Indigenous health checks and follow-ups

Figure 4 shows the rate of Indigenous‑‍specific health checks in 2020–‍21, by 6 different geographic classifications – state/territory, Greater Capital City Statistical Areas (GCCSA), remoteness area, Primary Health Network (PHN), Indigenous Regions (IREG) and Statistical Areas Level 3 (SA3). See Box 2 for information about the reporting of geographic data.

In 2020–‍21:

• Across states and territories, Queensland had the highest rate of Indigenous‑‍specific health checks (with 34% of the Aboriginal and Torres Strait Islander population receiving an Indigenous health check), followed by the Northern Territory (32%). Victoria had the lowest rate (14%) (Figure 4).
• Among the capital cities, Greater Darwin and Greater Brisbane had the highest rates of Indigenous‑‍specific health checks (36% and 35%, respectively), while Greater Melbourne had the lowest rate (9%). Queensland, Tasmania and the Northern Territory had somewhat higher rates of health checks in their capital city areas, relative to their ‘rest of state’ areas. The other states had health check rates that were higher in the ‘rest of state’ areas compared with their capital cities – particularly, in Victoria and New South Wales (Figure 4).
• Across PHNs, the rate of Indigenous‑‍specific health checks ranged from 5% (in Northern Sydney) to 36% (in both Western New South Wales and Brisbane North) (Figure 4).

Figure 4: Indigenous‑‍specific health check rates by geography and telehealth status, 2020–‍21

Across the 5 remoteness areas, the rate of Indigenous‑‍specific health checks in 2020–‍21 was generally higher in more remote areas – increasing from 24% in Major cities to 33% in Outer regional and Remote areas. Very remote areas were the exception to this general pattern, with a rate of 25% (Figure 4). This may be partly due to the use of mailing address to derive these rates – in particular, where a person lives in a Very remote area, but has mail delivered to a PO Box in a less remote location, the health check will be counted in the less remote location. Another explanatory factor would be the availability of GPs in more remote areas (RACGP 2020).

Across Indigenous Regions, the rate of Indigenous‑‍specific health checks was highest in Alice Springs (52%) and lowest in Melbourne (10%) (Figure 4). Note that the rate in Alice Springs is likely to be inflated, since many residents of Central Australia use PO Boxes located in Alice Springs for receiving mail. This means some of the health checks counted in Alice Springs probably belong to residents of Apatula (IREG).

Across SA3s, the rate of Indigenous‑‍specific health checks in 2020–‍21 ranged from 2% in Pittwater (NSW) to 54% in Townsville (Qld) (Figure 4; analysis relates to 329 areas for which rates could be reported).

On average, the rate of Indigenous‑‍specific health checks was higher in SA3s with larger Indigenous populations. For example, the rate of health checks, when averaged across the SA3s in 2020–‍21, was:

• 14% in SA3s with fewer than 1,000 Indigenous Australians (113 SA3s)
• 24% in SA3s with between 1,000 and 4,999 Indigenous Australians (174 SA3s)
• 32% in SA3s with 5,000 or more Indigenous Australians (42 SA3s).

In 2020–‍21, about 7 in 10 SA3s (71%, or 235 areas) had a rate below the national average (that is, a rate lower than 27.2%). This is because SA3s with larger populations – which tended to have higher rates of health checks – contribute more to the national rate than the smaller SA3s.

Breaking down the rates of Indigenous‑‍specific health checks by state/territory and age groups reveals some noteworthy differences between the jurisdictions (Figure 5).

Indigenous Australians aged 55 and over have the highest rates of health checks in all jurisdictions except the Northern Territory, where young children (aged 0–‍4) have the highest rate. Tasmania has a higher overall rate of Indigenous health checks than Victoria, predominantly due to differences in the oldest age groups (25–‍54 and ‘55 and over’) (Figure 5).

Figure 5: Indigenous‑‍specific health check rates by State or Territory, age group and telehealth status, 2020–‍21

As a proportion of all patients who received an Indigenous‑‍specific health check in 2020–‍21, around 5% had a health check completed at least partly via telehealth (12,000 out of 237,000 patients). There was considerable variation between areas though, with relatively high proportions of telehealth use in Greater Adelaide (16%), Greater Melbourne (14%), Greater Sydney (11%) and the Rest of Victoria (10%), contrasting with very low proportions in Greater Perth (1.2%), the Rest of Western Australia (1.5%), the Australian Capital Territory (1.7%) and Greater Darwin (1.9%) (Figure 6).

Figure 6: Proportion of Indigenous‑specific health check patients who received a health check via telehealth, by Greater Capital City Statistical Areas, 2020–‍21