Types of MBS-subsidised palliative medicine specialist services

Broadly, the MBS-subsidised palliative medicine specialist services can be categorised as follows:

  • Palliative medicine attendances
    • Attendances at hospital or surgery
    • Home visits
  • Palliative medicine case conferences
    • Community case conference–organisation and coordination
    • Community case conference–participation
    • Discharge case conference–organisation and coordination
    • Discharge case conference–participation.

In 2016–17 there were 80,244 MBS-subsidised services provided by palliative medicine specialists. Palliative medicine attendances in hospital or surgery made up the majority (66,210; 82.5%) of all MBS-subsidised palliative medicine specialist items in 2016–17, with a further 1 in 16 (5,105) of all items being consultations in the patient’s home. Palliative medicine specialists were more likely to organise and coordinate case conferences for patients (7.3%) than to participate at such conferences initiated by other care providers (3.8%).

MBS-subsidised palliative medicine specialist services by state and territory and remoteness

The rate of subsidised palliative medicine specialist services in 2016–17 varied among states and territories. Western Australia recorded the highest rate (677.5 per 100,000 population), double the national average rate (329.1) (Figure MBS.1). This was mainly due to the high rate of palliative medicine attendances in Western Australia (604.6).

Palliative medicine case conferences were most frequently recorded in Western Australia (72.8 per 100,000 population), followed by New South Wales (60.4).

Visualisation not available for printing

Source:  Australian Government Department of Health analysis of MBS data, unpublished.

Data source: Services provided by palliatice medicine specialists (131KB XLS)

 

In 2016–17, the highest rate of MBS-subsidised palliative medicine specialist services was recorded in Major cities, followed by Inner regional areas (367.6 and 281.9 per 100,000 population, respectively) (Figure MBS.2). The rate in Major cities is almost 4 times that for Very remote areas (102.8).

Visualisation not available for printing

Source:  Australian Government Department of Health analysis of MBS data, unpublished.

Data source: Services provided by palliative medicine specialists (131KB XLS)

MBS-subsidised palliative medicine specialist services over time

Between 2012–13 and 2016–17, the total number of MBS-subsidised palliative medicine specialist services increased by a quarter (25.9%) from 63,735 services in 2012–13 to 80,244, an average annual increase of 5.9%. As a population rate, this represents a 18.5% increase over the period, from 277.8 to 329.1 per 100,000.

During this same period, palliative medicine attendances experienced an average annual increase of 5.0%, and palliative medicine case conferences an increase of 15.4%.

Australian Government expenditure on MBS-subsidised palliative medicine specialist services

This section outlines the Australian Government’s expenditure through the MBS for palliative care-related services provided by palliative medicine specialists in 2016–17. Benefits paid are based on the MBS, with the schedule allocating a unique item number to each service, as well as indicating the scheduled payment amount. Further information on the specific MBS items and item groups for palliative medicine specialists can be found in the Medicare Benefits Schedule Book (DoH 2017).

Just over $6.1 million was paid in benefits for MBS-subsidised palliative medicine specialist services during 2016–17— equivalent to an average of $410 per patient. Western Australia had the highest rate of benefits per MBS patient of $632. Over four-fifths (84.7%) of total benefits paid were MBS items claimed for palliative medicine specialist attendances.

Between 2012–13 and 2016–17, the MBS benefits paid for all palliative medicine specialist services increased by 30.5% (from almost $4.7 million to more than $6.1 million). This equates to an average annual increase of 6.9%.

During this same period, the benefits paid for palliative medicine attendances increased at an average annual rate of 5.8%, whereas the benefits paid for palliative medicine case conferences increased at a rate of 14.3% per year.

Characteristics of patients receiving palliative medicine specialist services

Nationally, 14,930 patients received an MBS-subsidised palliative medicine specialist service during 2016–17, a rate of 61.2 patients per 100,000 population. During this time period, about 80,244 MBS-subsidised palliative medicine specialist services were provided, an average of 5.4 services per patient.

The majority (88.9%) of patients receiving an MBS-subsidised palliative medicine specialist service were aged 55 and older, and almost three-quarters (73.2%) were aged 65 and older. For the 55–64 age group the population rate was 83.1 per 100,000 population and the rate was 292.8 per 100,000 for those aged 65 and older  (Figure MBS.3).

About 1 in 140 (0.7%) patients receiving MBS-subsidised palliative medicine specialist services were aged 24 or under in 2016–17. The Australian Capital Territory had the highest rate of MBS-subsidised palliative care patients at 79.7 per 100,000 population, followed by Tasmania and New South Wales, with 78.6 and 75.5 per 100,000 respectively.

A slightly higher proportion of male patients (51.7%) received MBS-subsidised palliative medicine specialist services than female patients (48.3%).

Visualisation not available for printing

Source: Australian Government Department of Health analysis of MBS data, unpublished.

Data source: Services provided by palliative medicine specialists (131KB XLS)

References

ANZSPM (Australian and New Zealand Society of Palliative Medicine) 2008.
Defining the meaning of the terms consultant physician in palliative medicine and palliative medicine specialist. Canberra: ANZSPM. Viewed 8 January 2017.

ANZSPM 2009. Caring for people at the end of life: submission to the National Health and Hospitals Reform Commission. Canberra: ANZSPM Incorporated.

DoH 2017. Medicare Benefits Schedule Book, effective 1 December 2017. Canberra: Department of Health

Parker MH, Cartwright CM & Williams GM 2008. Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions. Medical Journal of Australia 188:450-6.

PCA (Palliative Care Australia) 2005. A guide to palliative care service development: A population based approach. Canberra: PCA.