Data sources and methods
Data sources
This report provides data on the health service usage, medication dispensing patterns, health status and mortality of refugees and humanitarian entrants using the Australian Bureau of Statistics' (ABS) Person-Level Integrated Data Asset (PLIDA) (previously known as Multi-Agency Data Integration Project (MADIP)).
The PLIDA data sets used in this analysis were:
- Person Linkage Spine (Spine – ABS)
- Settlement Database (SDB – Department of Home Affairs)
- Medicare Consumer Directory (MCD – Department of Health and Aged Care/Services Australia)
- Medicare Benefits Schedule (MBS – Department of Health and Aged Care)
- Pharmaceutical Benefits Scheme (PBS – Department of Health and Aged Care)
- 2021 Census of Population and Housing (Census – ABS)
- Causes of Death (COD – ABS)
- Deaths Registrations (Deaths – ABS)
- PLIDA Combined Demographics File (ABS).
This stage of work does not include hospital data when describing health service usage. In the second stage of analysis, the AIHW will link permanent migrants’ data from the Department of Home Affairs’ Settlement Database with health and welfare data sets held by the AIHW, including data from hospital admissions, emergency department presentations and specialist homelessness services.
Methods
Country of birth and time since arrival in Australia analysis
In this report, data are presented by country of birth and time since arrival in Australia for the humanitarian entrant and other permanent migrant cohorts and not the rest of the Australian population.
Reporting by time since arrival can provide insights into how migrants' health and health service use change as they settle in Australia. Many factors that influence health may change over time. Pre-arrival experiences, the effects of the migration process, familiarity with the Australian health care system and settling into Australia may impact migrants' interaction with the health system after arrival. Understanding how health changes with time since arrival in Australia can provide a greater understanding of these factors and allow services to be targeted more effectively to improve the health of migrants.
Health service use, medication dispensing, and long-term health conditions are reported for the year 2021. Therefore, reporting by year since arrival in Australia is point in time and relates to the cohorts who arrived in certain years:
- Arrival less than 5 years ago are migrants who arrived in the years 2017–2020.
- Arrival 5 to 10 years ago are migrants who arrived in the years 2011–2016.
- Arrival more than 10 years ago are migrants arrived in the years 2000–2010.
As this is a point in time analysis, differences between the cohorts may also reflect differences in the arrival cohorts, such as countries of origin or humanitarian situations in that time period. This analysis can identify patterns for further investigation using longitudinal data to identify factors that influence migrants' health after they arrive in Australia and over time.
The health status and outcomes of migrants can vary according to the place of birth due to diverse social, economic, environmental, cultural and genetic influences. People born in the same country may identify with common cultural characteristics and sociodemographic backgrounds and share particular health risk factors related to diet or cultural practices that affect their health outcomes. Analysing the data in this report by country of birth can help to identify health service use patterns or health concerns that are common to communities with similar cultural background and experiences. This can provide important insights into the unique health concerns for different groups of the humanitarian entrant population and inform the development of tailored health services and programs.
Reporting by country of birth reflects the recorded country the person was born in. This does not necessarily reflect a person’s ethnicity, nationality, or religious group. It also does not account for social and cultural differences within a country. This is particularly relevant for humanitarian entrants who may be born in refugee camps in countries of asylum. For example, a proportion of migrants born in Thailand identify as Karen, an ethnic minority group whose families have fled from Myanmar and lived in refugee camps in Thailand (Home Affairs 2018).
Country of birth has been used as a proxy for grouping migrants by cultural groups. It will be of interest to investigate the data by other cultural variables such as ethnicity, religion or language to provide further insights on the differences in health status and outcomes among the humanitarian entrant population in future work.
Data measures
There are two measures presented throughout the Health service use and Medication dispensing sections: rates of service/ medication dispensing per 1,000 people and proportion of the population with a service/ medication dispensed in 2021.
Rates provide information on the extent of service use or medication dispensing in the population, including when people use services or are dispensed medications multiple times and, when age-standardised, allow for comparison between population groups.
The proportion of the population accessing at least one service or dispensed at least one medication in 2021 provides information on how many people within a population are accessing a service or dispensed medication. This provides valuable information on population coverage as people are only counted once, no matter how many times they accessed a service within 2021. Proportion of the population measures are not age-standardised and reflect what is truly happening in the population. Due to this, differences in the proportion of the population measures between population groups may be due to age and direct comparisons should not be made.
Measures of long-term health conditions are presented as proportion of the population who reported living with common long-term health conditions and, when age-standardised, allow for comparison between population groups. Mortality measures are presented as deaths per 100,000 person years.
For more information about the data sources, measures and methods used in this analysis, see Technical notes.
References
Home Affairs (Department of Home Affairs) (2018) Bhutan-born community information summary, Home Affairs website, accessed 24 May 2023.