National Health Performance Authority, Healthy Communities: Expenditure on specialist attendances, 2012–13

Average Medicare benefits expenditure per person for non-hospital specialist attendances.

Attendances in this indicator are non-hospital specialist attendances.

Specialist attendances are Medicare benefit funded referred patient/doctor encounters, such as visits, consultations and attendances (including video conferencing), involving medical practitioners who have been recognised as specialists or consultant physicians for Medicare benefits purposes.

Specialist attendances comprise all items in Broad Type of Services Group 'C', as published in official MBS statistics by the Department of Human Services and the Department of Health.

In terms of the MBS structure, specialist attendances comprise all items in Group A3 (specialist attendances to which no other item applies), Group A4 (consultant physician attendances to which no other item applies), Group A8 (consultant psychiatrist attendances to which no other item applies), Group A9 (contact lens attendances), Group A12 (consultant occupational physician attendances to which no other item applies), Group A13 (public health physician attendances to which no other item applies), Group A15, Subgroup 2, but only Items 820 - 880 (case conferences) , Group A21 (medical practitioner (emergency physician) attendances to which no other item applies), Group A24 (pain and palliative medicine), Group A26 (neurosurgery attendances to which no other item applies), Group A28 (geriatric medicine), Group A29 (early intervention for children with autism, pervasive developmental disorder or disability) and Group T6, Subgroup 1 (anaesthesia consultations)

Rates directly age-standardised to the 2001 Australian population.

Total Medicare benefits expenditure for relevant attendances/visits – source MBS claims data.

Total Estimated Resident Population (ERP) as supplied by ABS.

In undertaking age standardisation of MBS data, the age of each person was determined from the last MBS service of any type, processed by the Department of Human Services in 2012–13. All MBS services for each individual processed in 2012–13 were attributed to the age in question.

For MBS data, Medicare Local and SA3 were determined having regard to the enrolment postcode for each person from the last MBS service of any type, processed by the Department of Human Services in 2012–13. All MBS services for each individual processed in 2012–13, were attributed to the postcode in question.

MBS postcode level data were allocated to Medicare Local and SA3 regions using concordance files provided by the ABS.

Numerator based on Medicare (MBS) data provided by Department of Health for the financial year of processing, 2012–13.

Denominator data – Estimated Resident Population at 30 June 2012 provided by the ABS.

Data elements used in computing the numerator were MBS item number, age of patient (based on age derived from the last MBS service processed for each individual in 2011–12) and patient enrolment postcode (based on the enrolment postcode from the last MBS service processed for each individual in 2011–12).

Presented per person.

Before MBS data are published by NHPA all confidential data cells are suppressed.

The current definition of confidential data is as follows:

• For number of MBS services and Medicare benefits expenditure:
  • if number of services is less than 6 or
  • if number of services is equal to or greater than 6 but
    • one provider provides more than 85% of services or two providers provide more than 90% of services or
    • one patient receives more than 85% of services or two patients receive more than 90% of services.
• If data on number of services is confidential, corresponding data on other measures such as MBS benefit paid is also regarded as confidential.