Health checks for First Nations people
-
27%
of First Nations people had a health check in 2022–23, almost back to the pre-pandemic level of 29%.
Through Medicare, First Nations people can receive health checks from their doctor that are specifically for Aboriginal and Torres Strait Islander people, as well as follow-up services from other health professionals. The health check is an opportunity for First Nations people to have their ears checked. For children 0–14 the health check should include an ear examination and for those aged 15–54 the health check should include an ear examination and hearing test (Department of Health and Aged Care n.d.).
About the data
This section presents information on First Nations people who had a First Nations-specific health check, including health checks billed to Medicare by Aboriginal Community Controlled Health Services or other health services for First Nations people, as well as by mainstream general practitioners.
The information comes from Medicare Benefits Schedule (MBS) data. The MBS is a list of health services covered by a Medicare rebate. Certain MBS items refer to health checks intended for people of Aboriginal and Torres Strait Islander origin (MBS item numbers 715, 228, 92004, 92011, 92016, and 92023).
As the data are limited to MBS items billed to Medicare, they do not provide a complete picture of health checks provided to First Nations people. For example, First Nations people may receive health care that is not First Nations-specific, that is provided in residential aged care, or through a health care provider who is not eligible to bill Medicare.
The minimum time allowed between health checks is 9 months, so people can have more than one health check in a year.
For more information about First Nations-specific health checks and follow-up services, see Health checks and follow-ups for Aboriginal and Torres Strait Islander people.
Note that different estimates of the First Nations population are used in the calculation of population rates for different analyses, generally depending on whether the information relates to a single time period or change over time. For this reason, there are minor inconsistencies in information across tables.
Development of a new indicator on ear health checks
The AIHW is developing a new indicator on ear health checks in primary care settings:
Proportion of First Nations regular clients aged 0–14 who received an ear health check in the previous 12 months, including whether a visual check, tympanic movement check, or both, were performed
Depending on the results of pilot testing, which started in 2024, that indicator would be reported as part of the national Key Performance Indicators (nKPI) collection, a set of primary health care indicators for First Nations people focusing on maternal and child health, preventative health, and chronic disease management. The collection contains data on First Nations regular clients of organisations that receive funding under the Indigenous Australians’ Health Programme.
While the new indicator is being developed, information on participation in health checks for First Nations people is provided.
Overview
The proportion of First Nations people who had a health check increased from 19% in 2013–14 to 29% in 2018–19, then fell during the pandemic before increasing again to 27% in 2022–23 (Figure SCREENING 7).
Age and sex
Around 24% of First Nations people had a health check in 2022–23, and the proportion increased with age (data table 2.2a). Note, these results are derived using different population estimates from those used for the analysis of change over time described above.
Around 1 in 5 First Nations females aged 0–14 had a health check in 2022–23 (21% or 34,100 people). Uptake of health checks was higher among older First Nations women. Nearly 2 in 5 First Nations women aged 65–74 (39% or 8,600 people) and a similar proportion of those aged 75 and over (38% or 3,600 people) had a health check in 2022–23.
About 23% of First Nations males aged 0–14 had a health check in 2022–23 (38,200 people), similar to the proportion for First Nations females in the same age group. Uptake of health checks among First Nations males then decreased with age to reach its lowest level among young adult males at around 16% of those aged 15–24 (16,200 people) and 25–34 (12,800 people). The proportion of First Nations men who had a health check then increased steadily with age to 36% of those aged 75 and over (2,700 people).
For First Nations people aged 15 and over, lower proportions of males had a health check in 2022–23 compared with females. The largest difference was among those aged 25–34. Among these young adults, 16% of First Nations males had a health check in 2022–23 (12,800 people), compared with 26% of females (19,900 people) (Figure SCREENING 3).
Figure SCREENING 3: Health checks for First Nations people, by age and sex, 2022–23
Column chart shows proportion of health checks for First Nations people increases with age and is generally higher for females than males.
| Age | Males | Females |
|---|---|---|
| 0–14 | 22.6 | 21.4 |
| 15–24 | 16.3 | 23.1 |
| 25–34 | 16.4 | 26.2 |
| 35–44 | 20.8 | 28.5 |
| 45–54 | 26.3 | 31.8 |
| 55–64 | 31.8 | 35.5 |
| 65–74 | 35.2 | 38.5 |
| 75 and over | 35.5 | 37.5 |
- Health checks for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: 715, 228 (face-to-face), 92004, 92011 (telehealth).
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011) were introduced in March 2020, in response to COVID-19 and associated restrictions.
- Per cent: the number of patients who received a health check for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
Among First Nations children 0–14, the proportion who had a health check in 2022–23:
- was highest at 26% for children aged 3–4 years (11,200 children)
- ranged from 21–23% for children aged 0–2 years, 5–6 years, 7–9 years and 10–14 years (Figure SCREENING 4).
Figure SCREENING 4: Health checks for First Nations children aged 0–14, by age
Column chart shows proportion of First Nations children who had health checks ranges from 21% of those aged 7–9 or 10–14 to 26% of those aged 3–4.
| Age | Per cent |
|---|---|
| 0–2 | 21.8 |
| 3–4 | 26.4 |
| 5–6 | 23 |
| 7–9 | 20.9 |
| 10–14 | 20.7 |
- Health assessments for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: 715, 228 (face-to-face), 92004, 92011 (telehealth).
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011) were introduced in March 2020, in response to COVID-19 and associated restrictions.
- Per cent: the number of patients who received a health assessment for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
Remoteness
In 2022–23, the proportion of First Nations people who had a health check was highest in Outer regional areas (31% or 59,800 people) and lowest in Major cities (21% or 88,000 people). This may be due to a range of factors including differences between these areas in the prevalence of health conditions, access to culturally appropriate health services or use of mainstream services not reflected in these data (Figure SCREENING 5).
Figure SCREENING 5: Health checks for First Nations people, by remoteness, 2022–23
| Remoteness | Per cent |
|---|---|
| Major Cities of Australia | 20.9 |
| Inner Regional Australia | 23.6 |
| Outer Regional Australia | 30.7 |
| Remote Australia | 28.6 |
| Very Remote Australia | 23.7 |
- Health assessments for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: - 715, 228 (face-to-face) - 92004, 92011 (telehealth)
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011) were introduced in March 2020, in response to COVID-19 and associated restrictions.
- Per cent: the number of patients who received a health assessment for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Geographical classifications are based on the address recorded in the patient's Medicare record.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
- Population denominators used to calculate rates by remoteness area were modelled by AIHW for this report. These rates may be slightly different to comparable estimates in other AIHW reports.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
State and territory
Across states and territories, the proportion of First Nations people who had a health check in 2022–23 ranged from 12% in Victoria, to 29% in the Northern Territory and 30% in Queensland (Figure SCREENING 6).
Figure SCREENING 6: Health checks for First Nations people, by state/territory, 2022–23
Column chart shows proportion of First Nations people who had health checks ranges from 12% in Victoria to 31% in Queensland.
| State | Per cent |
|---|---|
| NSW | 23.2 |
| Vic. | 11.9 |
| Qld | 30.3 |
| WA | 23.3 |
| SA | 18.7 |
| Tas. | 15.7 |
| ACT | 15.7 |
| NT | 28.9 |
- Health assessments for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: - 715, 228 (face-to-face) - 92004, 92011 (telehealth)
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011) were introduced in March 2020, in response to COVID-19 and associated restrictions.
- Patients: the number of unique patients who received a health assessment for First Nations people in the financial year. Data is a count of the number of First Nations patients, not a count of the number of services claimed.
- Per cent: the number of patients who received a health assessment for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
- Geographical classifications are based on the address recorded in the patient's Medicare record.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
Over time
There has been a long-term trend of rising health check uptake among First Nations people, but there was a considerable fall in uptake between 2018–19 and 2021–22 associated with the COVID-19 pandemic. During this period, Australian and state and territory governments placed restrictions on people’s movements and activities to prevent the disease from spreading (AIHW 2021).
After increasing from 19% (147,000 people) in 2013–14 to a peak of almost 29% in 2018–19, the proportion of First Nations people who had a health check fell to a low of 23% in 2021–22. Uptake of health checks then increased in 2022–23 to 27% (247,000 people), nearly returning to the pre-pandemic peak (Figure SCREENING 7).
Figure SCREENING 7: Health checks for First Nations people, 2013–14 to 2022–23
Line chart shows proportion of First Nations people who had health checks rose to 26% in 2018–19 before pandemic-era falls then rose to 24% in 2022–23.
| Year | Per cent |
|---|---|
| 2013–14 | 19.1 |
| 2014–15 | 21.5 |
| 2015–16 | 24 |
| 2016–17 | 26 |
| 2017–18 | 27.7 |
| 2018–19 | 28.5 |
| 2019–20 | 27.7 |
| 2020–21 | 27 |
| 2021–22 | 23.3 |
| 2022–23 | 27 |
- Health assessments for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: 715, 228 (face-to-face); 92004, 92011 (telehealth)
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011, 92016, 92023) were introduced in March 2020, in response to COVID-19 and associated restrictions. 92016 and 92023 were telephone items that were discontinued.
- Patients: the number of unique patients who received a health assessment for First Nations people in the financial year. Data is a count of the number of First Nations patients, not a count of the number of services claimed.
- Per cent: the number of patients who received a health assessment for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
- To calculate rates for the First Nations population, projections (medium series) based on the 2016 Census have been used (ABS 2006-to-2031). Rates for non-Indigenous Australians are calculated using total population estimates based on the 2016 Census (ABS 2022) and subtracting the projections for First Nations people.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
Among First Nations people aged 0–14 and 15–54, the proportion who had a health check increased in 2022–23 after pandemic-era declines, nearly returning to levels seen before the pandemic.
Among First Nations people aged 55 and over, the proportion who had a health check increased in 2022–23 to 39% (47,800 people), similar to the pre-pandemic peak (Figure SCREENING 8).
Figure SCREENING 8: Health checks for First Nations people, by age, 2013–14 to 2022–23
Line chart shows proportion of First Nations people aged 55 plus who had health checks now higher than pre-pandemic peak and rising in other ages.
| Year | 0–14 | 15–54 | 55 and over |
|---|---|---|---|
| 2013–14 | 17 | 18.9 | 28.1 |
| 2014–15 | 19.8 | 20.9 | 30.1 |
| 2015–16 | 22.7 | 23.1 | 32.5 |
| 2016–17 | 24.9 | 24.9 | 34.6 |
| 2017–18 | 26.7 | 26.4 | 37 |
| 2018–19 | 27.5 | 26.9 | 38.5 |
| 2019–20 | 25.6 | 26.5 | 38.5 |
| 2020–21 | 24.8 | 25.6 | 38.3 |
| 2021–22 | 20.7 | 22.1 | 34.8 |
| 2022–23 | 24.9 | 25.3 | 39.1 |
- Health assessments for Aboriginal or Torres Strait Islander (First Nations) people consist of Medicare Benefits Schedule (MBS) items: 715, 228 (face-to-face); 92004, 92011 (telehealth)
- The MBS items above are intended for people of Aboriginal or Torres Strait Islander descent, so all recipients are assumed to be First Nations people.
- Telehealth items (92004, 92011, 92016, 92023) were introduced in March 2020, in response to COVID-19 and associated restrictions. 92016 and 92023 were telephone items that were discontinued.
- Patients: the number of unique patients who received a health assessment for First Nations people in the financial year. Data is a count of the number of First Nations patients, not a count of the number of services claimed.
- Per cent: the number of patients who received a health assessment for First Nations people as a proportion of the First Nations population in each financial year.
- Patients may have received more than one health check in the same financial year. Patients who received more than one health check in the financial year are only counted once.
- Counts have been adjusted to avoid double counting patients across age groupings and geographical classifications.
- Data are reported by date of service. Only MBS items processed on or before 31 March 2024 have been analysed.
- To calculate rates for the First Nations population, projections (medium series) based on the 2016 Census have been used (ABS 2006-to-2031). Rates for non-Indigenous Australians are calculated using total population estimates based on the 2016 Census (ABS 2022) and subtracting the projections for First Nations people.
Source: AIHW analysis of MBS data; Populations based on Australian Bureau of Statistics (ABS) data.
Health check follow-up services
Follow-up services for First Nations people were added to the MBS list of health care services covered by a Medicare rebate in November 2008, as health checks alone have limited capacity to improve health outcomes.
Based on health needs identified during a health check, people can access up to 5 free Medicare services from allied health professionals in a calendar year with a referral from a GP. This includes services from audiologists and speech pathologists.
In 2022–23, audiologists provided around 1,600 follow-up services to 1,400 patients (AIHW 2024).
Australian Institute of Health and Welfare (AIHW) 2021. Tracking progress against the Implementation Plan goals for the Aboriginal and Torres Strait Islander Health Plan 2013–2023, AIHW, Australian Government. Viewed 28 September 2024.
AIHW 2024. Health checks and follow-ups for Aboriginal and Torres Strait Islander people, AIHW, Australian Government. Viewed 28 September 2024.
Department of Health and Aged Care n.d. Medicare Benefits Schedule - Item 715, Department of Health and Aged Care, Australian Government. Department of Health and Aged Care website. Viewed 30 September 2024.