Patterns in uptake of Better Access items were then examined separately by provider type – General Practitioner, Consultant Psychiatrist, Clinical Psychologist, General Psychologist, Occupational Therapist, and Social Worker. Data for the first three provider types map exactly to the General Practitioner Mental Health Treatment, Consultant Psychiatrist and Psychological Therapy Services item groups, respectively, examined in the previous section. However the Focussed Psychological Strategies item group examined previously combines services provided by three provider types – General Psychologists, Occupational Therapists and Social Workers. Hence these provider types are the focus of this section. Table 3.5 shows the number of persons who received services from each provider type, as well as the percentage they represent of all Better Access users, and the rate of uptake of each item group per 1,000 population for 2007, 2008 and 2009.
Table 3.5 shows that:
- Annual rates of uptake increased in each successive year for all provider types. For all provider types, however, the rate of increase slowed over time. The successive increases from 2007 to 2008, and 2008 to 2009 for each item group were: General Psychologist, 33.3% and 20.6%; Occupational therapist, 81.8% and 38.2%; and Social Worker, 81.6% and 40.1%.
- Of the 379,284 people using Focussed Psychological Strategies in 2009 (refer to Table 3.3 for total figures), 91.9% (348,417 people) used services provided by general psychologists, 1.3% (5,103 people) used services provided by Occupational Therapists, and 7.5% (28,276 people) used services provided by Social Workers. The corresponding figures for 2007 were 94.6%, 0.9% and 4.8%; for 2008 they were 92.9%, 1.2% and 6.5%.
Comparisons of the 2007 and post–2007 trends for each item group are shown in table 3.6. Together, figure 3.3 and table 3.6 indicate that:
- The rate of uptake of any General Psychologist Better Access item rose from 2.9 persons per 1,000 total population in the March 2007 quarter to 7.2 persons per 1,000 in the March 2010 quarter. Uptake of these items increased significantly in both the 2007 (RR = 1.193; P < 0.001) and post–2007 (RR = 1.048; P < 0.001) periods. Although the rate of growth was somewhat lower in the post–2007 period, but the rate of growth was significantly slower after 2007 (RR = 0.878; P < 0.001).
- The rates of uptake of any Occupational Therapist Better Access item rose from 0.02 persons per 1,000 total population in the March 2007 quarter to 0.11 persons per 1,000 in the March 2010 quarter. The rate of uptake of any Social Worker Better Access item rose from 0.10 per 1,000 total population in the March 2007 quarter to 0.60 per 1,000 in the March 2010 quarter. Uptake of Occupational Therapist and Social Worker items grew significantly in both the 2007 and post– 2007 periods, but the rate of growth was significantly slower after 2007.
Fig 3.3 Uptake of Better Access items by provider type by quarter, December 2006 quarter to March 2010 quarter.
[GP, General practitioner; CP, Consultant psychiatrist; PTS Psychological Therapy Services; FPS, Focussed Psychological Strategies]
Text version of Fig 3.3
Figures in this description are approximate as they have been read from the graph.| General Practitioners Rate per 1,000 population | Consultant psychiatrists Rate per 1,000 population | Clinical psychologists Rate per 1,000 population | General psychologists Rate per 1,000 population | Occupational therapists Rate per 1,000 population | Social workers Rate per 1,000 population | |
|---|---|---|---|---|---|---|
| December 06 | 4.0 | 1.0 | 0.0 | 1.0 | 0.0 | 0.0 |
| March 07 | 8.0 | 1.0 | 1.0 | 2.9 | 0.0 | 0.0 |
| June 07 | 9.5 | 1.0 | 2.0 | 4.0 | 0.0 | 0.1 |
| September 07 | 10.0 | 1.0 | 2.2 | 4.8 | 0.0 | 0.1 |
| December 07 | 10.3 | 1.0 | 2.4 | 5.0 | 0.0 | 0.1 |
| March 08 | 11.0 | 1.0 | 2.5 | 5.0 | 0.0 | 0.2 |
| June 08 | 12.4 | 1.0 | 3.0 | 6.0 | 0.1 | 0.3 |
| September 08 | 13.0 | 1.0 | 3.1 | 6.0 | 0.1 | 0.4 |
| December 08 | 13.1 | 1.0 | 3.1 | 6.1 | 0.1 | 0.5 |
| March 09 | 14.6 | 1.0 | 3.6 | 6.6 | 0.1 | 0.5 |
| June 09 | 14.6 | 1.0 | 4.1 | 7.4 | 0.1 | 0.6 |
| September 09 | 15.6 | 1.0 | 4.2 | 7.6 | 0.1 | 0.6 |
| December 09 | 14.8 | 1.0 | 4.1 | 7.5 | 0.1 | 0.6 |
| March 10 | 16.4 | 1.0 | 4.1 | 7.2 | 0.1 | 0.6 |
Table 3.5 Persons receiving MBS–subsidised Better Access services by provider type, 2007, 2008 and 2009
| 2007 N persons | 2007 % of persons | 2007 Rate (per 1,000) | 2008 N persons | 2008 % of persons | 2008 Rate (per 1,000) | 2009 N persons | 2009 % of persons | 2009 Rate (per 1,000) | |
|---|---|---|---|---|---|---|---|---|---|
| General Practitioner | 618,867 | 87.1 | 29.5 | 817,738 | 85.9 | 38.3 | 971,836 | 86.0 | 45.4 |
| Consultant psychiatrist | 87,947 | 12.4 | 4.2 | 93,736 | 9.9 | 4.4 | 100,434 | 8.9 | 4.7 |
| Clinical psychologist | 98,612 | 13.9 | 4.7 | 151,587 | 15.9 | 7.1 | 189,418 | 16.8 | 8.9 |
| General psychologist | 213,963 | 30.1 | 10.2 | 289,785 | 30.5 | 13.6 | 348,417 | 30.8 | 16.4 |
| Occupational therapist | 2,011 | 0.3 | 0.1 | 3,701 | 0.4 | 0.2 | 5,103 | 0.5 | 0.2 |
| Social worker | 10,918 | 1.5 | 0.5 | 20,157 | 2.1 | 1.0 | 28,276 | 2.5 | 1.3 |
| All Better Access itemsa | 710,840 | 100.0 | 33.8 | 951,454 | 100.0 | 44.5 | 1,130,384 | 100.0 | 52.8 |
2007 and 2008 figures have regard to all claims processed up to and including 30 April 2009; 2009 figures have regard to all claims processed up to and including 30 April 2010.
Rate per 1,000 total population; Rates are directly age–standardised.
a The sum of persons receiving services under each item group will be greater than for all Better Access items because a person may receive services from more than one type of provider.
Table 3.6 Estimated change in trends for uptake of MBS–subsidised Better Access services by Item group, March 2007 quarter to March 2010 quarter
| Trend in year 2007 RR (95% CI) | P | Trend after 2007 RR (95% CI) | P | Ratio of trendsa RR (95% CI) | P | |
|---|---|---|---|---|---|---|
| General Practitioner | 1.073 (1.051-1.094) | <0.001 | 1.044 (1.035-1.053) | <0.001 | 0.973 (0.945-1.002) | 0.067 |
| Consultant psychiatrist | 1.008 (1.982-1.034) | 0.567 | 1.009 (0.995-1.022) | 0.198 | 1.001 (0.959-1.045) | 0.958 |
| Clinical psychologist | 1.238 (1.138-1.348) | <0.001 | 1.056 (1.041-1.072) | <0.001 | 0.853 (0.798-0.912) | <0.001 |
| General psychologist | 1.193 (1.114-1.278) | <0.001 | 1.048 (1.034-1.062) | <0.001 | 0.878 (0.830-0.929) | <0.001 |
| Occupational therapist | 1.445 (1.317-1.585) | <0.001 | 1.081 (1.056-1.108) | <0.001 | 0.749 (0.682-0.821) | <0.001 |
| Social worker | 1.400 (1.272-1.540) | <0.001 | 1.083 (1.064-1.102 | <0.001 | 0.774 (0.717-0.836) | <0.001 |
2007 and 2008 figures have regard to all claims processed up to and including 30 April 2009; 2009 figures have regard to all claims processed up to and including 30 April 2010.
RR, rate ratio; CI, confidence interval.
a The ratio of the post–2007 trend to the 2007 trend.