Table 4.
Adjusteda risk ratio and 95% confidence interval of Medicare Benefits Schedule subsidised health care utilisation 12 months before and after Home Care Package access, 2017–2019
| Service Group / HCP Level | 12 months before and after HCP access | |
|---|---|---|
| Primary Care | Adjusted Risk Ratio (95% CI)e | |
| General Attendances | HCP Levels 1–2 | HCP Levels 3–4 |
| GP/Medical practitioner attendances | 0.90 (0.89–0.91) | 0.91 (0.89–0.93) |
| Urgent GP attendance after-hours | 0.90 (0.84–0.96) | 0.93 (0.85–1.03) |
| GP/Medical practitioner after-hours attendances | 1.07 (1.03–1.11) | 1.20 (1.13–1.28) |
| Nurse practitioners | 1.47 (1.27–1.70) | 1.34 (1.08–1.66) |
| Health Assessments / Management Plans | ||
| GP Health assessmentsb | 0.78 (0.74–0.82) | 0.85 (0.77–0.93) |
| GP Management plans | 0.83 (0.82–0.85) | 0.78 (0.75–0.81) |
| GP attendance associated with PIP/Non-referred attendance associated with PIP | 0.63 (0.58–0.69) | 0.59 (0.50–0.70) |
| Allied Health Services | ||
| Optometrical services | 0.78 (0.76–0.80) | 0.75 (0.71–0.79) |
| Comprehensive medication review | 0.88 (0.80–0.98) | 0.90 (0.76–1.08) |
| Dentistryc,d | 0.71 (0.47–1.07) | 1.13 (0.59–2.15) |
| Allied health service part of CDMP | 0.88 (0.87–0.90) | 0.80 (0.77–0.82) |
| Mental Health Services | ||
| GP Mental health treatment | 0.69 (0.64–0.73) | 0.63 (0.56–0.72) |
| Consultant psychiatrist attendances | 0.72 (0.66–0.79) | 0.65 (0.57–0.75) |
| Focused psychological strategies | 0.76 (0.69–0.85) | 0.66 (0.53–0.81) |
| Psychological therapy servicesd | 0.79 (0.68–0.91) | 0.79 (0.61–1.02) |
| Specialist Geriatric, Pain and Palliative Services | ||
| Pain medicined | 0.74 (0.63–0.87) | 0.79 (0.60–1.03) |
| Palliative medicined | 2.67 (2.08–3.44) | 1.88 (1.41–2.52) |
| Geriatric medicine | 0.76 (0.70–0.82) | 0.83 (0.73–0.95) |
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 (-12 to -9 months, n = 53,157; -9 to -6 months, n = 53,953; -6 to -3 months, n = 54,691; -3 to 0 months, n = 55,412; 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
eReference category = 12 months before HCP
Abbreviations MBS, Medicare Benefits Schedule; HCP, Home Care Package; GP, General Practitioner; PIP, Practice Incentive Program; CI, Confidence Interval; CDMP, Chronic Disease Management Plan