This indicator reports on the rate of Indigenous-specific Medicare Benefits Schedule (MBS) health checks among Aboriginal and Torres Strait Islander adults aged 25–54. The goal for this indicator is 63% 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 proportion of Aboriginal and Torres Strait Islander people aged 25–54 who received an Indigenous-specific health check increased over time from 25% in 2014–15 to 32% in 2018–19. However, in recent years, the rate has remained stable at around 31%.
- The rates in each of the 6 years from 2014–15 to 2019–20 were below the trajectory required to meet the goal for 2023. In 2019–20, the required trajectory point was 50%, compared with an actual rate of 31%.
- The rate in 2019–20 was similar to the previous 2 years. However, this period included the first 6 months of the COVID-19 pandemic (January to June 2020), corresponding with a drop in the number of health checks provided compared with the previous 6 month period (July to December 2019). For more information on the impacts of the COVID-19 pandemic on the provision of Indigenous health checks, see Impacts of COVID-19 on Indigenous-specific health checks.
In 2019–20, 90,586 health checks were provided for Indigenous adults aged 25–54. Indigenous females aged 25–54 were more likely than males of this age to have received a health check (36% compared with 27%).
The rate of health checks among Indigenous adults aged 25–54 varied by jurisdiction— ranging from 18% in Tasmania to 38% in Queensland.
Health checks delivered by Aboriginal Community Controlled Health Services
Indigenous Australians may access mainstream or Indigenous-specific primary health care services. They 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 2017–19, among Indigenous Australians aged 25–54:
- an estimated 48% of MBS 715 health checks were delivered by ACCHSs
- the proportion of health checks that were delivered by ACCHSs was highest in Western Australia (60%) and lowest in New South Wales/the Australian Capital Territory (36%).
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 as such have 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.