screening guidelines introduced in 2015-16 was identified. Limitations in MBS data categorisation, such as no item number specific to fasting glucose or insulin, prevented detailed analysis of other potentially relevant tests that might be used to screen for prediabetes and diabetes.

Open the doors to (de-identifiable) data.

Open the doors to (de-identifiable) data.

Using Multiple Administrative Health Datasets to Identify A Mental Illness Cohort

IntroductionIt is well established that mental illness is associated with poor physical health and chronic diseases possibly related to high levels of risk factors such as smoking, physical inactivity, poor diet and alcohol consumption. There is also evidence to suggest that having a mental illness may be related to poorer management of chronic diseases. Health service providers wanted to investigate this in Central and Eastern Sydney (CES).&#x0D; Objectives and ApproachThe purpose of this study was to scope the feasibility of identifying a mental illness cohort using CES residents from the 45 and Up Study (n=30,049) linked to administrative health datasets. These included Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) provided by Services Australia and hospital admissions provided by the NSW Centre for Health Record Linkage. We then compared differences in the identified cohort size, characteristics and the 8-year mortality rates.&#x0D; ResultsUsing only hospitalisation data, 6% of the CES cohort were identified as having a mental illness, compared to 17% using MBS data only, 26% PBS data only, 35%using both the MBS and PBS data and 36% using all of the data sources. Crude mortality was 58% in those identified in the hospitalisation data, 27% based on the PBS data,10% using MBS data, 21% using the MBS and PBS data and 23% based on all combined sources.&#x0D; Conclusion / ImplicationsWe decided that the most appropriate option was to include the MBS, PBS and hospitalisation data to identify the mental illness cohort. This cohort will now be used to examine difference in the management of chronic disease, such as care plans and cycles of care, between those who do and do not have a mental illness.

Validating Australian Government Medicare Benefits Schedule Data Against the National Joint Replacement Registry Data

IntroductionTo enhance the value of the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) we recently linked these data with administrative datasets including, Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). Understanding the validity of administrative data is important in establishing the reliability of these data for informing clinical practice and policy.&#x0D; Objectives &amp; ApproachThe study objective was to determine the validity of MBS data for capturing the occurrence of a joint replacement procedure. Using the AOANJRR procedures as the gold standard, we determined the sensitivity of the MBS data in correctly identifying hip joint replacement procedures.&#x0D; ResultsOf the 178,047 patients with a single primary total hip replacement occurring in a private hospital setting and recorded in the AOANJRR, 76% had a same-day MBS service claim indicative of that procedure, 2% had MBS procedures within +/- 7 days of the procedure while 18% had no MBS procedure codes indicative of a total hip joint replacement procedure. Of the procedures with no total hip MBS codes, 2% had MBS procedures codes indicating a total knee procedure, 1.7% had MBS procedure codes indicating a revision hip on that day and 13% of procedures had an in-hospital MBS hip anaesthetic administration code claimed on that day.&#x0D; Conclusion / ImplicationsGiven the increasing application of MBS data to describe health service use it is important to understand the validity of these data for identifying procedures undertaken in the private hospital setting. Using validated, gold standard data captured by the AOANJRR we identified that MBS data likely underestimate the occurrence of total hip replacement procedures. In addition, some MBS procedure codes are misattributed to other procedure types such as knee procedures and revision procedures.

Consent to Data Linkage in LSAC

IntroductionLinking the existing longitudinal data assets with administrative datasets provide the opportunity to transform longitudinal data into valuable assets to inform research and policy development.&#x0D; Objectives and ApproachThis paper will focus on Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) data linkage landscape and consents which are invaluable for the development of evidence-based health-social-economic policies.&#x0D; ResultsLSAC is Australia’s first nationally-representative longitudinal study of child development. Since 2004, two cohorts of 5,000 children and their parents have been interviewed every two years (B (baby) cohort and K (kindergarten) cohort). Over the years, multiple data linkage has been undertaken based on either parental consent or study child consent.&#x0D; In 2004 parents were asked to consent on behalf of the study child to link Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS)/Repatriation Pharmaceutical Benefits Scheme (RPBS) and Australian Childhood Immunisation Register (ACIR) administrative data to LSAC. The consent rate was 93% was for MBS, PBS and ACIR. Nearly 90% of B cohort parents provided consent to link Australian Early Development Census (AEDC)/National&#x0D; Assessment Program – Literacy and Numeracy (NAPLAN) and 95.4% of K cohort parents provided consent to link NAPLAN.Then ten years later, children in the K cohort were asked to consent to MBS/PBS and income-support administrative data. The rates were 86.6% for MBS, 85.4% for PBS and 81.2% for income-support administrative data. Parental consent to link their MBS, PBS and income-support administrative data was also sought and these rates varied between 60% to 88%.&#x0D; Conclusion/ImplicationsThe discussion will focus on differences in consent rates by time of consent, consenting individual and type of administrative data to be linked. Challenges and considerations that researches should be aware of when designing the linkage consent methodology will also be discussed.