A detailed profile was undertaken of the extent to which Better Access consumers used different combinations of the Better Access MBS items. To do this the items were grouped as follows:

GPPR: GP Mental Health Treatment Plan and Review items (2710 and 2712)

GPC: GP Mental Health Consultation items (2713)

CP: Consultant Psychiatry items (291, 293, 296, 297, 299)

PTS: Psychological Therapy Services items (80000, 80005, 80010, 80015, 80020) FPS: Focussed Psychological Strategies – Allied mental health items (80100, 80105, 80110, 80115, 80120, 80125, 80130, 80135, 80140, 80145, 80150, 80155, 80160, 80165, 80170)

These groupings were chosen for two reasons. Firstly, although Focussed Psychological Strategies can be provided by several types of allied health professionals (general psychologists, social workers and occupational therapists), the array of services provided are the same. The services provided by clinical psychologists (Psychological Therapy Services) are grouped separately because the intent of the service is different from that of Focussed Psychological Strategies. Secondly, the groupings distinguish between services provided by GPs for the purposes of planning and review, from those provided as consultation items.

Patterns of Better Access service use in terms of the various combinations in which people used these items were then explored. Analysis focused on patterns of care over the entire period of available data (i.e., the December 2006 quarter to the March 2009 quarter). This decision was made because Better Access treatment 'episodes' can continue across calendar years. Applying annual cut–offs to the data would potentially censor (i.e. truncate) an episode and thus underestimate the extent of interdisciplinary care, both in terms of the proportion of people who received interdisciplinary care and the volume of services they received.

The potential effects of such censoring are illustrated by revisiting the 3 examples of Better Access care patterns shown in the previous chapter. These are illustrated again in Figure 7.1. If the period of interest for analysis was restricted to calendar year 2007, for example, Person A would be correctly categorized of this person has having received interdisciplinary care in that year, and the number of services they received as part of their interdisciplinary care would also be correct. Person B, however, would be categorised as not having received interdisciplinary care because only their GP Mental Health Treatment Plan service would be counted. Person C would be correctly categorized as having received interdisciplinary care, but only two of the services they received would be counted. It is acknowledged however, that even by including all available data, there will still be some censoring effects. That is, interdisciplinary care may still be underestimated for people with ongoing episodes that are not complete by the end of the period covered by the data.

Table 7.1 lists each possible combination of the five item groups (GPPR, GPC, CP, PT and FPS), and presents the total number of persons who have used that combination and the total number of services received within that combination, in descending order of uptake. Table 7.2 contains the same information, but is presented in descending order of the total number of services received.

Of the 31 possible item group combinations, 3 combinations were used by more than half (58%) of all Better Access service users, and 7 combinations were used by 87% of all Better Access users (shaded cells; first seven rows of table 7.1). The 3 combinations with greatest population uptake involved one or other type of GP care only (GPPR alone, GPC alone), and GP Mental Health Treatment Plan or Review services in combination with Focused Psychological Strategies (GPPR+FP). The 7 combinations with greatest population uptake involved combinations that included GP services alone (GPPR alone, GPC alone, GPPR+GPC), 3 of the 4 the combinations involving GP care plus one of the either psychological therapies or focused psychological strategies (GPPR+FP, GPPR+PT, GPPR+GPC+FP), and Consultant Psychiatry services alone (CP alone).Top of page

When examined in terms of number of services used, there were 3 combinations that were used by 55% of all Better Access service users, and 7 combinations used by 77% of all Better Access users (shaded cells; first seven rows of table 7.2). The 7 items that accounted for the greatest number of services involved all of the combinations relating to GP services alone (GPPR alone, GPC alone, GPPR+GPC), and all of the combinations involving GP care plus one of the either psychological therapies or focused psychological strategies (GPPR+FP, GPPR+PT, GPPR+GPC+FP, GPPR+GPC+PT). The 3 most frequently used combinations all involved combinations of GP care plus psychological care, reflecting the Better Access protocols relating to the number and timing of services permitted.

In summary, these patterns indicate that the majority of people using Better Access services were provided these services by GPs alone (44.9% of consumers) or by combinations recorded in the Better Access data as involving GPs and allied health professionals only (39.7%).

Interestingly, 16.4% of people were recorded in the Better Access data as having received only GP Mental Health Consultation items (2713). It is beyond the scope of the data to determine the reasons that GPs may have elected to use this item without a prior GP Mental Health Treatment Plan (item 2710). However the data show that the average number of GP Mental Health Consultation items per consumer is only 1.7 (i.e. 442180 services / 255, 991 persons). This suggests that this item may be being used in instances where the GP considers the mental health issue does not require intensive treatment.

Figure 7.1 Simple examples of Better Access care patterns.

Text equivalent below for Figure 7.1 Simple examples of Better Access care patterns.

Vertical lines represent calendar year break.
A = GP Mental Health Treatment Plan.
B = GP Mental Health Treatment Review.
x = Focussed Psychological Strategies.

Text version of Figure 7.1

Simple examples of Better Access care patterns by calendar year:
  • Person A:
    • 2007 - GP Mental Health Treatment Plan, 6 Focussed Psychological Strategies, GP Mental Health Treatment Review
  • Person B:
    • 2007 - GP Mental Health Treatment Plan
    • 2008 - 6 Focussed Psychological Strategies
  • Person C:
    • 2007 - GP Mental Health Treatment Plan, 2 Focussed Psychological Strategies
    • 2008 - 5 Focussed Psychological Strategies, GP Mental Health Treatment Review, GP Mental Health Treatment Plan
    • 2009 - 2 Focussed Psychological Strategies
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Table 7.1 Patterns of interdisciplinary care among people who any Better Access MBS item, in descending order of population use, December 2006 quarter to March 2009 quarter.

Total persons (N)% of total personsTotal services used (N)% of total services
GPPR alone*
331,021
21.2
382,935
5.0
GPPR+FPS*
317,239
20.3
2,197,858
28.6
GPC alone*
255,991
16.4
442,180
5.8
GPPR+PTS*
131,864
8.5
955,873
12.4
GPPR+GPC*
112,412
7.2
466,215
6.1
CP alone*
101,389
6.5
109,785
1.4
GPPR+GPC+FPS*
98,429
6.3
1,069,902
13.9
GPPR+GPC+PTS
36,736
2.4
421,756
5.5
FPS alone
22,082
1.4
92,477
1.2
GPPR+PTS+FPS
21,607
1.4
282,617
3.7
GPPR+CP+FPS
20,137
1.3
204,254
2.7
GPPR+CP
16,630
1.1
38,730
0.5
GPPR+GPC+CP+FPS
13,875
0.9
222,438
2.9
GPC+CP
13,285
0.9
47,523
0.6
PTS alone
12,193
0.8
57,488
0.7
GPPR+GPC+PTS+FPS
10,499
0.7
188,743
2.5
GPPR+GPC+CP
10,298
0.7
66,938
0.9
GPPR+CP+PTS
9,529
0.6
101,383
1.3
GPPR+GPC+CP+PTS
5,622
0.4
92,963
1.2
GPPR+CP+PTS+FPS
3,363
0.2
57,878
0.8
CP+FPS
3,170
0.2
23,706
0.3
GPPR+GPC+CP+PTS+FPS
3,057
0.2
74,410
1.0
CP+PTS
2,763
0.2
22,465
0.3
GPC+FPS
2,160
0.1
14,218
0.2
PTS+FPS
1,286
0.1
14,786
0.2
GPC+PTS
891
0.1
6,620
0.1
GPC+CP+FPS
664
0.0
6,709
0.1
GPC+CP+PTS
501
0.0
5,277
0.1
CP+PTS+FPS
439
0.0
6,910
0.1
GPC+PTS+FPS
121
0.0
1,804
0.0
GPC+CP+PTS+FPS
81
0.0
1,438
0.0
Total
1,559,332
7,678,279

Data have regard to all claims processed up to and including 30 April 2009.
*Shaded cells (the first 7 rows) indicate item combinations used by 5% or more of total persons using Better Access services.
GPPR, GP Mental Health Treatment Plan and Review items (2710 and 2712); GPC, GP Mental Health Consultation items (2713); CP, Consultant Psychiatry items (291, 293, 296, 297, 299); PTS, Psychological Therapy Services items (80000, 80005, 80010, 80015, 80020); FPS, Focussed Psychological Strategies – Allied mental health items (80100, 80105, 80110, 80115, 80120, 80125, 80130, 80135, 80140, 80145, 80150, 80155, 80160, 80165, 80170).

Table 7.2 Patterns of interdisciplinary care among people who any Better Access MBS item, in descending order of services used, December 2006 quarter to March 2009 quarter

Top of page
Total persons (N)% of total personsTotal services used (N)% of total services
GPPR+FPS*
2,197,858
28.6
317,329
20.3
GPPR+GPC+FPS*
1,069,902
13.9
98,429
6.3
GPPR+PTS*
955,873
12.4
131,864
8.5
GPPR+GPC*
466,215
6.1
112,412
7.2
GPC alone*
422,180
5.8
255,991
16.4
GPPR+GPC+PTS*
421,756
5.5
36,736
2.4
GPPR alone*
382,935
5.0
331,021
21.2
GPPR+PTS+FPS
282,617
3.7
21,607
1.4
GPPR+GPC+CP+FPS
222,438
2.9
13,875
0.9
GPPR+CP+FPS
204,254
2.7
20,137
1.3
GPPR+GPC+PTS+FPS
188,743
2.5
10,499
0.7
CP alone
109,785
1.4
101,389
6.5
GPPR+CP+PTS
101,383
1.3
9,529
0.6
GPPR+GPC+CP+PTS
92,963
1.2
5,622
0.4
FPS alone
92,477
1.2
22,082
1.4
GPPR+GPC+CP+PTS+FPS
74,410
1.0
3,057
0.2
GPPR+GPC+CP
66,938
0.9
10,298
0.7
GPPR+CP+PTS+FPS
57,878
0.8
3,363
0.2
PTS alone
57,488
0.7
12,193
0.8
GPC+CP
47,523
0.6
13,285
0.9
GPPR+CP
38,730
0.5
16,630
1.1
CP+FPS
23,706
0.3
3,170
0.2
CP+PTS
22,465
0.3
2,763
0.2
PTS+FPS
14,786
0.2
1,286
0.1
GPC+FPS
14,218
0.2
2,160
0.1
CP+PTS+FPS
6,910
0.1
437
0.0
GPC+CP+FPS
6,709
0.1
664
0.0
GPC+PTS
6,620
0.1
891
0.1
GPC+CP+PTS
5,277
0.1
501
0.0
GPC+PTS+FPS
1,804
0.0
121
0.0
GPC+CP+PTS+FPS
1,438
0.0
81
0.0
Total
7,678,279
1,559,332

Data have regard to all claims processed up to and including 30 April 2009.
* Shaded cells (the first 7 rows) indicate item combinations comprising 5% or more of total Better Access services used.
GPPR, GP Mental Health Treatment Plan and Review items (2710 and 2712); GPC, GP Mental Health Consultation items (2713); CP, Consultant Psychiatry items (291, 293, 296, 297, 299); PTS, Psychological Therapy Services items (80000, 80005, 80010, 80015, 80020); FPS, Focussed Psychological Strategies – Allied mental health items (80100, 80105, 80110, 80115, 80120, 80125, 80130, 80135, 80140, 80145, 80150, 80155, 80160, 80165, 80170).