This report uses a new measure developed by the Australian Institute of Health and Welfare—the Geographically-adjusted Index of Relative Supply (GIRS). This index is used to look at the geographic supply of the clinical health workforce in seven key professions with particular relevance to Indigenous Australians, and to identify areas in Australia that face particular supply challenges. The professions considered were general practitioners, nurses, midwives, pharmacists, dentists, psychologists and optometrists. The GIRS scores were compared with the distribution of the Indigenous population to assess the extent to which Indigenous people live in areas with lower relative levels of supply.
The GIRS was developed to overcome limitations in using relatively simple provider-to-population ratios to compare areas with vastly different geographic characteristics. The GIRS takes data on hours worked in clinical roles and on main practice location from the 2014 National Health Workforce Data Set; it then adjusts it for three other factors—land size, population dispersion, and drive time to services—to create a score ranging from 0 to 8 for each of the seven professions in each Statistical Area level 2 (SA2) in Australia. Areas with lower GIRS scores are more likely to face workforce supply challenges than those with higher GIRS scores.
The report’s findings are as follows:
- GIRS scores of 0 or 1 (most likely to face supply challenges) occur most often for midwives, optometrists and psychologists, and least often for nurses.
- Over 19,000 Aboriginal and Torres Strait Islander women of child-bearing age (15–44 years) live in 120 SA2s with a low relative supply of midwives.
- Over 85,000 Aboriginal and Torres Strait Islander people live in 56 SA2s with a low relative supply of optometrists.
- Over 76,000 Aboriginal and Torres Strait Islander people live in 49 SA2s with a low relative supply of psychologists.
- For each profession, a higher proportion of Aboriginal and Torres Strait Islander people than non-Indigenous people live in areas with lower GIRS scores.
- While relative supply challenges are more common in remoter parts of Australia, the findings show that there is considerable variation in regional and remote areas.
- There were 155 SA2s out of 2,091 (8%) with a GIRS score of 0–1 in at least one profession. Nearly 20% of Aboriginal and Torres Strait Islander people live in these areas, compared with 3% of the non-Indigenous population.
- Over 72,000 Aboriginal and Torres Strait Islander people live in the 39 SA2s where at least four of the seven professions (that is, over half the professions) have GIRS scores of 0 or 1. Over 30,000 of these people live in the 13 SA2s where at least six of the seven professions have GIRS scores of 0 or 1.
The GIRS is an important resource for policy discussions on improving the supply of health services. It has limitations, however. In particular, it does not take into account outreach services and the distribution of the workforce supply within SA2s is unknown. As well, it cannot take into account the adequacy of services, whether the services are financially or culturally accessible, or the extent to which they meet the needs of the populations within each area. Future work could build on the GIRS by including these other factors.