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Monday, 11 November 1991
Page: 2892

(Question No. 1324)

Senator Herron asked the Minister representing the Minister for Health, Housing and Community Services, upon notice, on 15 October 1991:

  Do practitioners who direct bill order more pathology tests than those who do not.

Senator Tate —The Minister for Health, Housing and Community Services has provided the following answer to the honourable senator's question:

  Most medical practitioners direct bill to some extent. As such it is difficult to analyse any connection or to deal with the specifics of Senator Herron's question. Nevertheless, some material is available that indicates there is not a concern.

  Chapter 2 of the National Health Strategy Background Paper No 6 `Directions for Pathology', examined the rate of utilisation of pathology services by the extent to which the services were direct billed by the pathologists concerned. That analysis showed that in 1988-89, 55.6 per cent of pathology services were direct billed. The proportion was lower for patients with 4 pathology services or less and for those with the highest use of over 24 services per year on average. Between these extremes, direct billing varied from 56 per cent to 61.3 per cent of services. However, there was no relationship between the volume of services ordered per patient and the proportion of services which were direct billed.

  The health strategy paper on pathology also showed that there was very little difference in the number of pathology episodes per patient, the number of pathology services per episode and the number of pathology services per patient between patients who were direct billed for all pathology services and those patients billed for all pathology services.   

  In addition, National Health Strategy Background Paper No 5 `The Effects of Consumer Co-payments in Medical Care', examined direct billing and that analysis suggested that there were not quantitatively large differences in the use of services per patient attributable to direct billing.