TY - JOUR
T1 - Mental health consultations in the perinatal period
T2 - A cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia
AU - Chambers, Georgina M.
AU - Randall, Sean
AU - Mihalopoulos, Cathrine
AU - Reilly, Nicole
AU - Sullivan, Elizabeth A.
AU - Highet, Nicole
AU - Morgan, Vera A.
AU - Croft, Maxine L.
AU - Chatterton, Mary Lou
AU - Austin, Marie Paule
N1 - Funding Information:
The current study was funded by a National Health and Medical Research Council (NHMRC) Partnership grant (APP1028554: The Australian Perinatal Mental Health Reforms: Using Population Data to Evaluate their Impact on Service Utilisation and Related Cost-Effectiveness); beyondblue is a funding partner on this grant. Associate Professor Georgina Chambers, Professor Elizabeth Sullivan, Dr Nicole Highet, Associate Professor Maxine Croft, Associate Professor Cathrine Mihalopoulos, Professor Vera Morgan and Professor Marie-Paule Austin are Chief Investigators on the above grant. Associate Professor Cathrine Mihalopoulos is funded by a NHMRC Early Career Research Grant 1035887. Dr Nicole Highet was the former deputy CEO and National Perinatal Advisor of beyondblue between 2001 and 2013. Professor Marie-Paule Austin and Nicole Reilly are funded by St John of God Health Care, Sydney, Australia. We gratefully acknowledge substantial infrastructure and in-kind support of St John of God Health Care, and also thank Catherine Knox (Gidget Foundation) for her valuable contributions to this project.
Publisher Copyright:
© 2018 AHHA.
PY - 2018
Y1 - 2018
N2 - 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$133. Compared with women residing in regional and remote areas, women residing in major cities where more likely to access consultations, and these were more likely to be with a psychiatrist rather than an allied health professional or general practitioner. Conclusion. Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives.
AB - Objective. To quantify total provider fees, benefits paid by the Australian Government and out-of-pocket patients' costs of mental health Medicare Benefits Schedule (MBS) consultations provided to women in the perinatal period (pregnancy to end of the first postnatal year). Method. A retrospective study of MBS utilisation and costs (in 2011-12 A$) 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.
UR - https://www.scopus.com/pages/publications/85049333686
U2 - 10.1071/AH17118
DO - 10.1071/AH17118
M3 - Article
C2 - 29202924
AN - SCOPUS:85049333686
SN - 0156-5788
VL - 42
SP - 514
EP - 521
JO - Australian Health Review
JF - Australian Health Review
IS - 5
ER -
SDG 3 Good Health and Well-being