Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Utilisation of Medicare Chronic Disease Management item numbers for cancer survivors in Queensland, Australia (#387)

Md Mijanur Dr Rahman 1 , Shafkat Dr Jahan 2 , Elysia Dr Thornton-Benko 3 4 5 , Mahesh Assoc/Prof Iddawela 6 , Raymond Prof Chan 7 , Bogda Prof Koczwara 8 , Nicolas Assoc/Prof Hart 9 , Gail Prof Garvey 10
  1. The Daffodil Centre, The University of Sydney; a joint venture with the Cancer Council NSW, Figtree, NSW, Australia
  2. First Nations Cancer and Wellbeing Research Team School of Public Health, The University of Queensland, , Brisbane , QLD , Australia
  3. School of Clinical Medicine, Faculty of Medicine and Health, The Behavioural Sciences Unit, University of New South Wales, Kensington, , Sydney, NSW, Australia
  4. Kids Cancer Centre, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia
  5. Specialist General Practitioner/Primary Care Physician, Bondi Road Doctors, Bondi Junction , NSW, Australia
  6. Medical Oncologist, Alfred Health & Latrobe Regional Hospital, Melbourne, VIC, Australia
  7. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
  8. Senior Staff Specialist, Department of Medical Oncology, Flinders Medical Centre, Adelaide, SA, Australia
  9. Human Performance Research Centre School of Sport, Exercise, and Rehabilitation INSIGHT Research Institute | Faculty of Health University of Technology Sydney (UTS), Sydney, NSW, Australia
  10. School of Public Health Faculty of Medicine The University of Queensland Herston Qld 4006 Australia, Brisbane, QLD, Australia

Background: Chronic disease is prevalent among cancer survivors. This study aimed to examine the utilisation of Medicare-funded Chronic Disease Management (CDM) item numbers among cancer survivors and sociodemographic predictors of utilisation.

Methods: In this population-based retrospective study, we analysed CDM item number use for 86,571 adult cancer survivors who survived at least one year after a cancer diagnosis, identified in the CancerCostMod dataset – a linked administrative health dataset for all cancer diagnoses in Queensland between July 2011 and June 2015. The outcome was the initiation of at least one General Practitioner Management Plan (GPMP), Team Care Arrangement (TCA), Review (GPMP/TCA), or allied health services until June 2018.

Results: A total of 47,615 (55%) survivors initiated at least one GPMP; 43,286 (50%) initiated at least one TCA; 31,165 (36%) had at least one review of plan; and 36,359 (42%) accessed at least one allied health service. Allied health services accessed include physiotherapists (41%, n=14,907), podiatrists (27%, n=9816) and accredited exercise physiologists (19%, n=6908), with variations by cancer type. While survivors from lower socioeconomic groups had a higher likelihood of receiving GPMP (OR:1.16, 95%CI: 1.11-1.21) and TCA (OR=1.12, 95%CI: 1.07-1.16), they were less likely to access any allied health service (OR: 0.89, 95%CI: 0.85-0.93). Survivors living in remote areas were less likely to access TCA (OR:0.84, 95%CI:0.80-0.88) and allied health services (OR:0.63, 95%CI: 0.60-0.67) than those in the metropolitan areas.

Conclusion: Moderate utilisation of CDM item numbers was observed, with notable variations by survivors' characteristics and cancer type. Further research should comprehensively explore whether disparities in the utilisation of CDM items are greater in cancer survivors compared to other conditions, and whether the utilisation of the items meets cancer survivors’ service needs. Future research should also consider developing strategies to address disparities and improve equitable access to services provided under Medicare-funded CDM.