Indigenous health checks and follow-ups

Figure 16 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 6 different geographic classifications – state/territory, Greater Capital City Statistical Areas (GCCSA), remoteness area, Primary Health Network (PHN), Indigenous Region (IREG) and Statistical Areas Level 3 (SA3s). See Box 2 for more information about the geographic classifications.

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 generally greater impact on the SA3 data than the larger geographic classifications. See Box 5 in 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 2019–‍20:

• Across states and territories, the follow‑‍up rate varied from 17% in the Australian Capital Territory to 60% in the Northern Territory.
• Across GCCSAs, the follow‑‍up rate varied from 17% in the Australian Capital Territory to 64% in Greater Brisbane.
• Across remoteness areas, the follow‑‍up rate ranged between 44% and 46% in non-‍remote areas, and between 51% and 53% in remote areas.
• Across PHNs, the follow‑‍up rate varied from 17% in the Australian Capital Territory to 65% in Brisbane North.
• Across IREGs, the follow‑‍up rate ranged between 17% in the Australian Capital Territory and 73% in Alice Springs.
• Across 304 SA3s for which follow‑‍up rates could be reported, the follow‑‍up rate ranged from 8% to 76%. Of these SA3s, 66% (200 areas) had a rate below the national average (that is, less than 46.6%) (Figure 16).

Figure 16: Indigenous‑‍specific health check patients in 2019–‍20 who received an Indigenous‑‍specific follow‑‍up service in the 12 months following the health check, by geographic area

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 4). 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).

References

Bailie J, Schierhout GH, Kelaher MA, Laycock AF, Percival NA, O’Donoghue LR, McNeair TL, Chakraborty A, Beacham BD and Bailie RS (2014) ‘Follow‑up of Indigenous‑specific health assessments – a socioecological analysis’, Medical Journal of Australia, 200(11):653–‍657, doi:10.5694/mja13.00256.

Department of Health (2018) Report from the Aboriginal and Torres Strait Islander Health Reference Group, Department of Health, Australian Government.