• Karinna Saxby and Yuting Zhang.
• Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Melbourne, VIC.
• Med. J. Aust. 2024 Dec 17.

ObjectivesTo examine bulk-billing rates and out-of-pocket costs for non-bulk-billed general practitioner services in Australia at the Statistical Area 3 (SA3) level; to assess differences by area-level socio-economic disadvantage and remoteness.Study DesignRetrospective analysis of administrative data (Medicare claims data).Setting, ParticipantsAll Medicare claims for non-referred general practitioner services in Australia during the 2022 calendar year, as recorded in the Person Level Integrated Data Asset (PLIDA).Main Outcome MeasuresMean proportions of general practitioner services that were bulk-billed and mean patient out-of-pocket costs for non-bulk-billed general practitioner visits by SA3 region, adjusted for area-level age and sex, both overall and by area-level socio-economic disadvantage (Index of Relative Socioeconomic Disadvantage quintile) and remoteness (simplified Modified Monash Model category).ResultsDuring 2022, 82% (95% confidence interval [CI], 80-83%) of general practitioner services in Australia were bulk-billed; the mean out-of-pocket cost for non-bulk-billed visits was $43 (95% CI, $42-44). By SA3, mean bulk-billing rates ranged between 46% and 99%, mean out-of-pocket costs for non-bulk-billed general practitioner visit between $16 and $99. Bulk-billing rates were higher in regions in the most socio-economically disadvantaged quintile (86%; 95% CI, 84-88%) than those in the least disadvantaged quintile (73%; 95% CI, 70-76%); the mean rate was not significantly different for remote (86%; 95% CI, 79-92%) and metropolitan areas (81%; 95% CI, 79-83%). Out-of-pocket costs for non-bulk-billed general practitioner services were higher in remote ($56; 95% CI, $46-66) than in metropolitan areas ($43; 95% CI, $42-44), and lower in areas in the most socio-economically disadvantaged quintile ($42; 95% CI, $40-45) than in those in the least disadvantaged quintile ($47; 95% CI, $45-49).ConclusionAlthough most general practitioner services are bulk-billed, out-of-pocket costs for non-bulk-billed services are relatively high, particularly for people in remote and socio-economically disadvantaged areas of Australia.© 2024 AMPCo Pty Ltd.

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