OVERVIEW OF USE OF MBS SERVICES

The Medicare Benefits Schedule (MBS) is a key component of the Medicare system. It lists a range of subsidised health care services that, in broad terms, include consultation and procedural/therapeutic (including surgical) services, as well as diagnostic services¹.

This chapter provides an overview of the use of selected MBS subsidised health services in 2015-16 by persons aged 45 years and over who had at least one GP visit between November 2014 to November 2015 (the Study cohort). Almost all people (98%) in the Study cohort therefore used at least one MBS subsidised service in 2015-16, and almost all (96%) had at least one GP visit. Given this high proportion, analysis in the remainder of this chapter excludes discussion of GP services.

Amongst the Study cohort, around one in ten people (9%) saw a practice nurse in 2015-16. Half (50%) saw a specialist while 55% used diagnostic imaging services. Around four in five people (81%) used pathology services (collection and tests), while around one in five people (19%) used other allied health services. See the Glossary for more information on the MBS services presented in this publication.

	Number of persons '000	Proportion %	Number of services used million	Average number of services used(b) no. per person
General practitioner	8,430.2	95.6	76.5	8.7
Practice nurse	805.5	9.1	1.5	0.2
Specialist	4,418.1	50.1	20.4	2.3
Diagnostic imaging	4,837.2	54.9	15.6	1.8
Pathology collection(c)	7,134.3	80.9	26.3	3.0
Pathology tests(c)	7,172.1	81.3	59.8	6.8
Other allied health services(d)	1,696.1	19.2	6.7	0.8
All other services	6,355.8	72.1	26.0	3.0
Total persons who used at least one MBS service in 2015-16	8,624.7	97.8	232.8	26.4
_
Total persons aged 45 years and over who had at least one GP visit between November 2014 and November 2015	8,818.7	100.0	. .	. .
(a) See Appendix 1 – MBS items for a detailed list of MBS item codes for each type of service. See the Glossary for more information on each type of service. (b) Average number of services per person in the Study cohort (8.8 million people). (c) Pathology collection refers to the collection of pathology specimens (e.g. a blood specimen), while pathology tests refer to laboratory tests that analyse pathology specimens (e.g. measuring levels of cholesterol in a person’s blood). Multiple tests may be performed on a single pathology specimen. (d) Other allied health services refer to a range of services provided by health professionals who are not doctors, nurses or dentists; e.g. Aboriginal and Torres Strait Islander health practitioners, occupational therapists, psychologists and physiotherapists.

AGE AND SEX

In general, the proportion of people who used MBS services in 2015-16 increased with age. More than nine in ten people in the Study cohort aged 75-84 years used pathology services (92% and 93% for collection and tests respectively), while around three quarters (72%) saw a specialist and around two thirds (68%) used diagnostic imaging services.



Proportionally more women in the Study cohort than men used individual MBS services in 2015-16, with the largest differences being for diagnostic imaging services (58% of women compared with 51% of men) and pathology collection and tests (both 84% for women, and 77% and 78% respectively for men). Slightly more than half (52%) of women saw a specialist compared with slightly less than half (48%) of men. These differences can be attributed to:

• women aged 45-64 years in the Study cohort being more likely to use these services than men of the same age, and
• to a lesser extent, the slightly higher proportion of women aged 75 years and over than men of the same age in the Study cohort, given older people were more likely to use these services.

SELF-ASSESSED HEALTH AND NUMBER OF LONG-TERM HEALTH CONDITIONS

Study participants were asked to rate their health on a 5-point scale ranging from excellent to poor, and to identify particular health conditions they had (for example, diabetes or heart disease). Proportionally more people who rated their health as being fair or poor used MBS services in 2015-16 than people who rated their health more favourably. Similarly, proportionally more people with 3 or more health conditions used individual MBS services than people with fewer health conditions.




GEOGRAPHY

Variation in the use of health services across geographies may reflect the different demographic characteristics of these areas (for example, their age structures) as well as other factors such as the availability of particular health services. For example, in the absence of MBS subsidised specialist services a person may access specialist services as a public patient in a public hospital. Similarly a person may obtain treatment from a hospital emergency department if a GP service is not available.

State/territory

Use of MBS services across the states and territories broadly reflected that of Australia overall. Across jurisdictions, the proportion of people in the Study cohort who used pathology services in 2015-16 ranged between 73% and 83%, followed by diagnostic imaging (49%-58%) and specialist visits (41%-55%). Use of specialists amongst the Study cohort was highest in New South Wales (with 55% of people having at least one specialist visit in 2015-16) and lowest in Western Australia and the Northern Territory (both 41%).

Remoteness Areas

Across Remoteness Areas, use of individual MBS services was generally highest in Major Cities and lowest in remote areas of Australia. Of people in the Study cohort living in Major Cities, just over one half (52%) had seen a specialist in 2015-16, compared with two in five people in Very Remote areas (40%). Similarly, differences were apparent for diagnostic imaging and other allied health services. People in more remote areas often have poorer access to health care services² and may receive primary health care services that are not captured by MBS.



Index of Relative Socio-Economic Disadvantage

While patterns of use of MBS services in 2015-16 were broadly consistent across areas of disadvantage in Australia, people in the Study cohort living in areas of least disadvantage (quintile 5; see Socio-Economic Indexes for Areas in the Glossary) had slightly higher use of specialist services (55%) compared with the rest of Australia (between 48% and 49% for quintiles 1-4). Conversely, people living in areas of greater disadvantage (quintile 1) had higher use of other allied health services than people living in areas of least disadvantage (24% compared with 15% respectively) as well as higher use of practice nurses (12% compared with 5% respectively).

PRIVATE HEALTH INSURANCE

Study participants were asked whether they had private health insurance. More than half (54%) of people with private health insurance had seen a specialist in 2015-16 compared with 43% of people who did not have private health insurance. Conversely, proportionally fewer people with private health insurance used other allied health services than people who did not have private health insurance (16% compared with 25% respectively).



REFERENCES

1. Australian Government Department of Health Medical Services Advisory Committee, 2016, 'What is the MBS and Medicare?' Factsheet, viewed 5 November 2018, http://www.msac.gov.au/internet/msac/publishing.nsf/content/factsheet-03
2. Australian Institute of Health and Welfare 2016. Australia’s health 2016. Australia’s health series no. 15. Cat. no. AUS 199. Canberra: AIHW.