National Health Performance Authority, Healthy Communities: Expenditure on after-hours GP attendances, 2012–13

Average Medicare benefits expenditure per person on GP after-hours attendances.

GP after-hours attendances are Medicare benefit-funded after-hours patient/doctor encounters, such as visits and consultations, for which the patient has not been referred by another doctor. They include urgent and non-urgent non-referred attendances.

Relevant non-referred Medicare Benefits Schedule (MBS) items used in this indicator are:

For urgent attendances after hours, all items in MBS Group A11 (Urgent attendance after hours).

For non-urgent attendances after hours, all items in MBS Groups A22 (General practitioner attendances to which no other item applies) and A23 (other non-referred after hours attendances to which no other item applies).

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.

Rates directly age-standardised to the 2001 Australian population.

Total Medicare benefits expenditure for relevant attendances/visits – source: MBS claims data.

Total Estimated Resident Population (ERP) as supplied by ABS.

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.

• For number of MBS services and Medicare benefits expenditure:
  • 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 or
    • 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.