Geographic variation

Figure 10 shows the number and proportion of Aboriginal and Torres Strait Islander people who received an Indigenous-specific follow-up within 12 months of a health check, by four different geographic classifications—state/territory, remoteness area, Primary Health Network (PHN), and Statistical Areas Level 3 (SA3s).

This analysis is based on the postcode of the patient’s mailing address. As a result, the data may not reflect where the person actually lived—particularly for people who use PO Box addresses. This is likely to impact some areas more than others, and will also have a greater impact on the SA3 data than the larger geographic classifications. See Data sources and notes for information on areas most likely to be affected.

Among Aboriginal and Torres Strait Islander people who had an Indigenous-specific health check in 2016–17:

  • across states and territories, the follow-up rate varied from 12% in the Australian Capital Territory to 55% in the Northern territory
  • across PHNs, the follow-up rate varied from 12% in the Australian Capital Territory to 68% in Brisbane North
  • across remoteness areas, the follow-up rate ranged between 37% and 40% in non-remote areas, and between 43% and 46% in remote areas.
  • across 234 SA3s for which follow-up rates could be reported, the follow-up rate ranged from 7% to 81% . Of these SA3s, 61% (143 areas) had a rate below the national average (that is, less than 39.9%). 

Figure 10 Alternative text. Download data tables.

Reasons for variation between regions could be partly related to variation in the general health and need for follow-up care among different population groups (see also Box 3). However, there are likely also other contributing factors.

Research indicates that a broad range of factors can limit the use of Indigenous-specific follow-up services, such as a practitioners’ lack of awareness of item numbers; staffing issues; ineffective use of clinical information systems (e.g. for patient recall and reminders); communication and transport challenges for patients; and billing against non-Indigenous-specific items (Bailie et al. 2014). Also, some types of follow-up care cannot be billed to Medicare. For example, group services may offer increased cultural safety and improve the likelihood of patients attending follow-up care; however, patients cannot access rebates for some allied health services provided in a group setting (Department of Health 2018).