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Cate Swannell
Med J Aust 2018; 208 (6): . || doi: 10.5694/mja18.n0204
Published online: 2 April 2018

Researchers from Western Sydney University have found that many Australians may be at risk of developing cardiovascular disease because health checks are not being administered according to the national guidelines. They conducted an analysis of publicly available, linked patient records in the electronic databases of the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefit Scheme (PBS). On the basis of the PBS data, the researchers collated the de-identified records of patients who had received stable prescriptions of cholesterol-lowering medications during the 7-year period, 2008–2014, and could therefore be defined as being at high risk of developing heart disease. They found that 49% of patients receiving medications to lower their cholesterol levels did not undergo the recommended annual high-density lipoprotein-cholesterol (HDL-C) test in a given year; and that 19% of the same population received more HDL-C tests than were necessary. The study, published in BMJ Open, explored several possible explanations for this finding. One pointed to a lack in continuity of care and to the fact that people often consult several different practitioners. The study also identified implications for the federal health budget of current practice. During the study period, the increased yearly expenditure associated with test overutilisation was approximately $4.3 million, while the cost averted because of test underutilisation was approximately $11.3 million per year.




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