Objective: The Australian Government's landmark 2019 implementation of dedicated Medicare items for people with eating disorders was the first of its kind for a mental illness. We investigate the first 24 months of uptake of these items across regions, settings and healthcare disciplines, including intermediate changes to the program prompted by the COVID-19 pandemic.
Methods: This was a descriptive study using item data extracted from the Australian Medicare Benefits Schedule database for November 2019 to October 2021. Data were cross-tabulated by discipline, setting, consultation type and region.
Results: During the first 24 months of implementation of the scheme, 29 881 Eating Disorder Treatment and Management Plans (or care plans) were initiated, mostly by general practitioners with mental health training. More than 265 000 psychotherapy and dietetic sessions were provided, 29.1% of which took place using telehealth during the pandemic. Although the program offers up to 40 rebated psychological sessions, fewer than 6.5% of individuals completed their 20-session review under the scheme.
Conclusions: Uptake of the Medicare item for eating disorders was swift, and the item was used broadly throughout the pandemic. Although feedback from those with lived experience and experts has been overwhelmingly positive, data show that strategic adjustment may be needed and further evaluation conducted to ensure that the reform achieves the best outcomes for patients and families, and its policy intent. Full text.
Background/objective: Growth-alternative economic models such as wellbeing economies, steady state and degrowth perspectives have come to prominence as opportunities to foster human health and quality of life without exceeding planetary boundaries. Collectively these perspectives offer an avenue for holistic approaches to addressing planetary and human health, but to implement them will require substantial changes to institutions, governance systems and our general ways of life. Drawing from a literature review, our team identified four attributes of wellbeing economies and applied them to the textile and garment sector - one of the most globalised and complex supply chains. Type of program or service Application of alternative economic systems for planetary and human health.
Methods: We use a case study approach to analyse the global textile and garment industry 1, drawing on previously published literature to identify key attributes of wellbeing economies and demonstrate how they can be applied in practice.
Results: We describe four central principles for implementing growth alternative economic models in the fashion industry: i) Establishing limits; ii) Promoting fairness; iii) Developing new and just governance systems; and iv) Promoting new roles for business and systems of exchange.
Lessons learnt: Significant societal transformations will be required to achieve growth-alternative economic approaches; however, these approaches offer a real chance for achieving planetary and human health. The textile and garment industry provides a valuable case study to explore these possibilities.
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