Health checks and follow-ups for Aboriginal and Torres Strait Islander people

 Medicare Benefits Scheme (MBS) data

MBS data in this report were extracted by the AIHW from the MBS claim records data in the Australian Government Department of Health, Ageing and Disability’s Enterprise Data Warehouse.

MBS data were analysed according to the date that services were delivered, including only services for which an MBS benefit was paid, for services processed on or before 31 March 2025. It is possible for MBS data to change between releases of statistics due to the late lodgement of claims and adjustments to claims.

Table 1 lists the MBS items included in analyses for this report:

1. Item removed from MBS on 1 July 2021.

All people who received one of the health checks for First Nations people are assumed to be First Nations people.

The data include MBS items billed to Medicare by Aboriginal medical services, as well as by mainstream GPs and other health professionals.

These MBS items do not provide a complete picture of health checks or follow-‍up services provided to First Nations people. For example, First Nations people may receive similar care through other MBS items; through MBS items delivered in residential aged care; through health care providers who are not eligible to bill Medicare; or may have chosen to use private health insurance cover instead of Medicare.

The minimum time allowed between health checks is 9 months. People can therefore receive more than one health check in a year.

For follow-up items, there are limits on the number of services that can be billed to Medicare (up to 10 services per calendar year for one group of items, and up to 5 services per year for other groups).

Dashboard statistics

The dashboard presents statistics on the following measures:

Annual statistics

• The number of people who had a health check (participants).
• The proportion of the First Nations population who had a health check (uptake).
• The number of health check participants who had a follow-up and/or chronic disease management related service within 6 months of their health check (follow-up patients).
• The proportion of health check participants who had a follow-up and/or chronic disease management related service within 6 months of their health check (follow-up percentage).

Longitudinal statistics

• The number of people who had a health check over multiple years (cumulative participants).
• The proportion of the First Nations population who had a health check over multiple years (cumulative uptake).
• The average number of health checks that participants had over 5 years.
• The proportion of health check participants who had a previous health check within a defined timeframe (e.g. within 12, 15 or 18 months), or had no previous health checks.
• The rate of follow-up services and/or chronic disease management related services among health check participants (per 100), within 6 months of their health checks.
• The rate of follow-up services and/or chronic disease management related services among follow-up patients (per 100), within 6 months of their health checks.

Age groups

Statistics can be compared for various age groups, with more detailed age groups available for national data.

Individuals’ ages were determined based on the last day of each reference period (31 December for calendar years; 30 June for financial years), including longitudinal analyses pooling multiple years.

For analyses of health checks and of follow-up activity, age was calculated based on the reference period in which the health checks were delivered.

Geographic information

Statistics can be compared for various geographic levels. Most of these are part of the Australian Statistical Geography Standard (ASGS) Edition 3, other than the Primary Health Network (PHN) regions (2023 boundaries) and Local Government Areas (LGA) (2024 boundaries).

MBS data were corresponded from individuals’ Medicare enrolment postcode (from mailing address). Where postcodes fell across the boundaries of multiple areas (for example, multiple SA4s), data were apportioned based on the distribution of the First Nations population, according to AIHW analysis of Australian Bureau of Statistics (ABS) population estimates at 30 June 2021. Records with invalid postcode information could not be assigned to sub-national areas.

For analyses of health checks and of follow-up activity, postcode information from the last health check in the reference period was used for determining geographic location.

Cautionary notes:

• Where postcodes overlap multiple reporting areas, the use of population-based correspondence methods can introduce errors, as it assumes the health check participants are spread in the same way as the population.
• The available postcode information may not always reflect where individuals actually lived – particularly for people who have changed residence or who direct mail to a PO box, business address or another household.

These issues are likely to have a generally greater impact on the accuracy of smaller geographic areas and more remote areas.

Populations

Aboriginal and Torres Strait Islander population data used for calculating uptake align with the final 2021 Census-based estimated resident populations, the 2021 Census-based ‘Medium series’ projections and the 2021 Census-based backcast population estimates from the Australian Bureau of Statistics (ABS 2011-to-2031).

Where possible, population data were sourced from the ABS. For certain geographic levels, the AIHW undertook iterative proportional fitting to derive suitable population estimates (Remoteness Areas, Indigenous Regions, PHN regions, GCCSAs, SA4s, SA3s, LGAs).

Where necessary, the AIHW approximated population estimates for 31 December using the average (mean) of 30 June estimates for consecutive years.

Other methodological notes

Uptake calculations

• Uptake proportions were calculated by dividing the number of unique health check participants in the year ending 30 June or 31 December by the estimated First Nations population on the respective date.
  • End-of-year population estimates were used, rather than mid-year estimates, as they best represent the number of individuals 'at risk' of receiving a health check. Mid-year estimates are typically used for calculating true rates (e.g. events per person-year), where the relevant denominator reflects time spent at risk, not just the number of people.

Cumulative uptake

• Cumulative uptake proportions were calculated by dividing the number of unique health check participants in the reference period by the estimated First Nations population on the last day of the reference period.
• State or territory of residence was based on information from the most recent health check in the reference period. Participants may have received earlier health checks in a different state or territory.
• Some participants may have died or moved abroad. Therefore, proportions of the population may be overestimated. This would mainly impact the oldest age group. Children under 5 years old also skew results, since they may have been born partway through the reference period.

Average number of health checks over 5 years

• These analyses were calculated by dividing the number of health checks by the number of health check participants in the reference period.
• State or territory of residence was based on information from the most recent health check in the reference period. Participants may have received earlier health checks in a different state or territory.

Time between health checks

• These analyses relate to the length of time between individuals’ most recent health check in a given year and their previous most recent health check, if any, back to November 1999 (when health checks were first introduced for First Nations people aged 55 and over, under different MBS item numbers).
• Time intervals between health checks were calculated in terms of fully elapsed calendar months – where a calendar month has fully elapsed when the day's date returns to or surpasses the same-numbered day in consecutive months.
  • Health checks occurring less than n months apart are referred to as 'within n months' for brevity.
• Proportions use the group of patients who had at least one health check in the reference year as the denominator, and not the estimated First Nations population. Therefore, the proportions are specific to those who had health checks in the reference year, and do not reflect the time between health checks for the entire First Nations population.

Follow-up analyses

• To improve the timeliness of follow-up statistics, the follow-up window was reduced to 6 months (from 12 months, in previous editions of this report), and preliminary results for the latest year have been calculated based on health check participants from January to June.
• If a person has more than one health check in a given year, they are considered to have received a follow-up service if at least one occurred within 6 months following either health check.
• For rates of follow-up services per 100 health check participants or follow-up patients (longitudinal statistics), follow-up services were only counted following participants’ last health check in each year. This was to improve comparability between final estimates and preliminary estimates.
• For rates of follow-up services per 100 follow-up patients (longitudinal statistics), the denominators are specific to the group of MBS items selected.

Suppression of statistics

Suppression has been applied to protect individual confidentiality in areas, where services are rendered by a few providers or rendered to a few patients; or services are heavily dominated by a few providers.

Additionally, areas are suppressed if the geographic correspondence is understood to be too poor, or the relevant population is fewer than 100.

References

ABS (Australian Bureau of Statistics) (2011-to-2031), Estimates and projections, Australian Aboriginal and Torres Strait Islander population, ABS Website, accessed 4 August 2025.