Two decades of Medicare: An updated review of Medicare-subsidised dietetics services in Australia.

Abstract

Aim: This study aimed to describe the utilisation of item numbers for dietetic services available through the Australian Medicare Benefits Schedule, with particular focus on changes between 2015 and 2024.

Methods: This descriptive observational study used publicly available, population-level data from Medicare Australia describing item utilisation in terms of number and services per 100 000 population, benefit paid, and patient demographics for dietetic-related item numbers. Utilisation of related items for other allied health professions was also described. Data were analysed using descriptive statistics (frequency, percentage) and change in utilisation was calculated for periods defined a priori.

Results: The total number of Medicare-subsidised dietetic services increased by 7%, to 1691 services per 100 000 population, between 2015 and 2024. However, the number of chronic disease dietetic services per 100 000 population decreased by 12% over the decade, while other allied health professions increased over the same period. In addition, the proportion of group services for diabetes delivered by dietitians declined from 7% in 2015 to 4% in 2024, with just 13 services claimed per 100 000 population. Conversely, utilisation of dietetic services for eating disorders has consistently increased, with an annual growth rate between 8% and 47%, seeing 273 dietetic eating disorder services claimed per 100 000 in 2024.

Conclusions: Change in utilisation of Medicare-subsidised dietetic services varied over the last decade, with claims for eating disorders increasing while claims for chronic disease and diabetes group services decreased. The lack of dietitian-specific item numbers for case conferencing and some telehealth services impedes accurate evaluation of utilisation and, therefore, planning.