Mental health consultations in the perinatal period: A cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia

Chambers, GM; Randall, S; Mihalopoulos, C; Reilly, N; Sullivan, EA; Highet, N; Morgan, VA; Croft, ML; Chatterton, ML; Austin, MP

Mental health consultations in the perinatal period: A cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia

Chambers, GM Randall, S Mihalopoulos, C Reilly, N Sullivan, EA

Highet, N Morgan, VA Croft, ML Chatterton, ML Austin, MP

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Publication Type:: Journal Article
Citation:: Australian Health Review, 2018, 42 (5), pp. 514 - 521
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Chambers, GM	en_US
dc.contributor.author	Randall, S	en_US
dc.contributor.author	Mihalopoulos, C	en_US
dc.contributor.author	Reilly, N	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.contributor.author	Highet, N	en_US
dc.contributor.author	Morgan, VA	en_US
dc.contributor.author	Croft, ML	en_US
dc.contributor.author	Chatterton, ML	en_US
dc.contributor.author	Austin, MP	en_US
dc.date.available	2017-10-03	en_US
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	Australian Health Review, 2018, 42 (5), pp. 514 - 521	en_US
dc.identifier.issn	0156-5788	en_US
dc.identifier.uri	http://hdl.handle.net/10453/126188
dc.description.abstract	© 2018 AHHA. Objective. To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year). Method. A retrospective study of MBS utilisation and costs (in 2011-12 A$) for women giving birth between 2006 and 2010 by state, provider-type, and geographic remoteness was undertaken. Results. The cost of mental health consultations during the perinatal period was A$17.5 million for women giving birth in 2007, rising to A$29 million in 2010. Almost 9% of women giving birth in 2007 had a mental health consultation compared with more than 14% in 2010. An increase in women accessing consultations, along with an increase in the average number of consultations received, were the main drivers of the increased cost, with costs per service remaining stable. There was a shift to non-specialist care and bulk billing rates increased from 44% to 52% over the study period. In 2010, the average total cost (provider fees) per woman accessing mental health consultations during the perinatal period was A$689, and the average cost per service was A$133. Compared with women residing in regional and remote areas, women residing in major cities where more likely to access consultations, and these were more likely to be with a psychiatrist rather than an allied health professional or general practitioner. Conclusion. Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/1028554
dc.relation.ispartof	Australian Health Review	en_US
dc.relation.isbasedon	10.1071/AH17118	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Perinatal Care	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Mental Health Services	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Health Care Reform	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Health Care Costs	en_US
dc.subject.mesh	National Health Programs	en_US
dc.subject.mesh	Patient Acceptance of Health Care	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Mental health consultations in the perinatal period: A cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	42	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1605 Policy and Administration	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	42	en_US

Abstract:

© 2018 AHHA. Objective. To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year). Method. A retrospective study of MBS utilisation and costs (in 2011-12 A$) for women giving birth between 2006 and 2010 by state, provider-type, and geographic remoteness was undertaken. Results. The cost of mental health consultations during the perinatal period was A$17.5 million for women giving birth in 2007, rising to A$29 million in 2010. Almost 9% of women giving birth in 2007 had a mental health consultation compared with more than 14% in 2010. An increase in women accessing consultations, along with an increase in the average number of consultations received, were the main drivers of the increased cost, with costs per service remaining stable. There was a shift to non-specialist care and bulk billing rates increased from 44% to 52% over the study period. In 2010, the average total cost (provider fees) per woman accessing mental health consultations during the perinatal period was A$689, and the average cost per service was A$133. Compared with women residing in regional and remote areas, women residing in major cities where more likely to access consultations, and these were more likely to be with a psychiatrist rather than an allied health professional or general practitioner. Conclusion. Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives.

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http://hdl.handle.net/10453/126188