Optometrists participating in VOS

In 2010-11 there were 73 optometrists or optometry organisations that participated in VOS (Table 74). These are referred to as VOS optometrists in the following sections of this report, although it needs to be emphasised that some of the organisations involved employ or subcontract a number of optometrists. Sixty-two of these participated in Core VOS and 17 participated in VOS Indigenous Australians (with six participating in both programs). Twenty-six optometrists (35%) visited only one location and accounted for 13% of planned program expenditure. Eleven (15%) visited 10 or more locations and accounted for 46% of program expenditure.

The 11 VOS optometrists who visited more than one location included organisations with an exclusive focus on delivery of services to rural and remote communities. These include ICEE and the Fred Hollows Foundation. In most of these cases the services are delivered by a single or small number of optometrists. Combined, the 11 optometrists who provide services for more than 10 locations visit 343 locations across Australia, mostly in remote and very remote regions. During 2010-11, approximately 8,800 patients were seen by these optometrists.

Table 74 – Number of VOS optometrists, locations, visits and patients 2010-11
No. of locations visited by optometrist/ organisation: No. of optometrists/ organisations Planned locations visited Planned number of visits Reported patient examinations: VOS budgeted funding($) VOS estimated funding allocated ($)
non-Indigenous Indigenous Total
Core VOS and VOS Indigenous Australians
1. One location 26 26 389 4,225 82 4,307 481,947 463,505
2. Two to four locations 19 51 373 2,777 687 3,464 578,581 487,514
3. Five to nine locations 17 113 673 4,817 971 5,788 979,741 897,301
4. Ten or more locations 11 343 1,089 4,279 4,543 8,822 1,767,758 1,308,424
Total: 73 533 2,524 16,098 6,283 22,381 3,808,027 3,156,744
 
Core VOS
1. One location 24 24 374 4,042 68 4,110 422,085 403643
2. Two to four locations 14 36 351 2,718 162 2,880 501,493 441,187
3. Five to nine locations 15 98 626 4,197 580 4,777 763,912 686,139
4. Ten or more locations 9 252 842 3,626 3,072 6,698 1,323,425 910,035
Total: 62 410 2,193 14,583 3,882 18,465 3,010,915 2,441,004
 
VOS Indigenous Australians
1. One location 2 2 15 183 14 197 59,862 59,862
2. Two to four locations 5 15 22 29 525 554 77,088 46,327
3. Five to nine locations 4 15 47 227 264 491 215,829 211,162
4. Ten or more locations 6 91 247 622 1,344 1,966 444,333 398,389
Total: 17 123 331 1,061 2,147 3,208 797,112 715,740


Note: VOS estimated funding is based on the VOS database related to services for which patient activity was reported in 2010-11, totalling $3.2 million across oth programs. Actual expenditures for 2010-11 were reported as $3.4 million in 2010-11 (see earlier tables). The differences reflect issues in lags in payments (e.g. relating to previous financial years) and the structure of the VOS database.
Source: Analysis of VOS program data undertaken by Health Policy Analysis



On average, optometrists participating in VOS are budgeted to receive $52,000 per year. This varies from an average $18,536 for optometrists visiting one location to an average $160,705 for optometrists visiting 10 or more locations. VOS funding per location visited is lower for optometrists visiting more locations, reflecting a higher frequency of visits for optometrists visiting fewer locations. VOS funding per visit and the funding per patient generally increases with the number of locations visited. To some extent, these patterns reflect that VOS optometrists providing services to more locations are more likely to provide services to remote and very remote locations (see Table 76).
Table 75 – VOS funding per optometrists/organisation, per locations, per visit and per patient 2010-11
No. of locations visited by optometrist/ organisation: Planned VOS funding per optometrist/ organisation ($) Planned VOS funding per location visited ($) Planned VOS funding per visit ($) Actual VOS funding per patient ($)
Core VOS and VOS Indigenous Australians
1. One location 17,827 17,827 1,192 108
2. Two to four locations 25,659 9,559 1,307 141
3. Five to nine locations 52,782 7,941 1,333 155
4. Ten or more locations 118,948 3,815 1,201 148
Total: 43,243 5,923 1,251 141


Source: Analysis of VOS program data undertaken by Health Policy Analysis



Table 76 – Locations visited, number of visits and average VOS funding per patient by number of locations visits end remoteness of locations visited, 2010-11Top of page
No. of locations visited by optometrist/ organisation: RA2 Inner regional RA3 Outer regional RA4 Remote RA5 Very remote Total
Number of locations
1. One location 5 13 6 2 26
2. Two to four locations 5 14 10 22 51
3. Five to nine locations 7 29 34 43 113
4. Ten or more locations 13 60 69 201 343
Total: 30 116 119 268 533
Number of visits
1. One location 80 240 62 7 389
2. Two to four locations 67 186 43 77 373
3. Five to nine locations 21 266 222 164 673
4. Ten or more locations 62 356 212 459 1,089
Total: 230 1,048 539 707 2,524
Average cost per patient
1. One location 72 65 168 107 108
2. Two to four locations 78 96 105 130 141
3. Five to nine locations 284 234 236 161 155
4. Ten or more locations 116 201 250 162 148
Total: 87 101 212 183 141


Source: Analysis of VOS program data undertaken by Health Policy Analysis



Locations visited by VOS participants

Overall, there were 533 locations planned to be visited by VOS optometrists in 2010-11. Table 77 describes the characteristics of VOS services across the ASGC remoteness areas. Thirty (6%) of these were located in inner regional, 116 (22%) in outer regional, 119 (22%) in remote and 268 (50%) in very remote areas. The average number of planned visits per year per location ranges from 7.7 in inner region, to 9.0 in outer regional, 4.5 in remote and 2.6 in very remote areas (Table 79).

In terms of budgets, an estimated 5% of VOS funds are directed to locations in inner regional, 24% to outer regional locations, 24% to remote locations and 47% to very remote locations (Table 78). However, actual expenditure patterns are quite different, largely because many planned visits in very remote locations do not take place. As a result, only 39% of actual VOS expenditure relates to visits to very remote locations.

The average cost per visit increases with remoteness from around $890 for inner regional and outer regional areas to $1,670 for remote areas and $2,511 for very remote areas.
Table 77 – Number of VOS optometrists, locations, visits, patients and funding by ASGC remoteness area, 2010-11

Remoteness Area: No. of optometrists/ organisations Planned locations visited Planned number of visits Reported patient examinations: VOS budgeted funding($) VOS estimated funding allocated ($)
non-Indigenous Indigenous Total
Core VOS and VOS Indigenous Australians
RA2 Inner Regional 11 30 230 1,708 316 2,024 204,542 176,506
RA3 Outer Regional 29 116 1,048 7,773 1,152 8,925 927,894 905,236
RA4 Remote 14 119 539 2,933 984 3,917 900,106 831,464
RA4 Very Remote 19 268 707 3,230 3,577 6,807 1,775,485 1,243,538
Total: 73 533 2,524 15,644 6,029 21,673 3,808,027 3,156,744
 
Core VOS
RA2 Inner Regional 10 27 225 1,708 188 1,896 184,763 156,727
RA3 Outer Regional 24 98 962 7,401 664 8,065 711,541 688,883
RA4 Remote 11 96 480 2,632 742 3,374 761,547 698,392
RA4 Very Remote 17 189 526 2,842 2,288 5,130 1,353,064 897,002
Total: 62 410 2,193 14,583 3,882 18,465 3,010,915 2,441,004
 
VOS Indigenous Australians
RA2 Inner Regional 1 3 5 - 128 128 19,779 19,779
RA3 Outer Regional 5 18 86 372 488 860 216,353 216,353
RA4 Remote 6 23 59 301 242 543 138,559 133,072
RA5 Very Remote 5 79 181 388 1,289 1,677 422,421 346,536
Total: 17 123 331 1,061 2,147 3,208 797,112 715,740


Note: VOS funding allocated represents the budgetted amount, not the actual expenditure. Actual expenditures for 2010-11 were $3.4 million in 2010-11 compared with $3.8 million budgetted)
Source: Analysis of VOS program data undertaken by Health Policy Analysis



Table 78 – Proportion of locations, visits, patients and funding by ASGC remoteness area, 2010-11
Remoteness Area: Planned locations visited Planned number of visits Patient examinations: VOS budgeted funding($) VOS estimated funding allocated ($)
non-Indigenous Indigenous Total
Core VOS and VOS Indigenous Australians
RA2 Inner Regional 6% 9% 11% 5% 9% 5% 6%
RA3 Outer Regional 22% 42% 50% 19% 41% 24% 29%
RA4 Remote 22% 21% 19% 16% 18% 24% 26%
RA5 Very Remote 50% 28% 21% 59% 31% 47% 39%
Total: 100% 100% 100% 100% 100% 100% 100%


Source: Analysis of VOS program data undertaken by Health Policy Analysis



Table 79 – VOS funding per optometrists/organisation, per locations, per visit and per patient by ASGC remoteness area, 2010-11
Remoteness Area: Planned visits per year per location Planned VOS funding per optometrist/ organisation ($) Planned VOS funding per location visited ($) Planned VOS funding per visit ($) VOS funding per patient ($)
Core VOS and VOS Indigenous Australians
RA2 Inner Regional 7.7 18,595 6,818 889 87
RA3 Outer Regional 9.0 31,996 7,999 885 101
RA4 Remote 4.5 64,293 7,564 1,670 212
RA5 Very Remote 2.6 93,447 6,625 2,511 183
Total: 4.7 52,165 7,145 1,509 146


Source: Analysis of VOS program data undertaken by Health Policy Analysis



Table 80 and Table 81 describe the characteristics of VOS supported services across jurisdictions. Twenty-two per cent of funding for the program is provided to locations in Queensland, with 20% to Western Australia, 17% to New South Wales, 14% to the Northern Territory, 12% to South Australia, 9% to Tasmania and 6% to Victoria.

Table 80 – Number of VOS optometrists, locations, visits, patients and funding by state/territory, 2010-11Top of page
State / Territory No. of optometrists/ organisations Planned locations visited Planned number of visits Reported patient examinations: VOS budgeted funding($) VOS estimated funding allocated ($)
non-Indigenous Indigenous Total
Core VOS and VOS Indigenous Australians
NSW 17 69 609 4,379 1,161 5,540 652,609 644,571
Vic. 8 25 174 1,317 179 1,496 227,266 225,988
Qld 14 124 425 4,446 1,821 6,267 835,456 675,155
WA 8 99 256 784 812 1,596 764,776 526,769
SA 12 78 456 2,321 633 2,954 449,621 398,283
Tas. 6 27 331 1,731 55 1,786 357,533 351,699
NT 8 111 273 666 1,368 2,034 520,766 334,279
Total: 73 533 2,524 15,644 6,029 21,673 3,808,027 3,156,744
 
Core VOS
NSW 17 59 588 4,321 972 5,293 595,131 587,093
Vic. 7 19 158 1,281 - 1,281 109,022 107,744
Qld 14 124 425 4,446 1,821 6,267 835,456 675,155
WA 5 69 191 554 576 1,130 562,663 366,915
SA 8 59 410 2,104 85 2,189 323,527 284,971
Tas. 6 23 277 1,465 37 1,502 290,726 284,892
NT 5 57 144 412 391 803 294,390 134,234
Total: 62 410 2,193 14,583 3,882 18,465 3,010,915 2,441,004
 
VOS Indigenous Australians
NSW 2 10 21 58 189 247 57,478 57,478
Vic. 1 6 16 36 179 215 118,244 118,244
Qld                
WA 4 30 65 230 236 466 202,113 159,854
SA 4 19 46 217 548 765 126,094 113,312
Tas. 1 4 54 266 18 284 66,807 66,807
NT 5 54 129 254 977 1,231 226,376 200,045
Total: 17 123 331 1,061 2,147 3,208 797,112 715,740


Note: VOS funding allocated represents the budgeted amount, not the actual expenditure. Actual expenditures for 2010-11 were $3.4 million in 2010-11 compared with $3.8 million budgeted.
Source: Analysis of VOS program data undertaken by Health Policy Analysis



Table 81 – Proportion of locations, visits, patients and funding by jurisdiction, 2010-11
Remoteness Area: Planned locations visited Planned number of visits Patient examinations: VOS budgeted funding($) VOS estimated funding allocated ($)
non-Indigenous Indigenous Total
Core VOS and VOS Indigenous Australians
NSW 13% 24% 28% 19% 26% 17% 20%
Vic. 5% 7% 8% 3% 7% 6% 7%
Qld 23% 17% 28% 30% 29% 22% 21%
WA 19% 10% 5% 13% 7% 20% 17%
SA 15% 18% 15% 10% 14% 12% 13%
Tas. 5% 13% 11% 1% 8% 9% 11%
NT 21% 11% 4% 23% 9% 14% 11%
Total: 100% 100% 100% 100% 100% 100% 100%


Source: Analysis of VOS program data undertaken by Health Policy Analysis



Patients seen by VOS optometrists

Overall, approximately 22,400 patients were provided with VOS supported outreach services in 2010-11. Approximately 28% of these identified as being Aboriginal or Torres Strait Islander. Nine per cent of patients seen under the VOS program were located in inner regional areas, 40% in outer regional, 20% in remote and 31% in very remote areas. However, this distribution is different for the Indigenous population. Approximately 59% of Indigenous Australians seen by VOS optometrists live in very remote locations.

Optometrists supported under VOS Core provided 19,022 patient consultations of which 21% (4,016) identified as Aboriginal and Torres Strait Islander. Services supported provided as part of the VOS – Indigenous Australians provided an estimated 3,359 consultations to patients, of whom 67% (2,267) identified as Aboriginal and Torres Strait Islander.

The average cost to the Government for the provision of VOS services to each patient is $146 across the program. This varies by remoteness area, from $87 in inner regional to $101 in outer regional, $212 in remote and $254 in very remote locations.

DoHA administrative costs are estimated at $570,000 per year. This results in an estimated cost of $26 per patient seen, which, when combined with the costs for the provision of VOS services, totals an average of $172 per patient. Assuming these costs are distributed in a similar way to the budgeted allocations for VOS, DoHA administration costs vary from $15 per patient in inner regional areas to $39 per patient in outer regional areas.

The VOS estimate of $26 per patient for DoHA administration compares with the MSOAP estimate of around $18 per patient, including fundholder and DoHA costs.
Overall, the total cost per patient seen ($172) is approximately 3.5 times the cost of the underlying MBS benefits.

Figure 19 – VOS expenditures per patient actually seen by ASGC remoteness area, 2010-11
VOS expenditures per patient actually seen by ASGC remoteness area, 2010-11

Source: Analysis of VOS program data undertaken by Health Policy Analysis

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A text description of VOS expenditures per patient actually seen by ASGC remoteness area, 2010-11 chart is available on a separate page.