Health assessments
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A look at the Medicare requirements and the evidence around Health Assessments in Australia. Should we be doing them? Probably, but we need to be aware of why we're doing them.
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Health assessments
- 1. HEALTH ASSESSMENTS DR TIM SENIOR GP, THARAWAL ABORIGINAL CORPORATION FOR RVTS, FEBRUARY 2016
- 2. QUESTIONS TO PONDER Are you doing health assessments? Why are you (or why would you) do them? Who are you doing them on? (How can we decide on the best answers to these questions?)
- 3. MEDICARE AND HEALTH ASSESSMENTS
- 4. MEDICARE AND HEALTH ASSESSMENTS
- 6. WHAT SHOULD BE IN A HEALTH ASSESSMENT?
- 7. WHAT SHOULD BE IN A HEALTH ASSESSMENT?
- 9. WHATS THE EVIDENCE FOR HEALTH ASSESSMENTS?
- 13. AND THATS ALL THE EVIDENCE!
- 15. WHY DONT HEALTH CHECKS WORK? ANY IDEAS?
- 16. WHO ATTENDS HEALTH CHECKS?
- 17. FOLLOW-UP Practice infrastructure and systems for follow-up of health assessments Local health district infrastructure, systems and referral pathways
- 18. WHY DO WE DO HEALTH CHECKS THEN? Item 715 used to generate income for Aboriginal Medical Services. Used to measure Aboriginal Medical Services and Aboriginal and Torres Strait Islander Health Used for access to allied health for Aboriginal and Torres Strait Islander patients.
- 19. HEALTH ASSESSMENT AS RELATIONSHIP?
- 20. HEALTH CHECKS OR ANTICIPATORY CARE?
- 22. COMPARING ANTICIPATORY CARE AND HEALTH CHECKS
- 23. SO. No good evidence that general health checks help they may even harm! Be clear as to why you are doing them Theyre not the only method of preventive care Be a GP! Whatever you do requires organisation and follow-up.
- 24. ANY QUESTIONS, THOUGHTS, DISCUSSIONS?
Editor's Notes
- #4: But now NOT Health Kids Check! http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&qt=NoteID&q=A25
- #5: Time based items for all health Assessments, except 715, Aboriginal Health Assessment.
- #6: Lots of details from: http://www.health.gov.au/internet/main/publishing.nsf/Content/mha_resource_kit
- #7: These are the Requirements for billing Medicare
- #8: http://www.racgp.org.au/your-practice/guidelines/redbook/ Red book each of these interventions has evidence to support it also discussed thse with no advice and not recommended. (eg Vitamin D)
- #9: National Guide http://www.racgp.org.au/your-practice/guidelines/national-guide/
- #10: Not evidence for individual interventions, but evidence for having health check. Cochrane http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009009.pub2/abstract;jsessionid=62CBDA2C919043C31D0FA56F90FCD7FA.f01t04
- #11: Note no reduction in mortality or morbidity. Increased number of diagnoses so more people with a diagnosis, not living longer. Is this helpful? May be based on old evidence, less comprehensive checks than now, not all done in GP/Primary Care.
- #12: http://bjgp.org/content/64/618/e47.abstract
- #13: Yay! Good, right? Perhaps. Perhaps not. (If this result was the other way around, wed be trumpeting it!)
- #14: Pause so what do you think?
- #15: But health checks probably are helpful in people with intellectual disability
- #16: Invite people to make suggestions.
- #17: Low income, low socioeconomic status, unemployed, less well educated. Who are the most likely to need a health check? Exactly that group! It means we devote time and resources toward the people who need it the least.
- #18: Need mechanism for follow-up. In RVTS context that might well all be you! (That might make it easier or harder.
- #19: Income important, esp when Medicare rebates frozen. Measure yes, but evidence (eg Kanyini, Sentinel sites report) that preventive activities are being done, just not in health checks. Way to get extra allied health for those with chronic disease (or get it at all for those without. Ask for any other reasons we might do them.
- #20: You have to actively think about using it as relationship development especially for Aboriginal and Torres Strait Islander health. The computer template can easily distract us!
- #21: We see 85% of the population each year Can do preventive health in our consultations
- #22: Not a single health assessment. Anticipatory care.
- #23: No easy answers!
- #24: Be a GP relationship