Evaluation of the Better Access to Psychiatrists, Psychologists and GPs through the Medicare Benefits Schedule initiative: component B: an analysis of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) administrative data

4.3 Do rates of co-payment for Better Access services vary across population subgroups?

Page last updated: August 2010

Tables 4.8 to 4.10 profile the services and costs of Better Access services according to the consumers' age, gender, geographical region and level of relative socio–economic disadvantage, in 2007, 2008 and 2009. As patterns are reasonably similar across time, interpretation focuses on the 2009 data. The tables show that:

  • The proportion of services that were bulk–billed increased as level of remoteness increased – in 2009, from 54.2% in capital cities to 71.9% in remote areas. Conversely, the proportion of services that attracted a co–payment decreased – in 2009, from 45.8% in capital cities to 28.1% in remote areas. However the average co–payment was higher among people in remote areas ($37.38) and people in capital cities ($36.90) than those in other regions ($31.17–$33.02).

  • The proportion of services that were bulk–billed increased as level of relative socioeconomic disadvantage increased – in 2009, from 43.2% in areas of least disadvantage to 78.3% in areas of most disadvantage. Conversely, the proportion of services that attracted a co–payment decreased as level of relative socio–economic disadvantage increased – in 2009, from 56.8% in capital cities to 21.7% in remote areas. The average co–payment also decreased as level of relative socio–economic disadvantage increased (from $38.08 to $32.66).
The following series of figures (Figures 4.3 to 4.10) profile the rates of co–payment and average co–payments according to socio–demographic characteristics, for each of the item groups and provider types in 2009. Tables 4.11 to 4.13 provide detailed figures regarding the services and costs of Better Access services according to the consumers' age, gender, geographical region and level of relative socio–economic disadvantage, for each item group in 2007, 2008 and 2009.

Co–payment rates and average co–payments were firstly examined according to age group. Figure 4.3 and figure 4.4 show the percentage of Better Access services requiring a co–payment, and the average co–payment, according to age group. These show that, for GP services, the percentage of services requiring a co–payment increased with age until the 35–44 year age group, and decreased thereafter. For all other provider groups, the percentage of services requiring a co–payment tend to be higher for young people aged <15 years and to decrease with age, being lowest for older people aged 65 years and over. Average co–payments for most provider types, however, were reasonably similar across most age groups, but somewhat lower for the older (65 years plus) age group. In particular, in 2009 the average co–payment for people aged 65 years and over was lower for GP (17.1% lower), Psychological Therapy Services (16.7% lower) and Focussed Psychological Strategies items (18.3% lower) than the average co–payment for all age groups combined. However for Consultant Psychiatrist and Occupational Therapist services, the average co–payment was lowest for people aged < 15 years.

Gender patterns were examined next. Figure 4.5 and figure 4.6 show the percentage of Better Access services requiring a co–payment, and the average copayment, according to gender. These show that females have a slightly higher rate of services requiring co–payment (the exception being services provided by occupational therapists) but marginally lower average co–payments (again, with the exception of services provided by occupational therapists).
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Patterns according to geographical location were then examined. Figure 4.7 and figure 4.8 show the percentage of Better Access services requiring a co–payment, and the average copayment, according to geographical location. These show that people residing in capital cities have a higher rate of services requiring co–payment. Average co–payments tended to be higher in remote locations for certain services. In particular, the average co–payment for people in remote locations was between 15.3% and 27.8% higher for GP (27.8% higher), Psychological Therapy Services (25.4% higher) and Consultant Psychiatrist (15.3% higher) items than the average copayment for all geographical locations combined. However for other services (Focussed Psychological Strategies overall, General Psychologist and Social Worker items) average copayments were higher among people in capital cities.

Patterns according to relative socio–economic disadvantage were then examined. Figure 4.9 and figure 4.10 show the percentage of Better Access services requiring a co–payment, and the average copayment, according to level of disadvantage. These show that, for all provider types, people residing in areas of least disadvantage had the highest rate of services requiring a co–payment. The proportion of services requiring co–payment decreased steadily as level of disadvantage increased. Average co–payments showed a similar, although far less pronounced pattern. For example, co–payments for people in areas of greatest socio–economic disadvantage (IRSD quintiles 1 and 2) were approximately 16% less for GP services than people in other areas.

List of Figures

Rates of co-payment and average co-payments according to socio-demographic characteristics

List of Tables

All MBS-subsidised Better Access services received

MBS-subsidised GP Mental Health Treatment Better Access services received

MBS-subsidised Consultant Psychiatry Better Access services received

MBS-subsidised Psychological Therapy Services Better Access services received

MBS-subsidised Focussed Psychological Strategies Better Access services received

MBS-subsidised General Psychologist Better Access services received

MBS-subsidised Occupational Therapist Better Access services received

MBS-subsidised Social Worker Better Access services received