title: Uptake of Medicare chronic disease management incentives - a study into service providers' perspectives.
abstract: BACKGROUND
  Chronic disease is responsible for 80% of the burden of disease in Australia. The Australian Government Medicare Benefits Schedule (MBS) provides incentives through specific Medicare items to optimise chronic disease management (CDM), yet little is known about factors that influence their uptake.
  
  
  METHODS
  Exploratory qualitative research was used, which incorporated focus groups and interviews with 26 staff from nine general practices in southeast Queensland, together with review of practice-specific data on CDM income. Content analysis of qualitative data was undertaken to identify barriers, enablers and service models associated with MBS CDM item uptake. Triangulation of methods and data sources facilitated confirmation of findings.
  
  
  RESULTS
  Time pressures and unreliable MBS information were common barriers to uptake for general practitioners. Employing a nurse, team-based approaches, recall systems and using only selected MBS CDM item numbers were associated with best uptake.
  
  
  CONCLUSIONS
  Improved systems within general practice and Medicare may increase the uptake of MBS CDM item numbers.
authors.affiliation: School of Population Health, University of Queensland, Brisbane Queensland, Australia. l.holden@uq.edu.au
authors.forename: Libby
authors.initials: L
authors.lastname: Holden
authors.forename: Ian Douglas
authors.initials: ID
authors.lastname: Williams
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Patterson
authors.forename: Jane W
authors.initials: JW
authors.lastname: Smith
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
authors.forename: Lily
authors.initials: L
authors.lastname: Cheung
authors.forename: Robyn
authors.initials: R
authors.lastname: Chambers
authors.forename: Xanth A
authors.initials: XA
authors.lastname: Golenko
authors.forename: Robyn
authors.initials: R
authors.lastname: Weare
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy; D005260:Female; D058006:General Practice / Q000191:economics* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D036301:Qualitative Research; D012052:Reimbursement, Incentive / Q000191:economics / Q000706:statistics & numerical data*