Primary care use indicators

Data from the MBS, OSR and the 2018–19 NATSIHS highlight different aspects of recent primary care use among Aboriginal and Torres Strait Islander people.

General practice items

The most recent available MBS VII data show that, in 2021–22, there were:

  • 5.2 million non-referred (GP) attendances claimed by Aboriginal and Torres Strait Islander people (at an average of 7.2 per person in the 12 months). Non-referred (GP) attendances include everything from providing health advice; diagnosing medical conditions; ordering tests or following up on test results, repeat or new prescriptions; and managing acute issues. Both the overall number of non-referred attendances and the average number per person have increased steadily since 2016–17 (when there were 4.5 million claims at an average of 6.8 per person)
  • around 81,000 Chronic Disease Management Plans[1] and 69,000 Team Care Arrangements (TCAs)[2] prepared for Aboriginal and Torres Strait Islander people (Productivity Commission 2024).

As noted above, there are also Aboriginal and Torres Strait Islander-specific MBS items (that do not require VII adjustment). One of the key items is a specifically designed annual Medicare-funded health check, which supports engagement in comprehensive primary health care in a culturally safe way and is an opportunity to identify patients’ health goals and priorities, provide risk assessment and healthy lifestyle information and supports, and encourage early detection and treatment of common conditions that cause ill health and early death – for example, diabetes and heart disease (AIHW 2023b, 2024c; Butler et al. 2022; NACCHO/RACGP 2018).

The 2023 MBS data showed that:

  • 257,000 Aboriginal and Torres Strait Islander people (28% of the population) had a health check
  • 78,000 of those with a health check (31%) received a chronic disease management service. That proportion was strongly related to age, with 77% of patients aged 75 or older having a chronic disease management service in the same year, compared with 5.0% of patients aged 0–4 (AIHW 2024c).

Analysis of data from the nKPIs data collection suggest that GPs at ACCHOs conduct around 44% of all health checks despite making up only about 2.2% of full-time equivalent GPs.

Aboriginal and Torres Strait Islander specific PHCOs

The 2022–23 OSR included 213 Aboriginal and Torres Strait Islander specific PHCOs, which provided care to 413,789 Aboriginal and Torres Strait Islander clients. The majority of the clients (82%) received care from an ACCHO.

Client contacts can be used to highlight the amount of services received at the organisations as well as the multidisciplinary nature of the services. In 2022–23, the OSR indicated that the Aboriginal and Torres Strait Islander clients had around:

  • 1.5 million contacts with a GP
  • 1.5 million contacts with a nurse
  • 562,000 contacts with an Aboriginal Health Practitioner or Aboriginal Health Worker
  • 292,000 contacts with an Allied Health Worker
  • 242,000 contacts with a Social and Emotional Wellbeing (SEWB) Worker
  • 76,000 contacts with a midwife (AIHW 2024a).

Self-reported use

The NATSIHS data can be used to highlight the types of primary care services used by respondents, as well as whether or not they had a usual source of care. The data show that, in 2018–19:

  • nearly everyone (750,300 or 92% of Aboriginal and Torres Strait Islander people) had a usual source of care
  • 45% (368,000) of Aboriginal and Torres Strait Islander people had accessed some form of health care in the previous 2 weeks. In these 2 weeks, 23% (186,400) of Aboriginal and Torres Strait Islander people had consulted a GP, 22% (181,700) had consulted other health professionals, and 4.9% (38,000) of those aged 2 and over had seen a dentist
  • 86% (698,300) of Aboriginal and Torres Strait Islander people had seen a GP in the past 12 months, and 44% of Aboriginal and Torres Strait Islander people aged 2 and over (338,200) had seen a dentist in the past 12 months.

Notes:

  1. A Chronic Disease Management Plan can help people with chronic medical conditions by providing an organised approach to care. It is a plan of action agreed between a patient and their GP which identifies the patient’s health and care needs, sets out the services to be provided by the GP, and lists the actions the patient can take to help manage their condition.
  2. TCAs are for patients with complex care needs requiring multidisciplinary care, and need a GP to collaborate with at least 2 other health or care providers who will deliver ongoing treatment or services. TCAs provide access to Medicare-subsidised care from selected allied health care providers for individual treatment services. Eligible allied health services include Aboriginal and Torres Strait Islander health services, diabetes education services, audiology, exercise physiology, dietetics, mental health services, occupational therapy, physiotherapy, podiatry, chiropractic services, osteopathy, psychology and speech pathology.
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