Overview
Measuring expenditures on health services for Aboriginal and Torres Strait Islander people began in 1997, and has been undertaken in accordance with commitments given through the Framework Agreements on Aboriginal and Torres Strait Islander Health negotiated between the Commonwealth and States and Territories. The project is managed by the Commonwealth Department of Health and Ageing, with reports released every three years. The project identifies expenditure on specific health programs for Aboriginal and Torres Strait Islander people as well as the estimated Indigenous component of expenditures on all mainstream health services. The project examines health resource distribution by different levels of government, the private sector, by region and by primary and secondary/tertiary health care. To put these numbers into perspective, corresponding numbers for the non-Indigenous population are also reported.
The life circumstances of Aboriginal and Torres Strait Islander people differ from the general Australian population in a number of important respects that significantly affect their general health status and consequent health care needs. Despite Indigenous Australians' much poorer health status, total expenditures per person for health services for Aboriginal and Torres Strait Islander people are not much higher than for the rest of the population.
Relative health expenditure is marked by use of public versus private health care and access to health services and health benefits, and health expenditure reporting is dependent on the availability of quality data.
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Expenditure
Expenditure on health goods and services for Aboriginal and Torres Strait Islander peoples during 2001-02 was estimated at $1,788.6 million. About 62.7% of this was directed to two areas of expenditure - services provided to admitted patients in acute-care hospitals ($682.5 million) and community health services ($439.9 million).
There are, however, significant differences in the patterns of expenditure. Aboriginal and Torres Strait Islander people are, on average, much higher users of publicly funded health services than non-Indigenous people. Reflecting their significantly lower income level, Indigenous Australians used fewer privately funded services such as doctors in private practice, private hospitals, dentists and other privately funded allied health professionals. When relative income position was taken into account, public expenditures on the health of Aboriginal and Torres Strait Islander people appear to have been similar to that for non-Indigenous people in low-income groups.
Indigenous Australians have a significantly poorer health status (measured in terms of life expectancy, mortality and morbidity) than non-Indigenous Australians. It should therefore be expected that per capita investment of health resources to achieve quality for Aboriginal and Torres Strait Islander peoples should be much higher than for other Australians. In this context it is noteworthy that on a per person basis, estimated expenditure on health for Aboriginal and Torres Strait Islander peoples averaged $3,901, compared with $3,308 for non-Indigenous people - a ratio of 1.18:1.
Funded health care
Aboriginal and Torres Strait Islander people have low levels of access to, and use of, health services such as Medicare, the Pharmaceutical Benefits Scheme (PBS) and private GPs.
The combined expenditure on Medicare and the PBS contributed to 6.6% of total health expenditure on Indigenous people in 2001-02. The comparable figure for non-Indigenous people was 23%.
Living remotely
The relative isolation of the target Indigenous populations greatly influences the costs of producing and delivering health goods and services. Consequently, the geographic distribution of the Indigenous population (26% live in remote areas, compared with only 2% of the total Australian population) greatly impacts on both the levels of health expenditure and the quantity of goods and services that can be provided to communities and individuals living in these areas. Variations in Indigenous health status across geographic regions are likely, although these are not easily substantiated by the available data. It is a generally held fact that Australians living in remote areas have poorer health compared to Australians living in regional and urban areas.
Further information
For more information on Indigenous health and welfare expenditure, go to Expenditure.