Dr Kerry Hancock, Lung Foundation Australia General Practitioner Advisory Group Chair
Lung Foundation Australia estimates that 1 in 7 Australians aged 40 years and over have some form of Chronic Obstructive Pulmonary Disease (COPD)1 however around half of the people living with COPD symptoms do not know they have the condition.2
Spirometry is a lung function test used to confirm the diagnosis of COPD, and is an essential tool for GPs to ensure patients receive an accurate diagnosis and timely access to treatment.
Anecdotally, GPs report that the low rebate for office-based spirometry, currently $17.50, is one of the main barriers to improving the use of diagnostic spirometry in the primary care setting. Following on from the Medicare Review Taskforce recommendation, from November 1, 2018, there will be a new item number (item 11505) for pre and post-bronchodilator. The schedule fee will be listed as $41.10 and the MBS rebate at about $35.00. This item number can only be claimed once per year, per patient with the intention to confirm a diagnosis of COPD, asthma or another cause of airflow limitation.
Lung Foundation Australia’s General Practitioner Advisory Group Chair, Dr Kerry Hancock, said the increased rebate is a step towards ensuring equitable access but it is important that GPs are well supported to perform this important diagnostic test to minimise misdiagnosis in patients.
“Well-performed spirometry is essential to avoiding delayed and misdiagnosis, and unnecessary cost to patients, achieving better symptom control, reducing the risk of exacerbation and maximizing quality of life,” Dr Hancock said.
“It is essential that training and quality assurance programs are in place to improve the skills and confidence of GPs and their practice nurses in performing high quality spirometry testing to improve early and accurate diagnosis rates of COPD and asthma.”
Although the increased rebate associated with the new item number is a positive step toward supporting early diagnosis of respiratory conditions like COPD, not all GPs will be able to make use of the benefit, Dr. Kerry Hancock explains.
“Unfortunately, the increased rebate does not meet the true cost of performing spirometry in general practice. This means many GPs will still require access to refer their patients to other facilities that perform spirometry such as lung function laboratories in public hospitals or services associated with private respiratory specialists.”
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- Toelle B, Xuan W, Bird T, Abramson M, Atkinson D, Burton D, James A, Jenkins C, Johns D, Maguire G, Musk A, Walters E, Wood-Baker R, Hunter M, Graham B, Southwell P, Vollmer W, Buist A, Marks G. Respiratory symptoms and illness in older Australians: The Burden of Obstructive Lung Disease (BOLD) study. Med J Aust 2013;198:144-148
- Xuan W, Toelle B, Bird T, Abramson M, Graham B, James A, Johns D, Maguire G, Wood-Baker R, Marks G. Prevalence of respiratory symptoms, illnesses and spirometric diagnoses in the Australian BOLD study. Respirology 2011; 16: 51