. 2024 Mar 29;36(1):83. doi: 10.1007/s40520-024-02731-9

Table 3.

Adjusted^a incidence proportion of Medicare Benefits Schedule subsidised primary care, allied health, mental health, geriatric, pain and palliative services among Home Care Package (HCP) recipients by 3-month interval in the 12 months after their HCP access

Service Group / HCP Level	0 to 3 months N = 109,558	3 to 6 months N = 102,264	6 to 9 months N = 94,032	9 to 12 months N = 87,140
General Attendances
GP/Medical practitioner attendances	89.7 (89.0-90.3)	86.4 (85.3–87.4)	87.9 (87.2–88.6)	85.2 (84.1–86.4)	86.7 (86.0-87.4)	84.0 (82.8–85.2)	81.1 (80.4–81.8)	79.5 (78.3–80.8)
Urgent GP attendance after-hours	2.74 (2.63–2.85)	4.47 (4.23–4.72)	2.68 (2.57–2.80)	4.31 (4.07–4.57)	2.42 (2.31–2.54)	3.87 (3.63–4.13)	2.11 (2.00-2.22)	3.37 (3.13–3.62)
GP/Medical practitioner after-hours attendances	8.54 (8.35–8.74)	10.4 (10.1–10.8)	8.53 (8.33–8.74)	10.5 (10.1–10.9)	8.25 (8.04–8.46)	10.1 (9.65–10.5)	7.45 (7.24–7.65)	9.32 (8.92–9.74)
Nurse practitioners	0.55 (0.50–0.60)	0.70 (0.61–0.79)	0.56 (0.51–0.61)	0.74 (0.65–0.85)	0.54 (0.49–0.60)	0.71 (0.61–0.82)	0.53 (0.48–0.58)	0.67 (0.57–0.78)
Health Assessments / Management Plans
GP Health assessments^b	9.71 (9.42–10.01)	7.75 (7.31–8.22)	9.48 (9.18–9.79)	7.59 (7.14–8.08)	8.48 (8.19–8.79)	7.47 (6.99–7.97)	7.98 (7.69–8.29)	7.00 (6.52–7.52)
GP Management plans	27.1 (26.8–27.5)	24.7 (24.1–25.3)	25.4 (25.1–25.8)	22.9 (22.4–23.5)	25.0 (24.6–25.4)	22.1 (21.5–22.7)	22.5 (22.1–22.9)	19.7 (19.1–20.3)
GP Attendance associated with PIP/Non-referred attendance associated with PIP	1.18 (1.12–1.26)	1.05 (0.95–1.17)	1.20 (1.13–1.28)	0.94 (0.84–1.06)	1.10 (1.03–1.17)	0.93 (0.82–1.06)	0.96 (0.89–1.03)	0.80 (0.69–0.92)
Allied Health Services
Optometrical services	15.4 (15.1–15.6)	11.6 (11.2–12.0)	15.3 (15.0-15.6)	11.2 (10.8–11.6)	14.4 (14.2–14.7)	11.0 (10.5–11.4)	13.0 (12.7–13.3)	9.81 (9.40–10.2)
Comprehensive medication review	1.12 (1.05–1.19)	1.05 (0.93–1.17)	1.08 (1.01–1.19)	0.98 (0.87–1.11)	1.00 (0.93–1.07)	1.02 (0.90–1.15)	0.93 (0.86-1.00)	0.89 (0.78–1.03)
Dentistry^c,d	0.07 (0.05–0.09)	0.06 (0.04–0.10)	0.06 (0.04–0.08)	0.06 (0.03–0.09)	0.06 (0.05–0.08)	0.06 (0.04–0.10)	0.05 (0.04–0.07)	0.07 (0.05–0.12)
Allied health service part of CDMP	35.5 (35.1–35.9)	28.8 (28.2–29.4)	34.0 (33.6–34.4)	27.1 (26.5–27.8)	32.8 (32.4–33.2)	26.3 (25.6–26.9)	30.7 (30.3–31.2)	24.3 (23.6–25.0)
Mental Health Services
GP Mental health treatment	2.15 (2.06–2.24)	1.76 (1.63–1.92)	1.97 (1.88–2.06)	1.58 (1.45–1.73)	1.91 (1.82–2.01)	1.52 (1.38–1.67)	1.66 (1.58–1.76)	1.35 (1.21–1.50)
Consultant psychiatrist attendances	1.15 (1.08–1.22)	1.37 (1.25–1.50)	1.10 (1.04–1.17)	1.39 (1.27–1.53)	1.02 (0.95–1.09)	1.20 (1.08–1.34)	0.91 (0.84–0.97)	1.05 (0.93–1.18)
Focused psychological strategies	0.75 (0.70–0.81)	0.51 (0.44–0.59)	0.69 (0.64–0.77)	0.48 (0.41–0.56)	0.67 (0.62–0.73)	0.46 (0.39–0.53)	0.60 (0.55–0.65)	0.37 (0.31–0.44)
Psychological therapy services^d	0.38 (0.35–0.42)	0.32 (0.26–0.38)	0.37 (0.34–0.41)	0.30 (0.25–0.37)	0.38 (0.34–0.42)	0.29 (0.24–0.36)	0.33 (0.29–0.37)	0.27 (0.22–0.34)
Specialist Geriatric, Pain and Palliative Services
Pain medicine^d	0.30 (0.27–0.34)	0.30 (0.24–0.36)	0.32 (0.29–0.36)	0.32 (0.27–0.39)	0.30 (0.27–0.34)	0.35 (0.29–0.42)	0.26 (0.23–0.30)	0.30 (0.24–0.37)
Palliative medicine^d	0.46 (0.42–0.51)	0.70 (0.61–0.80)	0.36 (0.32–0.40)	0.60 (0.51–0.69)	0.32 (0.29–0.36)	0.50 (0.42–0.59)	0.24 (0.21–0.28)	0.42 (0.35–0.51)
Geriatric medicine	1.95 (1.86–2.04)	1.96 (1.81–2.12)	1.74 (1.65–1.83)	1.80 (1.66–1.97)	1.50 (1.42–1.59)	1.59 (1.45–1.75)	1.23 (1.16–1.32)	1.45 (1.30–1.61)

Service Group / HCP Level

0 to 3 months
N = 109,558

3 to 6 months
N = 102,264

6 to 9 months
N = 94,032

9 to 12 months
N = 87,140

HCP L 1–2
n = 81,500

HCP L 3–4
n = 28,058

HCP L 1–2
n = 76,649

HCP L 3–4
n = 25,615

HCP L 1–2
n = 71,017

HCP L 3–4
n = 23,015

HCP L 1–2
n = 66,282

HCP L 3–4
n = 20,858

Primary Care

Adjusted IP
(95%CI)

General Attendances

GP/Medical practitioner attendances

89.7

(89.0-90.3)

86.4

(85.3–87.4)

87.9

(87.2–88.6)

85.2

(84.1–86.4)

86.7

(86.0-87.4)

84.0

(82.8–85.2)

81.1

(80.4–81.8)

79.5

(78.3–80.8)

Urgent GP attendance after-hours

2.74

(2.63–2.85)

4.47

(4.23–4.72)

2.68

(2.57–2.80)

4.31

(4.07–4.57)

2.42

(2.31–2.54)

3.87

(3.63–4.13)

2.11

(2.00-2.22)

3.37

(3.13–3.62)

GP/Medical practitioner after-hours attendances

8.54

(8.35–8.74)

10.4

(10.1–10.8)

8.53

(8.33–8.74)

10.5

(10.1–10.9)

8.25

(8.04–8.46)

10.1

(9.65–10.5)

7.45

(7.24–7.65)

9.32

(8.92–9.74)

Nurse practitioners

0.55

(0.50–0.60)

0.70

(0.61–0.79)

0.56

(0.51–0.61)

0.74

(0.65–0.85)

0.54

(0.49–0.60)

0.71

(0.61–0.82)

0.53

(0.48–0.58)

0.67

(0.57–0.78)

Health Assessments / Management Plans

GP Health assessments^b

9.71

(9.42–10.01)

7.75

(7.31–8.22)

9.48

(9.18–9.79)

7.59

(7.14–8.08)

8.48

(8.19–8.79)

7.47

(6.99–7.97)

7.98

(7.69–8.29)

7.00

(6.52–7.52)

GP Management plans

27.1

(26.8–27.5)

24.7

(24.1–25.3)

25.4

(25.1–25.8)

22.9

(22.4–23.5)

25.0

(24.6–25.4)

22.1

(21.5–22.7)

22.5

(22.1–22.9)

19.7

(19.1–20.3)

GP Attendance associated with PIP/Non-referred attendance associated with PIP

1.18

(1.12–1.26)

1.05

(0.95–1.17)

1.20

(1.13–1.28)

0.94

(0.84–1.06)

1.10

(1.03–1.17)

0.93

(0.82–1.06)

0.96

(0.89–1.03)

0.80

(0.69–0.92)

Allied Health Services

Optometrical services

15.4

(15.1–15.6)

11.6

(11.2–12.0)

15.3

(15.0-15.6)

11.2

(10.8–11.6)

14.4

(14.2–14.7)

11.0

(10.5–11.4)

13.0

(12.7–13.3)

9.81

(9.40–10.2)

Comprehensive medication review

1.12

(1.05–1.19)

1.05

(0.93–1.17)

1.08

(1.01–1.19)

0.98

(0.87–1.11)

1.00

(0.93–1.07)

1.02

(0.90–1.15)

0.93

(0.86-1.00)

0.89

(0.78–1.03)

Dentistry^c,d

0.07

(0.05–0.09)

0.06

(0.04–0.10)

0.06

(0.04–0.08)

0.06

(0.03–0.09)

0.06

(0.05–0.08)

0.06

(0.04–0.10)

0.05

(0.04–0.07)

0.07

(0.05–0.12)

Allied health service part of CDMP

35.5

(35.1–35.9)

28.8

(28.2–29.4)

34.0

(33.6–34.4)

27.1

(26.5–27.8)

32.8

(32.4–33.2)

26.3

(25.6–26.9)

30.7

(30.3–31.2)

24.3

(23.6–25.0)

Mental Health Services

GP Mental health treatment

2.15

(2.06–2.24)

1.76

(1.63–1.92)

1.97

(1.88–2.06)

1.58

(1.45–1.73)

1.91

(1.82–2.01)

1.52

(1.38–1.67)

1.66

(1.58–1.76)

1.35

(1.21–1.50)

Consultant psychiatrist attendances

1.15

(1.08–1.22)

1.37

(1.25–1.50)

1.10

(1.04–1.17)

1.39

(1.27–1.53)

1.02

(0.95–1.09)

1.20

(1.08–1.34)

0.91

(0.84–0.97)

1.05

(0.93–1.18)

Focused psychological strategies

0.75

(0.70–0.81)

0.51

(0.44–0.59)

0.69

(0.64–0.77)

0.48

(0.41–0.56)

0.67

(0.62–0.73)

0.46

(0.39–0.53)

0.60

(0.55–0.65)

0.37

(0.31–0.44)

Psychological therapy services^d

0.38

(0.35–0.42)

0.32

(0.26–0.38)

0.37

(0.34–0.41)

0.30

(0.25–0.37)

0.38

(0.34–0.42)

0.29

(0.24–0.36)

0.33

(0.29–0.37)

0.27

(0.22–0.34)

Specialist Geriatric, Pain and Palliative Services

Pain medicine^d

0.30

(0.27–0.34)

0.30

(0.24–0.36)

0.32

(0.29–0.36)

0.32

(0.27–0.39)

0.30

(0.27–0.34)

0.35

(0.29–0.42)

0.26

(0.23–0.30)

0.30

(0.24–0.37)

Palliative medicine^d

0.46

(0.42–0.51)

0.70

(0.61–0.80)

0.36

(0.32–0.40)

0.60

(0.51–0.69)

0.32

(0.29–0.36)

0.50

(0.42–0.59)

0.24

(0.21–0.28)

0.42

(0.35–0.51)

Geriatric medicine

1.95

(1.86–2.04)

1.96

(1.81–2.12)

1.74

(1.65–1.83)

1.80

(1.66–1.97)

1.50

(1.42–1.59)

1.59

(1.45–1.75)

1.23

(1.16–1.32)

1.45

(1.30–1.61)

^aAdjusted for sex, age category, number of comorbidities and state of residence

^bOnly individuals 75 + years old were eligible and only once/year, therefore cohort restricted to 75 + only (0 to 3 months, n = 56,124; 3 to 6 months, n = 52,825; 6 to 9 months, n = 48,934; 9 to 12 months, n = 46,136)

^cAustralian Capital Territory (n = 1497) excluded from the analyses due to low service utilization

^dNorthern Territory (n = 245) excluded from the analyses due to low service utilization

Abbreviations HCP, Home Care Package; L, Levels; GP, General Practitioner; PIP, Practice Incentive Program; IP, Incidence Proportion; CI, Confidence Interval; CDMP, Chronic Disease Management Plan