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Definition

The total Medicare benefits expenditure for non-referred GP attendances claimed through the Medicare Benefits Schedule (MBS).

Indicator Summary

Numerator
Total amount of claims for non-referred (GP) attendances claimed through the Medicare Benefits Schedule (MBS)
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Denominator
Total estimated resident population (ERP)
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Computation

Medicare benefits expenditure on GP attendances per person

GP attendances are on Medicare benefit-funded patient/doctor encounters, such as visits and consultations, for which the patient has not been referred by another doctor. GP attendances exclude services provided by practice nurses and Aboriginal and Torres Strait Islander health practitioners on a GP’s behalf.

In terms of 'Broad Type of Service' Groups, …

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Disaggregation
By Medicare Local catchments, Medicare Local peer groups and SA3
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Calculation rules

Computation Rule
Description

Medicare benefits expenditure on GP attendances per person

GP attendances are on Medicare benefit-funded patient/doctor encounters, such as visits and consultations, for which the patient has not been referred by another doctor. GP attendances exclude services provided by practice nurses and Aboriginal and Torres Strait Islander health practitioners on a GP’s behalf.

In terms of 'Broad Type of Service' Groups, GP attendances comprise all items in Broad Type of Service Groups 'A' – GP/VRGP non-referred attendances, 'M' - Enhanced Primary Care and 'B' Non-referred other attendances as published in official MBS statistics by the Department of Human Services and the Department of Health.

Expenditure on GP attendances does not include benefits paid for bulk billing items (MBS Items 10990, 10991, and 10992). These items are in 'Miscellaneous Services' (Category 9) in the MBS and are claimed as 'stand alone' items where the bulk billed service is a non-hospital unreferred service (other than pathology or diagnostic imaging) involving a person who is under 16 years of age or concessional. Since it is not always possible to determine the MBS item to which the incentive item relates expenditure on these items is included in 'Other MBS' (Broad Type of Service Group 'L') in official statistics.

For the year of processing expenditure on bulk billing incentive items (MBS Items 10990, 10991 and 10992) other than pathology and diagnostic imaging was $542.6 million.

In undertaking age standardisation of MBS data, the age of each person was determined from the last MBS service of any type, processed by the Department of Human Services in 2012–13. All MBS services for each individual processed in 2012–13, were attributed to the age in question.

For MBS data, Medicare Local and SA3 were determined having regard to the enrolment postcode for each person from the last MBS service of any type, processed by the Department of Human Services in 2012–13. All MBS services for each individual processed in 2012–13, were attributed to the postcode in question.

MBS postcode level data were allocated to Medicare Local and SA3 regions using concordance files provided by the ABS.

Numerator based on Medicare (MBS) data provided by Department of Health for the financial year of processing, 2012–13.

Denominator data – Estimated Resident Population at 30 June 2012 provided by ABS.

Presented per person.

Before MBS data are published by NHPA all confidential data cells are suppressed.

The current definition of confidential data is as follows:

  • For number of MBS services:
    • if number of services is less than 6 or if number of services is equal to or greater than 6 but
      • one provider provides more than 85% of services
        or two providers provide more than 90% of services
      • one patient receives more than 85% of services
        or two patients receive more than 90% of services.
  • If data on number of services is confidential, corresponding data on other measures such as MBS benefit paid is also regarded as confidential.
Denominators
Total estimated resident population (ERP)
Disaggregation
By Medicare Local catchments, Medicare Local peer groups and SA3

Comments

Origin:
Healthy Communities

References

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