Md Mijanur Rahman

COSA's Survivorship Fellowship program was established in 2020 to help build capacity in survivorship research. Fellows receive mentorship, guidance and support from the Survivorship Executive Committee comprised of internationally renowned senior clinicians and researchers in cancer survivorship. Dr Md Mijanur (Mijan) Rahman was one of four Survivorship Fellows appointed in 2022. Prof Nicolas Hart and Prof Gail Garvey were his primary co-mentors.

Fellowship Project

Utilisation of Medicare Chronic Disease Management item numbers for people with cancer in Queensland, Australia

Objective

Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigated Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors.

Methods

Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis.

Results

In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11–1.21) and TCA (OR: 1.12, 95% CI: 1.07–1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85–0.93). People with cancer living in remote areas were less likely to receive TCA (OR: 0.84, 95% CI: 0.80–0.88) or utilise allied health services (OR: 0.63, 95% CI: 0.60–0.67) than those in metropolitan areas.

Conclusion

Our findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer’s care needs are being met and ways to optimise the supportive care of these people.