Utilisation of government-subsidised chronic disease management plans and cardiovascular care in Australian general practices

Coorey, Genevieve; Campain, Anna; Mulley, John C.; Usherwood, Tim; Redfern, Julie; Harris, Mark; Zwar, Nicholas; Parker, Sharon; Coiera, Enrico; Peiris, David

doi:10.1186/s12875-022-01763-2

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…purchased over-the-counter), or medicines purchased privately. 32 Medicines prescribed in public hospitals or obtained privately are also not recorded in PBS data sets, and the PBS data set only measures dispensation and not whether the medicine was actually taken. 13 Some treatments were not captured in the PBS, such as opioid substitution treatment.…”

Section: Limitations Of Linked Administrative Datamentioning

confidence: 99%

“…34,35 Similarly, MBS data did not include all procedures and excludes those covered by compensation systems 27 and services delivered to patients in public hospitals. 32,35 Also, MBS expenditure can't necessarily be pinpointed to a particular condition, especially in the case of general pathology tests or services. 34 Appropriate use of administrative data to measure disease prevalence needs to be considered, as some diseases may not require any medical care and, therefore, administrative data may not provide additional information.…”

Section: Limitations Of Linked Administrative Datamentioning

confidence: 99%

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The use of linked administrative data in Australian randomised controlled trials: A scoping review

Fahridin,

Agarwal,

Bracken

et al. 2024

Clinical Trials

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Background/Aims: The demand for simplified data collection within trials to increase efficiency and reduce costs has led to broader interest in repurposing routinely collected administrative data for use in clinical trials research. The aim of this scoping review is to describe how and why administrative data have been used in Australian randomised controlled trial conduct and analyses, specifically the advantages and limitations of their use as well as barriers and enablers to accessing administrative data for use alongside randomised controlled trials. Methods: Databases were searched to November 2022. Randomised controlled trials were included if they accessed one or more Australian administrative data sets, where some or all trial participants were enrolled in Australia, and where the article was published between January 2000 and November 2022. Titles and abstracts were independently screened by two reviewers, and the full texts of selected studies were assessed against the eligibility criteria by two independent reviewers. Data were extracted from included articles by two reviewers using a data extraction tool. Results: Forty-one articles from 36 randomised controlled trials were included. Trial characteristics, including the sample size, disease area, population, and intervention, were varied; however, randomised controlled trials most commonly linked to government reimbursed claims data sets, hospital admissions data sets and birth/death registries, and the most common reason for linkage was to ascertain disease outcomes or survival status, and to track health service use. The majority of randomised controlled trials were able to achieve linkage in over 90% of trial participants; however, consent and participant withdrawals were common limitations to participant linkage. Reported advantages were the reliability and accuracy of the data, the ease of long term follow-up, and the use of established data linkage units. Common reported limitations were locating participants who had moved outside the jurisdictional area, missing data where consent was not provided, and unavailability of certain healthcare data. Conclusions: As linked administrative data are not intended for research purposes, detailed knowledge of the data sets is required by researchers, and the time delay in receiving the data is viewed as a barrier to its use. The lack of access to primary care data sets is viewed as a barrier to administrative data use; however, work to expand the number of healthcare data sets that can be linked has made it easier for researchers to access and use these data, which may have implications on how randomised controlled trials will be run in future.

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Section: Limitations Of Linked Administrative Datamentioning

confidence: 99%

Section: Limitations Of Linked Administrative Datamentioning

confidence: 99%

The use of linked administrative data in Australian randomised controlled trials: A scoping review

Fahridin,

Agarwal,

Bracken

et al. 2024

Clinical Trials

View full text Add to dashboard Cite

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Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia

Rahman,

Jahan,

Koczwara

et al. 2024

Aust. Health Rev.

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Objective Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigates Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors. Methods Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis. Results In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11–1.21) and TCA (OR: 1.12, 95% CI: 1.07–1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85–0.93). People with cancer living in remote areas were less likely to receive TCA (OR: 0.84, 95% CI: 0.80–0.88) or utilise allied health services (OR: 0.63, 95% CI: 0.60–0.67) than those in metropolitan areas. Conclusion Our findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer’s care needs are being met and ways to optimise the supportive care of these people.

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The effectiveness of chronic disease management planning on self-management among patients with diabetes at general practice settings in Australia: a scoping review

Ghasemiardekani,

Willetts,

Hood

et al. 2024

BMC Prim. Care

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Background Medicare provides significant funding to improve, encourage and coordinate better practices in primary care. Medicare-rebated Chronic Disease Management (CDM) plans are a structured approach to managing chronic diseases in Australia. These chronic disease care plans are intended to be a vehicle to deliver guideline-based / evidence-based care.. However, recommended care is not always provided, and health outcomes are often not achieved. This scoping review aimed to identify the specific components of CDM plans that are most effective in promoting self-management, as well as the factors that may hinder or facilitate the implementation of these plans in general practice settings in Australia. Method A comprehensive search was conducted using multiple electronic databases, considering inclusion and exclusion criteria. Two reviewers independently screened the titles and abstracts of the identified studies via Covidence, and the full texts of eligible studies were reviewed for inclusion. A data extraction template was developed based on the Cochrane Effective Practice and Organization of Care Group (EPOC) to classify the intervention methods and study outcomes. A narrative synthesis approach was used to summarize the findings of the included studies. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist. Results Seventeen articles were included in the review for analysis and highlighted the effectiveness of CDM plans on improving patient self-management. The findings demonstrated that the implementation of CDM plans can have a positive impact on patient self-management. However, the current approach is geared towards providing care to patients, but there are limited opportunities for patients to engage in their care actively. Furthermore, the focus is often on achieving the outcomes outlined in the CDM plans, which may not necessarily align with the patient’s needs and preferences. The findings highlighted the significance of mutual obligations and responsibilities of team care for patients and healthcare professionals, interprofessional collaborative practice in primary care settings, and regular CDM plan reviews. Conclusion Self-management support remains more aligned with a patient-centred collaboration approach and shared decision-making and is yet to be common practice. Identifying influential factors at different levels of patients, healthcare professionals, and services affecting patients’ self-management via CDM plans can be crucial to developing the plans.

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Utilisation of government-subsidised chronic disease management plans and cardiovascular care in Australian general practices

Cited by 4 publications

References 27 publications

The use of linked administrative data in Australian randomised controlled trials: A scoping review

The use of linked administrative data in Australian randomised controlled trials: A scoping review

Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia

The effectiveness of chronic disease management planning on self-management among patients with diabetes at general practice settings in Australia: a scoping review

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