Box 7.1: Assessment and management plans
As there are no specific MBS items for dementia diagnosis and management services, a number of MBS items may be claimed by GPs and other specialists for services involved in diagnosing and managing dementia including:
- Geriatrician Referred Patient Assessment and Management Plans (MBS items 141–147; referred to as ‘Geriatrician referred plans’) are comprehensive assessment and management plan services provided by a consultant physician or specialist in geriatric medicine to patients who have been referred by a GP. These services are for patients aged 65 and over with complex health issues and who are at significant risk of poor health outcomes.
- Chronic Disease Management Items (MBS group A15; referred to as ‘Chronic disease plans’) are management plan services for people with chronic or terminal health conditions, or conditions that require care from a GP and at least 2 other health or care providers.
These plans aim to provide comprehensive and up-to-date information on the patient’s health priorities, actions for patients to take to manage their condition/s and achieve their health goals, as well as information on health and community services available to the patient. In addition to assessing a patient’s current and past medical history, assessments may involve an assessment of physical, psychological (including cognition) and social function, as well as advanced care planning.
In 2016–17, on average, there were substantially more geriatrician referred plans (17 per 100 people) and chronic disease plans (131 per 100 people) for people with dementia than people without dementia (1.4 and 55 per 100 people, respectively) (Figure 7.5).
These differences between people with and without dementia were mainly due to differences among people living in the community. On average there were:
- 18 times as many geriatrician referred plans for people with dementia as there were for people without dementia living in the community
- 2.7 times as many chronic disease plans for people with dementia as there were for people without dementia living in the community.
By comparison, there were 1.7 times as many geriatrician referred plans for people with dementia as there were for people without dementia living in residential aged care. However, the average number of chronic disease plans was slightly higher for people without dementia than people with dementia living in residential aged care.
Figure 7.5: Geriatrician referred plans and chronic disease plans for people with and without dementia (plans per 100 people), by place of residence in 2016–17