Module 3: Access to health care services

Overall, Aboriginal and Torres Strait Islander people experience poorer health than non-Indigenous Australians, but they do not always have the same level of access to health services. This module includes some selected measures of access to health care services that cover the different levels of the health system. The measures compare use of various services for Indigenous and non-Indigenous Australians as a way of broadly monitoring disparities in access. Disparities in access and use of health services may indicate problems with the cultural safety of services, but there may be many other factors, such as remoteness, affordability, previous experiences of racism in health care environments for themselves, family or community members and fear of how they will be treated.

For example, potentially preventable hospitalisations (hospitalisations for conditions that can be effectively treated in a non-hospital setting) can serve as a proxy measure of access to timely, effective and appropriate primary and community-based care. Systematic differences in hospitalisation rates for Indigenous Australians and non-Indigenous Australians can indicate gaps in the provision of population health interventions, primary care services, and continuing care support. The rate of potentially preventable hospitalisations is affected by the interaction of a broad range of factors; however, culturally safe primary health care could help better detect and manage health risk factors and conditions and thereby reduce rates of potentially preventable hospitalisations. 

What data are available?

The measures in this module are based on national administrative data collections covering immunisation, Medicare Benefits Schedule (MBS), hospitals, mortality, perinatal and elective surgery waiting times.

For further information on the data sources used in this module, see Module 3 – Data sources and data gaps.

Key findings

Selected measures of access to health care services for Indigenous and non-Indigenous Australians are used to monitor disparities in access as they may indicate problems with the cultural safety of services, though many other factors can also impact on access to and use of services (for example, remoteness, affordability, previous experiences of racism, presence of co-morbidities).

  • In the two-year period 2018–2019, 27% of Indigenous women aged 40 and over received a free mammogram through BreastScreen Australia. Based on age-standardised rates, 26% of Indigenous women aged 40 and above received a mammogram, compared with 34% of non-Indigenous women.
  • Indigenous Australians waited longer to be admitted for elective surgery in 2019–20 than non-Indigenous Australians—50% of Indigenous patients were admitted for elective surgery within 49 days, compared with 38 days for non-Indigenous patients.
  • In 2019, the avoidable mortality rate for Indigenous Australians was 222 per 100,000. The Indigenous age-standardised rate was over 3 times that for non-Indigenous Australians (323 and 98 per 100,000 respectively).
  • In 2019–20, the rate of potentially preventable hospitalisations for Indigenous Australians was around 3 times the rate for non-Indigenous Australians (68.4 compared with 23.3 per 1,000, based on age-standardised rates).
  • In 2019, of 5,311 registered cases of rheumatic heart disease, 82% were Indigenous Australians compared with 18% non-Indigenous Australians.

See Module 3 data tables for all data presented in this module.

Data gaps and limitations

Disparities in access may be due to a range of factors other than a lack of cultural safety. The data provide overall measures of access, but do not include information on all the factors that can impact on access, such as affordability, previous experiences of racism, the presence of co-morbidities or patient choice.

Module 3 domains: