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45–49-year-old Health Assessment

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Content last updated 10/04/2024

45–49-year-old Health Assessment

The 45–49-year-old health assessment is for a patient who, in the clinical judgement of the medical practitioner and based on the identification of a specific risk factor, is at risk of developing a chronic disease.

A health assessment at this stage in life can assist patients to make the necessary lifestyle changes to prevent or delay the onset of chronic disease.

Improving the completion rates of health assessments in general practice can be a great Quality Improvement (QI) activity, benefiting both patients and the practice.

Eligibility criteria

The 45–49-year-old health assessment is for patients “at risk of developing chronic disease”. The decision that a patient is at risk of developing a chronic disease is a clinical judgement made by the GP. However, at least one risk factor must be identified.

Risk factors that the GP may consider include, but are not limited to:

  • lifestyle risk factors, such as smoking, physical inactivity, poor nutrition or alcohol use;
  • biomedical risk factors, such as high cholesterol, high blood pressure, impaired glucose metabolism or excess weight; and
  • a family history of a chronic disease.

Identifying patients and practice processes

Health assessments work best if there is some pre-planning. Some questions you might want to consider before conducting a series of assessments are:

  • Do you have a team member who can identify eligible patients and recall them? Do the team members have access to Primary Sense?
  • Have you checked Provider Digital Access (PRODA) to see if the patients have already had a health assessment billed before recalling?
  • Do you use a recall/reminder system to invite patients to book for an assessment? Will this age group respond better to SMS, letters or phone calls (or a combination)? Will patients know what a health assessment is?
  • Do all staff know what a health assessment is? Do they know what the benefits are and why patients are recommended to have one?
  • Do all staff know the practice process for booking in a health assessment? For example: How long with the nurse? How long with the GP?
  • What will you charge for the assessments? Offering to bulk bill might provide an incentive for a patient to attend.
  • Are all GPs aware of the correct item number to be billed and the billing rules?
  • Do you have a template to record the assessment? Do staff know the record keeping responsibilities?

What is included in a 45–49-year-old health assessment?

Health assessments are generally made up of the following elements:

  • information collection, including taking a patient history and undertaking or arranging examinations and
  • investigations as required;
  • making an overall assessment of the patient;
  • recommending appropriate interventions;
  • providing advice and information to the patient;
  • keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and
  • offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

Medicare Benefits Schedule (MBS)

Health assessment MBS items are used, and practice nurses can contribute to the assessment.

The 45–49-year-old health assessment can only be claimed once for each patient, and there are four time-based health assessment items, consisting of brief, standard, long and prolonged consultations:

  • 701: assessment lasting <30 minutes $62.75
  • 703: assessment lasting 30–45 minutes $145.80
  • 705: assessment lasting 45–60 minutes $201.15
  • 707: assessment lasting >60 minutes $284.20

Opportunities for your practice

Conducting the 45–49-year-old health assessment is a good way to engage your patients and to provide health promotion and prevention messages to them.

Impacts of the COVID-19 pandemic may have resulted in a reduction in preventative health activities; due to this the GCPHN QI Team focus in 2022-23 is to provide support for general practices to increase the number of eligible patients with a health assessment recorded.

General practice staff are encouraged to consider participation in QI activities with a focus on health assessments as a component of their COVID-19 pandemic recovery phase. This will support identification of vulnerable and at-risk patients and implementation of appropriate preventative health interventions that may be missing or overdue.

An activity like this may help your practice to meet PIP QI/ accreditation requirements. QIMs that support preventative health activities including comprehensive health assessments can include:

  • QIM 2
  • QIM 3
  • QIM 7
  • QIM 8
  • QIM 9

Additionally, health assessments provide a critical opportunity to identify if a patient has developed a chronic disease. This may lead to the patient being recalled to the practice for a GP Management Plan or a Mental Health Treatment Plan, which can improve care for the patients through proactive care planning.

Completing this assessment also helps to build your relationship and trust with patients, making them more likely to return to you or your practice for their future care.

More information

Resources to support with identifying eligible patients

Resources to support your practice with implementing a health assessment QI activity:

  • Health assessment QI action plan examples
  • Health assessment toolkit

Templates

  • Most clinical software is pre-loaded with a 45–49-year-old health assessment template.
  • A proforma is also available from the Department of Health.

Resources for general practice