Overview
Aboriginal and Torres Strait Islander people can receive an annual health check, designed specifically for Indigenous Australians and funded through Medicare (Department of Health 2021). This Indigenous‑specific health check was introduced in recognition that Indigenous Australians, as a group, experience some particular health risks.
The aim of the Indigenous‑specific health check is to encourage early detection and treatment of common conditions that cause ill health and early death – for example, diabetes and heart disease.
During the health check, a doctor – or a multidisciplinary team led by a doctor – will assess a person’s physical, psychological and social wellbeing (Department of Health 2021). The doctor can then provide the person with information, advice, and care to maintain and improve their health.
The doctor may also refer the person to other health care professionals for follow‑up care, as needed – for example, physiotherapists, podiatrists or dietitians.
As part of the Australian Government’s COVID‑19 response, temporary telehealth items were introduced in March 2020 to help reduce the risk of community transmission of COVID‑19 and provide protection for patients and health care providers (Department of Health 2020).
This report presents information on the use of:
- health checks provided under the Indigenous‑specific Medicare Benefits Schedule (MBS) items 715, 228, 93470 and 93479; and
- follow‑up services provided under Indigenous‑specific MBS items 10987, 81300–81360, 93546–93558, 93571–93573 and 93579–93591;
as well as telehealth:
- health checks provided under the Indigenous‑specific Medicare Benefits Schedule (MBS) items 92004, 92016, 92011 and 92023; and
- follow‑up services provided under Indigenous‑specific MBS items 93200, 93202, 93048, 93061, 93592 and 93593.
The data include all Indigenous‑specific health checks and follow‑ups billed to Medicare by Aboriginal Community Controlled Health services or other Indigenous health services, as well as by mainstream GPs and other health professionals.
Note that the data are limited to Indigenous‑specific MBS items, and do not provide a complete picture of health checks and follow‑ups provided to Indigenous Australians. For example, Indigenous Australians may receive similar care through other MBS items (that is, items that are not specific to Indigenous Australians), or through a health care provider who is not eligible to bill Medicare (see also Data sources and notes). These have not been included in this report.
Throughout the report, ‘Indigenous‑specific health checks’ is used interchangeably with ‘health checks’ to assist readability. Similarly, ‘Indigenous‑specific follow‑up services’ is used interchangeably with ‘follow‑ups’.
This report differs from the previous edition, due to: new 2020–21 data; the introduction of new MBS items for Indigenous‑specific health checks delivered in Residential Aged Care Facilities (RACF); new Greater Capital City Statistical Areas (GCCSA) level analysis; and refinement of the analysis of time between consecutive health checks (see Data sources and notes).
The health check rate dropped for a second year in a row
27.2% of Indigenous Australians (about 237,000 people) had an Indigenous‑specific health check in 2020–21, compared with 28.0% in 2019–20 (239,000 people) and the peak rate of 28.8% in 2018–19 (241,000 people).
Older age groups had the highest rates
In 2020–21, Indigenous Australians aged 65 and over had the highest rate of Indigenous‑specific health checks, at 40% of the population. The age group with the lowest rate of health checks was 15–24 year-olds, at 22%.
More females than males had health checks
In 2020–21, Indigenous females had higher rates of health checks than males, overall (29% and 25%, respectively), and had substantially higher rates than males among people aged 15–34.
Health check rates differ vastly between areas
In 2020–21, the area with the highest rate of health checks was Townsville (SA3), at 54% of the Indigenous population. At the low end, less than 5% of the Indigenous population had a health check in some areas, such as Pittwater (SA3) in Sydney and Boroondara (SA3) in Melbourne.
Over half the Indigenous population had a health check in 5 years
Over the 5‑year period from 1 July 2016 to 30 June 2021, about 553,000 Indigenous Australians received at least one health check. This is equivalent to over half (63%) of the projected Indigenous population at 30 June 2021.
People in more remote areas wait the longest between health checks
In 2020–21, the average Indigenous‑specific health check patient living in Very Remote areas had their previous health check 27 months earlier, compared with 22 months earlier among patients living in Major Cities.
Follow‑up services fell for the first time
Fewer Indigenous Australians received Indigenous‑specific follow‑up services in 2020–21 than in 2019–20 (154,000 people in 2020–21 compared with 164,000 people in 2019–20). The number of patients had increased in all previous years.
Most follow‑up care was delivered by an Aboriginal Health Practitioner or Practice Nurse
In 2020–21, the vast majority of Indigenous‑specific follow‑up services were delivered by an Aboriginal Health Practitioner or Practice Nurse (290,500 out of the total 358,000 services, or 81%), as opposed to an Allied Health professional (67,500 services).
More older people and females received follow‑up care after a health check
Among the patients who received an Indigenous health check in 2019–20, 47% received an Indigenous‑specific follow‑up service in the 12 months following their health check (112,000 out of 239,000 patients). Patients aged 65 and over had the highest rate of follow‑up, at 56%, and females had a higher rate of follow‑up than males in every adult age group.
Follow‑up rates among health check patients differ vastly between areas
Among the patients who received an Indigenous health check in 2019–20, those who lived in Brisbane Inner – West (SA3) had the highest rate of follow‑up care in the 12 months following their health check, at 76%. Some areas had follow‑up rates below 10%, such as Limestone Coast (SA3) and Wellington (SA3).
The annual follow‑up rate among health check patients stopped increasing
Looking at the Indigenous health check patients from 2010–11 to 2019–20, the proportion who received an Indigenous‑specific follow‑up service in the 12 months following their health check increased in every year until 2019–20, when the rate of follow‑up dropped very slightly (46.8% for 2018–19’s patients compared with 46.7% for 2019–20).
References
Department of Health (2020) Coronavirus (COVID‑19) – Telehealth items guide, Department of Health, Australian Government, accessed 22 February 2022.
Department of Health (2021) Annual health checks for Aboriginal and Torres Strait Islander people, Department of Health, Australian Government, accessed 3 June 2022.