Project overview

This project brings together Aboriginal and Torres Strait Islander people’s own lived experiences of primary health care use and unmet needs as reflected in national survey data with an analysis of the locations of primary health care services relative to where Aboriginal and Torres Strait Islander people live. The results can be used to identify geographic areas with service gaps, and subgroups within the population who have the highest levels of unmet need.

Specifically, data from the Australian Bureau of Statistics (ABS) 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) are used to explore factors associated with Aboriginal and Torres Strait Islander people’s access to, preferences for, use of, and unmet need for, primary health care. The selection of the variables for the analysis was based on a conceptual framework and literature review, and includes:

  • 10 national measures of primary health care availability, use and unmet needs. These measures were disaggregated by a set of independent variables from 4 domains: location/demographic factors, socioeconomic and social capital factors, cultural identity and experiences of racism/discrimination, and health/disability status
  • 5 questions on people’s experiences of primary health care, asked only of those in non-remote areas.

The spatial analysis uses 2022–23 data from the Online Services Report (OSR) collection on the service locations of Aboriginal and Torres Strait Islander specific primary health care organisations[1] – including 326 services/clinics provided by Aboriginal Community Controlled Organisations (ACCHOs), 120 service delivery sites funded by the Indigenous Australians’ Health Programme (IAHP) but provided by government or non-government (NGO) organisations, and 2024 data on the practice locations of 7,192 mainstream GPs from the National Health Services Directory (NHSD) – to calculate drive times to the included primary health care services.

The results are used to identify Indigenous Areas (IAREs)[2] where at least 200 Aboriginal and Torres Strait Islander people live more than a 1-hour drive to a primary health care service (service gap areas).[3] It is important to note that this is a baseline measure of access and captures only whether there is a service within that drive time – it does not take the current capacity of the practice to serve patients or the cultural safety of the services into account. It also does not reflect whether individuals have the resources to be able to travel to the locations.

The 2 streams of work (that is, the NATSIHS analysis and spatial analysis) were conducted separately, with the results brought together at the end to look at how people’s perceptions of service availability in their local area matched with the drive time analysis.

Notes:

  1. Aboriginal and Torres Strait Islander specific primary health care organisations receive funding from the Australian Government through the IAHP to provide comprehensive and culturally safe care to Aboriginal and Torres Strait Islander clients. The majority of these organisations are managed by ACCHOs. Only ACCHOs that receive IAHP funding are included in the analysis as those that do not receive the funding are not required to report to the OSR.
  2. IAREs are medium-sized geographic areas built from whole Indigenous Locations. They are designed for the release and analysis of more detailed statistics for Aboriginal and Torres Strait Islander people. Whole IAREs aggregate to form Indigenous Regions (ABS 2021).
  3. This includes drive times to particular service types as well as to any primary health care service.
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