Universal healthcare reform for community treatment of eating disorders in Australia: report of the first 2 years of operation

Sarah Maguire; Emma Bryant; Lorraine Ivancic; MAINSTREAM Research Collective MAINSTREAM Research Collective; Natasha Nassar

doi:10.1071/phrp32232211

RESEARCH ARTICLE (Open Access)

Universal healthcare reform for community treatment of eating disorders in Australia: report of the first 2 years of operation

Sarah Maguire ^A , Emma Bryant ^A ^* , Lorraine Ivancic ^B , MAINSTREAM Research Collective MAINSTREAM Research Collective and Natasha Nassar ^B

+ Author Affiliations

- Author Affiliations

^A InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia

^B Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia

^C Various, MAINSTREAM Research Collective (consortium authorship) includes: Prof Stephen Touyz, Ms Danielle Maloney, Dr Jane Miskovic-Wheatley, Phillip Aouad, Dr Sarah Maguire, the InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, University of Sydney; Prof Ian Hickie from the Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney; Prof Janice Russell, Central Clinical School, Faculty of Medicine and Health, University of Sydney; Dr Sloane Madden, School of Medicine, Faculty of Medicine and Health, University of Sydney; Dr Warren Ward, School of Medicine, University of Queensland; Dr Michelle Cunich, Boden Institute, Faculty of Medicine and Health, University of Sydney, Prof Natasha Nassar, Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney; and Ms Claire Diffey, Centre for Excellence in Eating Disorders, Victoria.

^* Correspondence to: emma.bryant@sydney.edu.au

Public Health Research and Practice 33, e32232211 https://doi.org/10.17061/phrp32232211

Published: 5 July 2023

2023 © Maguire et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objective: The Australian Government’s landmark 2019 implementation of dedicated Medicare items for people with eating disorders was the first of its kind for a mental illness. We investigate the first 24 months of uptake of these items across regions, settings and healthcare disciplines, including intermediate changes to the program prompted by the COVID-19 pandemic. Methods: This was a descriptive study using item data extracted from the Australian Medicare Benefits Schedule database for November 2019 to October 2021. Data were cross-tabulated by discipline, setting, consultation type and region. – Results: During the first 24 months of implementation of the scheme, 29 881 Eating Disorder Treatment and Management Plans (or care plans) were initiated, mostly by general practitioners with mental health training. More than 265 000 psychotherapy and dietetic sessions were provided, 29.1% of which took place using telehealth during the pandemic. Although the program offers up to 40 rebated psychological sessions, fewer than 6.5% of individuals completed their 20-session review under the scheme. Conclusions: Uptake of the Medicare item for eating disorders was swift, and the item was used broadly throughout the pandemic. Although feedback from those with lived experience and experts has been overwhelmingly positive, data show that strategic adjustment may be needed and further evaluation conducted to ensure that the reform achieves the best outcomes for patients and families, and its policy intent.