Rosenberg Sebastian, Park Shin Ho, Hickie Ian
Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
Aust Health Rev. 2022 Dec;46(6):660-666. doi: 10.1071/AH22154.
Objective This study set out to present data on out-of-pocket payments for Medicare mental health services provided by general practitioners (GP), psychiatrists, clinical psychologists and other psychologists, to explore how much is spent on out-of-pocket payments for mental health; if any trends could be seen; and what variations exist across regions. Methods We performed secondary analysis of publicly available data on Medicare-subsidised GP, allied health and specialist health care across Australia. We merged and interrogated data covering the period 2013-19 and 2019-21 to create a data set covering eight full years of Medicare mental health services, arranged by profession and by region. Results Out-of-pocket payments for mental health care in Australia have been rising consistently over the period 2013-21, at a considerably faster rate than overall expenditure on mental health care. There is wide variation in out-of-pocket payments depending on where you live. Conclusions The impact of out-of-pocket payments on community access to mental health care is growing. This has implications, especially in poorer communities, for access to care. This should be an important consideration taken as the Australian Government considers next steps in national mental health reform, including the Better Access Program, currently under evaluation.
目的 本研究旨在呈现关于全科医生（GP）、精神科医生、临床心理学家及其他心理学家提供的医疗保险心理健康服务自付费用的数据，以探究心理健康自付费用的支出情况；是否能看出任何趋势；以及各地区存在哪些差异。方法 我们对澳大利亚医疗保险补贴的全科医疗、辅助医疗和专科医疗的公开可用数据进行了二次分析。我们合并并审查了涵盖2013 - 19年和2019 - 21年期间的数据，以创建一个涵盖八年医疗保险心理健康服务的数据集，按职业和地区进行排列。结果 在2013 - 21年期间，澳大利亚心理健康护理的自付费用持续上升，增速远快于心理健康护理的总支出。自付费用因居住地点而异，差异很大。结论 自付费用对社区获得心理健康护理的影响正在增加。这对获得护理产生了影响，尤其是在较贫困社区。在澳大利亚政府考虑国家心理健康改革的下一步举措（包括目前正在评估的“更好获得计划”）时，这应是一个重要的考虑因素。
