In March 2020, measures to reduce the risk of community transmission of COVID-19, including limiting public gatherings and reducing non-essential travel, were put in place across Australia (Health 2020a).
Medicare benefits schedule data
In response to these restrictions, a range of temporary telehealth MBS items were made available to allow continuity of care for patients, as well as to provide protection for both patients and health care providers from the risk of COVID-19 (Health 2020b). This included telehealth items for Indigenous-specific health checks, namely MBS items 92004, 92011, 92016 and 92023.
MBS items for Indigenous-specific health checks
All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check. 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 required aspects 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. Therefore, 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.
Sources: Health 2020b and Health 2020c.
Did the number of Indigenous-specific health checks provided reduce during the COVID-19 period?
The restrictions are likely to have changed the behaviour of many Australians, including the way and frequency with which people engaged with health care services. To investigate the potential impacts the restrictions may have had on the rates of Indigenous Australians receiving a health check, data are analysed on the number of health checks processed each month from July 2019 to June 2021. This period covers the first 18 months of the COVID-19 pandemic in Australia.
Nationally, across all age groups:
- There was a drop in the number of health checks provided in December 2019 and January 2020—this is likely not related to the COVID-19 pandemic; this pattern has been consistently observed each year and likely reflects the changed behaviour of Australians around the Christmas and school holiday period.
- A further drop was seen in March 2020, followed by a sharp decrease in April 2020—corresponding with the introduction and subsequent increase of restrictions. While a decrease during these months has been seen for previous years, likely related to the Easter holiday period, the decrease in checks in 2020 was larger than that seen in 2019.
- A drop was also seen in August 2020, as well as April 2021 (although this was not as large as the dip in March and April 2020).
- The biggest dip in total (all ages) number of health checks provided between one financial year and another in was in April 2020, which was 21% lower than the number provided in April 2019 (15,845 compared with 20,062).
- The number of health checks in December 2020 was higher than that in December 2019 and December 2018.
Similar patterns were observed across the states and territories. For example, the number of health checks in April 2020 was lower than in April 2019 in all states and territories, except Tasmania. In Tasmania, while there was a small dip in March 2020, this was followed by a sharp increase in April, and the number of checks provided between March 2020 and June 2020 were consistently higher than the number provided in the same months in 2019.
From July 2020, Victoria experienced an increase in community transmission of COVID-19, resulting in an increase of restrictions across the state. However, in Victoria, there was a dip in the number of health checks in July and August 2020, coinciding with its lockdown. From August 2021, Victoria has experienced another increase in cases, which can be analysed as data become available.
From July 2021, New South Wales also experienced an increase in community transmission. As more data become available, the impact of this on the number of health checks can be explored.
There were some differences in patterns across age groups. For those aged under 15, the number of health checks provided between July 2019 and February 2020 were similar to the same months in the previous year. Among older age groups, there was an improvement seen in the number of health checks provided in July 2018 to February 2020. In June 2020 as well as June 2021, older age groups were more likely than younger age groups to have similar numbers or exceeded the number of checks provided in the June of 2019 (see archived report for further details).
Number of Indigenous-specific MBS health checks for Aboriginal and Torres Strait Islander people, by age group, month of processing, 2018–19, 2019–20 and 2020–21