This indicator reports on the rate of Indigenous-specific Medicare Benefits Schedule (MBS) health checks among Aboriginal and Torres Strait Islander people aged 55 and over. The goal for this indicator is 74% 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 2021a).
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.
In response to the COVID-19 pandemic, temporary telehealth items for Indigenous-specific health checks have been made available from March 2020:
- Health checks provided via videoconference: MBS item 92004 (provided by GPs) and MBS item 92011 (provided by non-vocationally recognised medical practitioners)
- Health checks provided via teleconference (when videoconferencing is not available): MBS item 92016 (provided by general practitioners) and MBS item 92023 (provided by non-vocationally recognised medical practitioners).
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-specific 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 2020).
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 people aged 55 and over in 2020–21 was 45%, which was below the trajectory point of 65% required to meet the goal.
- The rate increased from 35% in 2014–15 to 45% in 2020–21.
- The rates in the 7 years from 2014–15 to 2020–21 were below the trajectory required to meet the goal for 2023. In 2020–21, the required trajectory point was 65%, compared with an actual rate of 45%.
- The rate in 2020–21 was the same as the previous two years. While this period was during the COVID-19 pandemic in Australia, more checks were provided in 2020–21 than in 2019–20. However, the rate remained stable due to an increase in the population size between years. For more information see Impacts of the COVID-19 on data.
In 2020–21, 44,624 health checks were provided for Indigenous adults aged 55 and over. Indigenous females aged 55 and over were more likely than males of this age to have received a health check (48% compared with 42%).
The rate of health checks among Indigenous adults aged 55 and over varied by jurisdiction—ranging from 27% in Victoria to 56% in Queensland in 2020–21.
Health checks delivered by Aboriginal Community Controlled Health Organisations
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 Organisations (ACCHOs) 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 ACCHOs.
In 2019–2020, among Indigenous Australians aged 55 and over:
- An estimated 40% of Indigenous checks were delivered by ACCHOs
- The proportion of health checks that were delivered by ACCHOs was highest in the Northern Territory (59%) and lowest in Victoria/Tasmania (29%).
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 ACCHOs. Additionally, not all health checks performed at ACCHOs are claimed through the MBS and have therefore not been captured in these estimates. Services provided by ACCHOs who did not provide information to the nKPI data collection were also not included.
The estimated proportion of health checks provided by ACCHOs is high when compared with workforce size. In 2019–20, there were around 540 full-time equivalent (FTE) GPs employed in ACCHOs (AIHW 2021b). This represented roughly 1.8% of the total FTE GP workforce (based on about 29,700 total GP FTEs, using data from the National Health Workforce Dataset for 2019) (Health 2021).
Sources: AIHW analysis of Indigenous primary health care nKPI data and Medicare Benefits Schedule data.
Figure 15.1: Rate of Indigenous-specific MBS health checks for Aboriginal and Torres Strait Islander people aged 55 and over