Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Nutr Diet. 2022 Sep;79(4):481-488. doi: 10.1111/1747-0080.12743. Epub 2022 Jun 12.
The aim of the study was to describe the quantity and cost of in-person and telehealth dietetics services reimbursed under Australia's Medicare Benefits Scheme, before and during the coronavirus pandemic.
Publicly available Medicare Benefits Scheme dietetics service activity data were extracted from an online database, between January 2019 and June 2021. For allied health telehealth items, it was assumed that between 10% and 20% of all consults were dietetic related.
Dietetics service claims reimbursed through the Medicare Benefits Scheme averaged 115 thousand per quarter in 2019. In quarter 2 of 2020, service delivery dropped by 25% compared to quarter 1 of 2020 and 32% compared to 2019. This drop recovered in quarters 3 and 4, with dietetic consultations claimed through the Medicare Benefits Scheme remaining relatively comparable to 2019 data. Dietetics services cost AUD 5,868,021 in quarter 1 2019 and AUD 5,742,632 in quarter 1 2020. Since the introduction of allied health telehealth items, the number of consultations claimed per quarter has accounted for between 17.7% (quarter 2 2020) and 4.5% (quarter 2 2021) of all consultations per quarter.
The provision and costs of dietetics services in Australia have remained relatively constant compared to 2019 data, indicating telehealth was being used for substitutive rather than additive care, apart from an initial reduction of 25% between March and June 2020. The introduction of telehealth items for dietitians has been modest, peaking at 17.7% and now consistently averaging 5% of total dietetics services. The permanent implementation of telehealth items is unlikely to cause significant increases in cost or access and will assist Australians to eat better to support improved chronic disease outcomes.
本研究旨在描述澳大利亚医疗保险福利计划（Medicare Benefits Scheme）下，在冠状病毒大流行之前和期间，现场和远程医疗营养服务的数量和成本。
从在线数据库中提取了 2019 年 1 月至 2021 年 6 月期间公开的医疗保险福利计划营养服务活动数据。对于联合健康远程医疗项目，假设所有咨询中约有 10%至 20%与营养相关。
2019 年，通过医疗保险福利计划报销的营养服务索赔平均每季度为 11.5 万澳元。与 2020 年第一季度相比，2020 年第二季度的服务提供量下降了 25%，与 2019 年相比下降了 32%。这一下降在第三和第四季度得到了恢复，通过医疗保险福利计划报销的营养咨询与 2019 年的数据基本持平。2019 年第一季度，营养服务费用为 586.8021 万澳元，2020 年第一季度为 574.2632 万澳元。自引入联合健康远程医疗项目以来，每季度报销的咨询次数占每季度总咨询次数的比例分别为 17.7%（2020 年第二季度）和 4.5%（2021 年第二季度）。
与 2019 年的数据相比，澳大利亚的营养服务的提供和成本基本保持不变，表明远程医疗除了 2020 年 3 月至 6 月期间最初下降 25%外，主要用于替代而非附加护理。营养师远程医疗项目的引入规模较小，峰值为 17.7%，目前平均占营养服务总量的 5%。远程医疗项目的永久实施不太可能导致成本或获得显著增加，并将帮助澳大利亚人吃得更好，以支持改善慢性疾病结果。
