Geographic variation

Figure 15 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 5 different geographic classifications—state/territory, 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 2018–19:

  • Across states and territories, the follow-up rate varied from 16% in the Australian Capital Territory to 61% in the Northern Territory.
  • Across remoteness areas, the follow-up rate ranged between 45% and 46% in non-remote areas, and between 52% and 53% in remote areas.
  • Across PHNs, the follow-up rate varied from 16% in the Australian Capital Territory to 68% in Brisbane North.
  • Across IREGs, the follow-up rate ranged between 16% in the Australian Capital Territory and 76% in Alice Springs.
  • Across 306 SA3s for which follow-up rates could be reported, the follow-up rate ranged from 10% to 75%. Of these SA3s, 72% (219 areas) had a rate below the national average (that is, less than 46.8%).

Figure 15: Indigenous-specific health check patients in 2018–19 who received an Indigenous-specific follow-up service in the 12 months following the health check, by geographic area

Maps and bar graphs showing the number and proportion of Indigenous-specific health check patients in 2018–19 who had an Indigenous-specific follow-up within 12 months of their Indigenous-specific health check, by state and territory, remoteness, PHN, Indigenous Region, and SA3.

In 2018–19, across states and territories, the Northern Territory had the highest rate of Indigenous-specific follow-up (with 61% of the Indigenous population receiving an Indigenous-specific follow-up within 12 month of their Indigenous-specific health check), followed by Queensland (53%). Australian Capital Territory had the lowest rate (16%). PHNs, Indigenous Regions, and SA3s are coloured by ‘Metropolitan status’, which just distinguishes areas by how much of the population lived in Major Urban areas (cities of 100,000 or more) in 2016.

Refer to tables ‘FS05’ to ‘FS09’ in 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 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).