Uptake of Medicare Benefits Schedule items by psychologists and other mental health practitioners

摘要

This paper provides a background to the mental health policy changes introduced by the Council of Australian Governments (COAG) in 2006. It then considers a major Australian Government COAG reform, the revision of the Medicare Benefits Schedule (MBS), by analysing the month-by-month utilisation of the available time-series data for the 17-month period (1 November 2006-31 March 2008) when new items for psychologists, social workers and occupational therapists were introduced. There are a number of unique problems associated with monthly time-series data. Essentially, there is a problem of heterogeneity that arises from the non-uniformity of the temporal unit of a 'month'. Second, there is an issue of the population covered by Medicare altering through time. Both of these problems are addressed in the present analysis of the time-series data. The two groups of psychologists created by the MBS changes dominate the provision of the new services, providing 96.4% of the new services. Psychologists, who are not deemed clinical psychologists in the MBS changes, are the group providing most of the services. Virtually all services are individual, not group, and are provided in a consulting room. The temporal adoption of the new items was continuing to grow by March 2008. Implications of this analysis for psychologists are discussed.