Service gap areas
This section focuses on the IARE-level estimates of the number and percentage of Aboriginal and Torres Strait Islander people who live inside/outside a 1-hour drive to a particular service type. Following the AIHW’s previous work, a cut-off point of 200 people in an IARE who are outside a 1-hour drive was used to define a service gap area.[1]
Table 6.3 shows that, of the 412 IAREs (Indigenous Areas) included in the analysis, there are 183 (34%) where everyone lives within a 1-hour drive to an IAHP-funded ACCHO, and 123 where between 1 and 199 people live outside a 1-hour drive (30%); there are 106 service gap areas where 200 or more people live outside a 1-hour drive (36%). Of these service gap areas, 25 are IAREs with more than 1,000 people who live outside a 1-hour drive to an IAHP-funded ACCHO.
Number of Aboriginal and Torres Strait Islander people in the IARE outside a 1-hour drive | Primary care service type: | Primary care service type: | Primary care service type: | Primary care service type: |
|---|---|---|---|---|
0 | 183 | 206 | 241 | 273 |
1–49 | 76 | 94 | 83 | 104 |
50–99 | 30 | 32 | 4 | 10 |
100–199 | 17 | 20 | 9 | 11 |
Subtotal IAREs with <200 people outside a 1-hour drive | 306 | 352 | 337 | 398 |
200–299 | 21 | 14 | 10 | 4 |
300–399 | 17 | 9 | 7 | 4 |
400–499 | 8 | 3 | 9 | 1 |
500–599 | 10 | 6 | 12 | 2 |
600–699 | 8 | 6 | 5 | 1 |
700–799 | 7 | 3 | 6 | — |
800–899 | 8 | 5 | 3 | 1 |
900–999 | 2 | 1 | 2 | — |
1000–1999 | 16 | 8 | 13 | — |
2000–2999 | 8 | 4 | 7 | 1 |
3000–3200 | 1 | 1 | 1 | — |
Subtotal IAREs with 200+ people outside a 1-hour drive (service gap areas) | 106 | 60 | 75 | 14 |
Total IAREs | 412 | 412 | 412 | 412 |
Note: One IARE has more than 3,000 Aboriginal and Torres Strait Islander people living outside a 1-hour drive to an IAHP-funded ACCHO or any IAHP-funded service. That is a different IARE to the one with over 3,000 Aboriginal and Torres Strait Islander people living outside a 1-hour drive to a mainstream GP.
Sources: Service locations for the IAHP-funded services are from the 2022–23 OSR data collection and include only those with declared primary health functions (excluding sites providing only maternal and child health services). Mainstream GP locations are from the NHSD, excluding sites also in the OSR. For more details see Appendix 1.
When the broader category of all IAHP-funded services is considered, there are a smaller number of service gap areas – 60 (15% of all) IAREs have more than 200 people who live outside a 1-hour drive to an IAHP-funded service, with 13 of those having more than 1,000 people outside a 1-hourr drive.
There are 75 IAREs (18%) where more than 200 people live outside a 1-hour drive to a mainstream GP, including 21 IAREs with more than 1,000 residents outside a 1-hour drive.[2] The number of IAREs where more than 200 people live outside a 1-hour drive to any of the included services is considerably smaller – 14, or 3.4% of IAREs.
Table 6.3 highlighted the service gap areas for each individual type of primary care service, but a single IARE can appear in all columns. When the unit of analysis is the IARE, there are 131 IAREs where an estimated 200 or more Aboriginal and Torres Strait Islander people live outside a 1-hour drive to at least one of the included service types. These are the service gap IAREs.
Distribution of the 131 service gap IAREs
Remoteness
There is a strong association between remoteness and being classified as a service gap area. Over half of all the 131 service gap areas were Very remote IAREs (74 IAREs, 57%), and those 74 service gap areas represent 78% of all Very remote IAREs (Table 6.4).
Remoteness area | Number of service gap IAREs | % total service gap IAREs | Total number of IAREs in remoteness category | % IAREs in that remoteness category that are service gap IAREs |
|---|---|---|---|---|
Major cities | 1(b) | 0.8 | 107 | 0.9 |
Inner regional | 16 | 12.2 | 87 | 18.4 |
Outer regional | 25 | 19.1 | 95 | 26.3 |
Remote | 15 | 11.5 | 28 | 53.6 |
Very remote | 74 | 56.5 | 95 | 77.9 |
Total | 131 | 100.0 | 412 | 31.8 |
- Service gap areas are defined as IAREs where 200 or more Aboriginal and Torres Strait Islander people live outside a 1-hour drive to the selected service.
- Snowy-Monaro. While the majority (≈60%) of the Aboriginal and Torres Strait Islander population live in Major cities SA1s, the service gap populations live in Inner and Outer regional areas.
Sources: Service locations for the IAHP-funded services are from the 2022–23 OSR data collection and include only those with declared primary health functions (excluding sites only providing maternal and child health services). Mainstream GP locations are from the NHSD, excluding sites also in the OSR. For more details see Appendix 1.
While the next largest number of service gap areas are Outer regional (25) and Inner regional (16), they make up a much smaller proportion of all IAREs in those remoteness classifications (26% and 18%, respectively).
State/territory
Both the largest number of service gap areas and the highest proportion of all IAREs in the jurisdiction are in the Northern Territory, where 41 of the 62 IAREs (66%) are service gap areas, followed by Queensland (with 30 service gap areas, 35% of all IAREs) and Western Australia (with 25 service gap areas, 36% of all IAREs) (Table 6.5). These results are related to the remoteness distributions within these states/territories.
State/territory | Number of service gap IAREs | % total service gap IAREs | Total number of IAREs in state/territory | % IAREs in that state/territory that are |
|---|---|---|---|---|
NSW | 20 | 15.3 | 107 | 18.7 |
VIC | 2 | 1.5 | 39 | 5.1 |
Qld | 30 | 22.9 | 85 | 35.3 |
WA | 25 | 19.1 | 69 | 36.2 |
SA | 10 | 7.6 | 32 | 31.3 |
Tas | 3 | 2.3 | 11 | 27.3 |
ACT | — | — | 3 | — |
NT | 41 | 31.3 | 62 | 66.1 |
Other territories | — | — | 4 | — |
Total | 131 | 100.0 | 412 | 31.8 |
- Service gap areas are defined as IAREs where 200 or more Aboriginal and Torres Strait Islander people live outside a 1-hour drive to the selected service.
Sources: Service locations for the IAHP-funded services are from the 2022–23 OSR data collection and include only those with declared primary health functions (excluding sites providing only maternal and child health services). Mainstream GP locations are from the NHSD, excluding sites also in the OSR. For more details see Appendix 1.
Number/type of service gaps
As indicated previously, an IARE is classified as a service gap area if 200 or more Aboriginal and Torres Strait Islander people live more than a 1-hour drive to at least one of the included primary care services. From a policy perspective, it is important to further group the 131 IAREs by the number and types of service gaps. For example, having access to no primary care service at all is different from having access to at least one type of service (acknowledging that it may not be people’s preferred service).
Table 6.6 presents the distribution of the service gap IAREs by the number and type of service gaps and also how they are distributed across remoteness areas.
Table 6.6: Distribution of the 131 service gap IAREs(a), by the number/types of gaps they have and remoteness
Table 6.6 shows that there are:
- 12 IAREs that are service gap areas only for IAHP-funded ACCHOs (that is, there is no service gap for IAHP-funded services or mainstream GPs). Ten of those are in regional areas and 2 in Very remote areas
- 44 IAREs that are service gap areas for IAHP-funded ACCHOs and for any IAHP-funded service (there is no service gap for mainstream GPs). One of those is a Major city,[3] 30 are regional areas, and 13 are Remote/Very remote areas
- 34 IAREs that are service gap areas for IAHP-funded ACCHOs and for mainstream GPs (but not for other IAHP-funded services). Six are Remote and 28 are Very remote areas
- 2 IAREs that are service gap areas for IAHP-funded ACCHOs, any IAHP-funded service, and for mainstream GPs. Because of the locations of the individual services and distribution of the population within the IARE, fewer than 200 people live outside a 1-hour drive to any type of service. Both are Very remote areas
- 14 IAREs that are service gap areas across all categories – that is, at least 200 Aboriginal and Torres Strait Islander people in those IAREs live outside a 1-hour drive to any included primary health service. All but one are Very remote areas (the other is an outer regional area in New South Wales)
- 25 IAREs that are service gap areas only for mainstream GPs. Two of these are Remote areas and 23 are Very remote areas (that is, they are not service gap areas for IAHP-funded ACCHOs/other IAHP-funded services).
More detailed information on each of the 131 service gap IAREs is presented in Table 6.7. Each row includes:
- identifying information about the IARE (state/territory, remoteness, IREG, IARE name)
- an indication of whether the IARE is a service gap area for each type of included service (Yes/No). Service gaps are highlighted in yellow
- the number of Aboriginal and Torres Strait Islander people outside a 1-hour drive to the service type.[4]
The table has an internal ordering following the categories in Table 6.6, beginning with the 12 IAREs that have been identified as service gap areas for IAHP-funded ACCHOs only. Within each of the groupings, the rows are sorted by the number of Aboriginal and Torres Strait Islander people outside a 1-hour drive to an IAHP-funded ACCHO.[5], [6]
More information on each individual IARE can be found using the AIHW’s Regional Insights for Indigenous Communities website.
Table 6.7 shows that:
- the IARE with the highest number of Aboriginal and Torres Strait Islander people outside a 1-hour drive to an IAHP-funded ACCHO is Central Capricorn, an Outer regional area in the Rockhampton IREG in Queensland. All 3,062 people in the IARE live outside a 1-hour drive to an IAHP-funded ACCHO and to any IAHP-funded service. An estimated 11 people live outside a 1-hour drive to a mainstream GP, so it is not classified as a service gap area for mainstream GPs or for access to any included primary care service (Row 13)
- Kaiwalagal – Inner Islands, a Very remote IARE within the Torres Strait IREG in Queensland, has the second highest number of Aboriginal and Torres Strait Islander people outside a 1-hour drive to an IAHP-funded ACCHO (all 2,926 of the local population, who also live outside a 1-hour drive to a mainstream GP). Nearly everyone, however, lives within a 1-hour drive to an IAHP-funded service, so the area is not classified as a service gap area for IAHP-funded services or for any included service (Row 57)
- Ramingining – Milingimbi and Outstations, a Very remote IARE within the Nhulunbuy IREG in the Northern Territory, has an estimated population of 2,278 Aboriginal and Torres Strait Islander people. Looking across the row shows that no-one lives within a 1-hour drive of any of the included service types – IAHP-funded ACCHO, any IAHP‑funded service, or mainstream GP (Row 93).
Table 6.7: Indigenous Areas (IAREs) with at least 200 Aboriginal and Torres Strait Islander people who live more than a 60-minute drive from at least one type of selected primary care service (service gap area) (n=131)
See 
PDF publication pp. 86-92.
Notes:
- Tables with results for each area for each of the 4 service types (IAHP-funded ACCHO, all IAHP-funded services, mainstream GPs, and any primary care service) are available at Data. They can be used to identify areas with people outside a 30-minute drive to each service type and/or to identify IAREs with fewer than 200 people outside a 1-hour drive. Shorter drive times (15 minutes) are available in the dashboard.
- Some of the IAREs may have access to an IAHP-funded ACCHO or other IAHP-funded service.
- As noted in Table 6.4, while the majority (≈60%) of the Aboriginal and Torres Strait Islander population within the IARE lives in Major cities SA1s, the service gap populations live in Inner and Outer regional areas.
- <10 is used for IAREs where the estimated number of Aboriginal and Torres Strait Islander people outside a 1-hour drive is between 1 and 9.
- Except for the final grouping, where IAREs have been sorted by the number of people outside a 1-hour drive to a mainstream GP.
- The same information is presented separately for each state/territory in Appendix 2, tables A2.23 to A2.29.