Report 1 : Indigenous health checks and follow-ups
Through Medicare (MBS item 715), Aboriginal and Torres Strait Islander people can receive Indigenous-specific health checks from their doctor, as well as referrals for Indigenous-specific follow-up services.
- In 2017–18, 230,000 Indigenous Australians had one of these health checks (29%).
- The proportion of Indigenous health check patients who had an Indigenous-specific follow-up service within 12 months of their check increased from 12% to 40% between 2010–11 and 2016–17.
Report 2 : Regional variation in uptake of Indigenous health checks and in preventable hospitalisations and deaths
Potentially preventable hospitalisations (PPH) and potentially avoidable deaths (PAD) are hospitalisations and deaths that are considered potentially preventable through timely access to appropriate health care.
While the risk of these health outcomes depends on population characteristics to some degree, relatively high rates indicate a lack of access to effective health care.
In Australia, Aboriginal and Torres Strait Islander people have PPH and PAD rates that are more than 3 times as high as those for non-Indigenous people.
All Indigenous Australians are eligible for Indigenous-specific health checks, which are a part of the Australian Government’s efforts to improve Indigenous health outcomes. The health checks are conducted by GPs and are listed as item 715 on the Medicare Benefits Schedule.
In this report, we contrast the geographical variation in Indigenous PPH and PAD with the variation in uptake of Indigenous-specific health checks at the local-area level (Statistical Area Level 3), by Primary Health Network and by state or territory.
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Overall, areas with large Indigenous populations tend to have high rates of PPH and PAD and high uptake rates of Indigenous health checks. That areas with high rates of health checks also tend to have high rates of PPH and PAD may seem counterintuitive. However, any effects of the health checks on the rates of PPH and PAD are likely to become more apparent over time as there has recently been a dramatic increase in the rates of Indigenous health checks in many parts of Australia. It is reasonable to expect that there will be some lag time between an increase in the uptake of health checks and when positive effects on health outcomes can be seen.
We use a regression model to identify areas with unexpectedly high or low rates of PPH given the demographic composition of their populations and other characteristics of the areas (such as remoteness). Cape York, Tasmania and the northern parts of the Northern Territory stand out as regions with unexpectedly low rates of PPH. Regions with unexpectedly high rates include Central Australia, the Kimberley and some inner parts of Darwin, Perth and Brisbane.
Unexpectedly high or low rates of PPH can be due to a number of factors including:
- performance of the local health-care services, including past performance affecting the health of local people
- accessibility of hospitals and relative use of hospitals or other health-care services
- people with poor health moving from areas without services to areas with services (for high rates)
- unaccounted factors that influence the risk of PPH
- data issues.
These factors are all potentially important. How they influence reported health outcomes needs to be better understood to ensure that policy and management decisions are based on the best available information.
Aboriginal and Torres Strait Islander people can receive an annual health check, designed specifically for Indigenous Australians and funded through Medicare (Department of Health 2016).
This Indigenous-specific health check was introduced in recognition that Indigenous Australians, as a group, experience some particular health risks.
The aim of the Indigenous-specific health check is to encourage early detection and treatment of common conditions that cause ill health and early death—for example, diabetes and heart disease.
NACCHO note : Many of ACCHO’s throughout Australia offer incentives like Deadly Choices shirts to have a 715 Health Check
During the health check, a doctor—or a multidisciplinary team led by a doctor—will assess a person’s physical, psychological and social wellbeing (Department of Health 2016). The doctor can then provide the person with information, advice, and care to maintain and improve their health.
The doctor may also refer the person to other health care professionals for follow-up care as needed—for example, physiotherapists, podiatrists or dieticians.
This report presents information on the use of:
- health checks provided under the Indigenous-specific Medicare Benefits Schedule (MBS) item 715; and
- follow-up services provided under Indigenous-specific MBS items 10987 and 81300 to 81360.
The data include all Indigenous-specific health checks and follow-ups billed to Medicare by Aboriginal Community Controlled Health services or other Indigenous health services, as well as by mainstream GPs and other health professionals.
Note that the data are limited to Indigenous-specific MBS items, so do not provide a complete picture of health checks and follow-ups provided to Indigenous Australians.
For example, Indigenous Australians may receive similar care through other MBS items (that is, items that are not specific to Indigenous Australians), or through a health care provider who is not eligible to bill Medicare (see also Data sources and notes).
Throughout the report, ‘Indigenous-specific health checks’ is used interchangeably with ‘health checks’ to assist readability. Similarly, ‘Indigenous-specific follow-ups’ is used interchangeably with ‘follow-ups’.
Indigenous-specific health checks and follow-ups: data summary
Number of health checks
In 2017–18, there were about 236,000 Indigenous-specific health checks provided to about 230,000 Aboriginal and Torres Strait Islander people. The minimum time allowed between checks is 9 months, and so people can receive more than 1 health check in a year.
Between 2010–11 and 2017–18, the number of Indigenous Australians receiving a health check more than tripled—from about 71,000 to 230,000 patients.
Figure 3 shows the rate of Indigenous-specific health checks by four different geographic classifications—state/territory, remoteness area, Primary Health Network (PHN), and Statistical Areas Level 3 (SA3s).
This analysis is based on the postcode of the patient’s given mailing address. As a result, the data may not reflect where the person actually lived—particularly for people who use PO Boxes. This is likely to impact some areas more than others, and will also have a greater impact on the SA3 data than the larger geographic classifications. See Data sources and notes for information on areas most likely to be affected.
- across states and territories, the Northern Territory had the highest rate of Indigenous-specific health checks (with 38% of the Aboriginal and Torres Strait Islander population receiving an Indigenous health check), followed by Queensland (37%). Tasmania had the lowest rate (13%).
- across PHNs, the rate of Indigenous-specific health checks ranged from 4% (in Northern Sydney) to 42% (in Western Queensland).
Number of follow-ups
Health checks are useful for finding health issues; however, improving health outcomes also requires appropriate follow-up of any issues identified during a health check (Bailie et al. 2014, Dutton et al. 2016).
Based on needs identified during a health check, Aboriginal and Torres Strait Islander people can access Indigenous-specific follow-up services—from allied health workers, practice nurses, or Aboriginal and Torres Strait Islander Health practitioners—through MBS items 10987, and 81300–81360 (see also Box 2).
Indigenous Australians may receive follow-up care through other MBS items that are also available to non-Indigenous patients. For example, if a person is diagnosed with a chronic health condition, the GP might prepare a GP Management Plan, or refer the person to a specialist. Data in this report relate to Indigenous-specific items only.
In 2017–18, there were about 324,000 Indigenous-specific follow-up services provided to 133,000 Indigenous Australians. This was an increase from around 18,500 follow-ups provided to 9,900 patients in 2010–11 (Figure 7).