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The Australian Institute of Health and Welfare estimated
in 1994 that there were 1,659 podiatrists in the six
States in Australia (the Australian Capital Territory
and Northern Territory were excluded at that time due to
absence of registration..) Private practice accounts for
around 70% of service delivery of Podiatry in Australia,
however podiatrists also consult in hospitals (offering
inpatient and outpatient services), community health
centres and aged care facilities. Specialised services
might include training and rehabilitation consultancy
for sporting clubs, occupational health for industrial
organisations or mobility training for disabled
children.
Podiatry services do not attract a Medicare rebate,
however funding sources for public services include
Federal Aged and Disabled care services (under the
Health and Community Care or HACC program) and State
Community Health programs. Access, eligibility and range
of services available varies significantly both within
and between States due to the variations in funding
criteria and local influences and constraints. Some
people covered by the Veterans Affairs program are
entitled to subsidised podiatry services, generally
provided in private practice. Most private health
insurance agencies offer their members with upper range
"Extras" benefits, rebates for a range of
Podiatry services.
The Australian Institute of Health and Welfare (1992)
reported that based upon twenty year projections of
current data,
"the demand for podiatry services is growing
approximately twice as fast as population growth:"
The prevalence of foot problems in the general
community has been estimated to range between 20 and 40
percent. (NSW 1994, Payne 1990) This figure rises for
persons over the age of 65, for whom the manifestations
of disease processes are more likely as are the presence
of structural foot changes and associated pathology. The
incidence of diabetes in our community (3%, Diabetes
Australia, 1997) is not only increasing, but thought to
be underestimated by as much as 50%. Furthermore, over
half of all people with diabetes are over the age of 65.
It is well recognised that the proportion of elderly
within our community will increase in the future, along
with demands for a range of health care services. A
Victorian survey (New Focus Research, 1997) found that
only 15% of general health consumers or their families
had ever utilised podiatry services, indicating that the
need for podiatric care and potential impact may well be
significantly underestimated.
In 1994, the Department of Health and Community
Services (Victoria) reported that,
"There is quite substantial evidence that
podiatry is a very important source of primary health
care...as severe or chronic foot problems can lead to a
decrease in mobility and increased likelihood of a move
to hospital or institutional care. Podiatrists play an
important role in maintaining independence in high risk
groups"
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