Women's uptake of Medicare Benefits Schedule mental health items for general practitioners, psychologists and other allied mental health professionals

Abstract

Objective: To quantify women's uptake of Medicare Benefits Schedule mental health items, compare characteristics of women by mental health service use, and investigate the impact on Medicare costs. Design, setting and participants: Analysis of linked survey data and Medicare records (November 2006 – December 2007) of 14 911 consenting participants of the Australian Longitudinal Study on Women's Health (ALSWH) across three birth cohorts (1921–1926 [“older cohort”], 1946–1951 [“mid‐age cohort”], and 1973–1978 [“younger cohort”]). Main outcome measures: Uptake of mental health items; 36‐Item Short Form Health Survey (SF‐36) Mental Health Index scores from ALSWH surveys; and patient (out‐of‐pocket) and benefit (government) costs from Medicare data. Results: A large proportion of women who reported mental health problems made no mental health claims (on the most recent survey, 88%, 90% and 99% of the younger, mid‐age and older cohorts, respectively). Socioeconomically disadvantaged women were less likely to use the services. SF‐36 Mental Health Index scores among women in the younger and mid‐age cohorts were lowest for women who had accessed mental health items or self‐reported a recent mental health condition. Mental health items are associated with higher costs to women and government. Conclusion: Although there has been rapid uptake of mental health items, uptake by women with mental health needs is low and there is potential socioeconomic inequity.

Mental health service use: Is there a difference between rural and non-rural women in service uptake?

“…37 It is also possible that women were accessing mental health services outside of the MBS, such as community health services, other GP services that are not mental health specific or services provided under the Better Outcomes in Mental Health Care program. This study shows that a higher proportion of women in major cities have accessed BAS services compared with non-urban women, with registered psychologists being the most commonly used BAS service for major citydwelling women.…”

“…15 The BAS, introduced under Medicare in November 2006, encourages a multi-disciplinary approach by allowing GPs to refer patients to psychologists, allied health care workers or psychiatrists and by providing a Medicare rebate for these services. [34][35][36][37][38] The current paper extends on this research by examining the uptake of BAS services in relation to area of residence. [34][35][36][37][38] The current paper extends on this research by examining the uptake of BAS services in relation to area of residence.…”

The runaway giant: ten years of the Better Access program

“…Other independent research has indicated that the Better Access program has failed to address key service gaps and socio‐demographic challenges, particularly affecting people living in regional and rural areas . About 60% of all services under Better Access were provided to women in 2007–08 and this has remained unchanged.…”

Resource Misallocation in Australia’s Mental Health Sector under Medicare: Evidence from Time-series Data*

“…That study also examines the gender differences in diagnoses. A more recent survey‐based study (Byles et al. , 2011) also suggests this gender‐related problem: among women, those with low mental health “need” are consuming mental health services in Australia under Medicare and those with high mental health need are not consuming services, relatively speaking.…”

“…That study also examines the gender differences in diagnoses. A more recent survey-based study (Byles et al, 2011) those with high mental health need are not consuming services, relatively speaking. These various results strongly suggest that the extent of non-correspondence between service utilisation and ''need'' warrants further investigation.…”