Goal 4: Indigenous-specific health checks—children aged 0–4

This indicator reports on the rate of Indigenous-specific Medicare Benefits Schedule (MBS) health checks among Aboriginal and Torres Strait Islander children aged 0–4. The goal for this indicator is 69% by 2023.

Why is it important?

All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check, subsidised through Medicare. These checks can be received for free at Aboriginal Medical Services and bulk billing clinics. The Indigenous-specific health checks were introduced in recognition that Indigenous Australians, as a group, experience some particular health risks. The aim of the Indigenous-specific health checks is to encourage early detection and treatment of common conditions that cause ill health and early death—for example, diabetes and heart disease (AIHW 2019).

What data are available?

The following Indigenous-specific health checks are listed on the MBS:

  • MBS item 715: available from 1 May 2010, provided by general practitioners (GPs)
  • MBS item 228: available from 1 July 2018, provided by non-vocationally recognised medical practitioners (non-VR MPs).

In response to the COVID-19 pandemic, temporary telehealth items for Indigenous-specific health checks have been made available from March 2020 (through to March 2021):

  • Health checks provided via videoconference: MBS item 92004 (provided by GPs) and MBS item 92011 (provided by non-VR MPs)
  • Health checks provided via teleconference (when videoconferencing is not available): MBS item 92016 (provided by general practitioners) and MBS item 92023 (provided by non-VR MPs).

While many of the required components of an Indigenous-specific health check can be completed as a remote service via telehealth, some components can only be delivered through face-to-face consultation with the patient. This could include any necessary physical examinations such as a blood pressure check. For an Indigenous health check undertaken by telehealth to be processed via Medicare, all components of the health check, including both remotely delivered and face-to-face, must be completed (Health 2020a).

Administrative data are available on the number of health checks for which a claim has been processed by Services Australia.

What do the data show?

Progress towards the goal is not on track.

  • The rate of Indigenous-specific health checks among Aboriginal and Torres Strait Islander children increased over time from 26% in 2014–15 to 30% in 2017–18. However, the rate stabilised at around 29–30% in recent years from 2016–17 to 2018–19.
  • The rates from 2014–15 to 2019–20 were all below the trajectory points required to meet the goal by 2023.
  • The rate fell from 29% in 2018–19 to 27% in 2019–20. This decrease is likely to reflect changes in behaviour due to measures introduced in early 2020 to reduce the spread of COVID-19.
  • However, as the rates for the 5 time periods before the COVID-19 pandemic (2014–15 to 2018–19) were all below the trajectory points required, the status of the goal has not been changed by this decrease. For more information on the impacts of the COVID-19 pandemic on the provision of Indigenous-specific health checks, see Impacts of COVID-19 on Indigenous-specific health checks.

In 2019–20, 26,240 health checks were provided for Indigenous children aged 0–4, corresponding to a rate of 27%. The rate of health checks among Indigenous children aged 0–4 varied by jurisdiction—ranging from 10% in Tasmania to 42% in the Northern Territory in 2019–20.

Health checks delivered by Aboriginal Community Controlled Health Services

Indigenous Australians may access Indigenous-specific health checks at mainstream or Indigenous-specific primary health care services. These health checks are available through community clinics, Aboriginal Community Controlled Health Services (ACCHSs) and other health care facilities.

The Indigenous primary health care national Key Performance Indicators (nKPIs) data collection provides information on primary health care organisations that receive funding from the Department of Health to provide primary health care services mainly to Aboriginal and Torres Strait Islander people.

Data from the national Key Performance Indicator (nKPI) data collection can be used, together with MBS data, to estimate the proportion of health checks delivered by ACCHSs.

In 2018–19, among Indigenous Australians aged 0–4:

  • an estimated 47% of MBS 715 health checks were delivered by ACCHSs
  • the proportion of health checks that were delivered by ACCHSs was highest in South Australia and Victoria/Tasmania (both 65%) and lowest in New South Wales/the Australian Capital Territory (39%).

It is important to note that these proportions underestimate the true proportion as the nKPI data collection only captures regular clients who received a health check at ACCHSs. Additionally, not all health checks performed at ACCHSs are claimed through the MBS and have therefore not been captured in these estimates. Services provided by ACCHSs who did not provide information to the nKPI data collection were also not included.

The estimated proportion of health checks provided by ACCHSs is high when compared with workforce size. In 2018–19, there were around 500 full-time equivalent (FTE) GPs employed in ACCHSs (AIHW 2020). This represented roughly 1.8% of the total FTE GP workforce (based on about 28,400 total GP FTEs, using data from the National Health Workforce Dataset for 2018) (Health 2020b).

For more information, refer to the accompanying data tables.

Sources: AIHW analysis of Indigenous primary health care nKPI data and Medicare Benefits Schedule data.

Figure 4.1: Rate of Indigenous-specific MBS health checks for Aboriginal and Torres Strait Islander children aged 0–4

This figure shows the baseline data from 2006–07 to 2013–14, trajectory to the goal from 2014–15 to 2022–23. New data from 2014–15 to 2019–20 for the proportion of Indigenous Australians aged 0–4 who attended a MBS health check are also plotted. The rate was trending upwards up until 2017–18. The rate fell from 29.1% in 2018–19 to 27.1% 2019–20, which is likely to reflect changes in service use due to COVID-19.

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Figure 4.2: Rate of Indigenous-specific MBS health checks for Aboriginal and Torres Strait Islander children aged 0–4, by state and territory and sex, 2019–20

The figure shows the rate of MBS health checks among Indigenous Australians aged 0–4, by jurisdiction and sex. The highest rates are in the Northern Territory (41.6% of males, 42.2% of females). The largest difference across sexes is in the Australian Capital Territory (17.7% of males and 12.9% of females).

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Figure 4.3: Proportion of Indigenous-specific MBS health checks (MBS item 715) for Aboriginal and Torres Strait Islander children aged 0–4, by type of service provider and state/territory, 2018–19

The figure shows the proportion of MBS 715 health checks that took place, by type of service provider. South Australia had the highest rate of services provided by Aboriginal Community Controlled Health Services (65%). New South Wales/the Australian Capital Territory had the lowest rate of services provided by Aboriginal Community Controlled Health Services (39.3%).

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References

AIHW (Australian Institute of Health and Welfare) 2019. Indigenous health checks and follow-ups. Cat. no. IHW 209. Canberra: AIHW. Viewed 15 October 2020.

AIHW 2020. Aboriginal and Torres Strait Islander-specific primary health care: results from the OSR and nKPI collections. Cat. no. IHW 227. Canberra: AIHW. Viewed 27 October 2020.

Health (Department of Health) 2020a. Coronavirus (COVID-19) – Telehealth items guide. Canberra: DoH. Viewed 15 October 2020.

Health 2020b. Health Workforce Data. Viewed 27 October 2020.