Impacts of COVID-19 on Indigenous-specific health checks

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).

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 Indigeous-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 (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 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 on the number of health checks processed each month from July 2019 to June 2020 was used. This period covers the first 6 months of the COVID-19 pandemic in Australia.

Nationally, across all age groups:

  • There was a dip in the number of health checks provided in December and January—this is 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 dip was seen in March 2020, followed by a sharp decrease in April—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.
  • The total (all ages) number of health checks provided in April 2020 was 21% lower than the number provided in April 2019 (20,062 compared with 15,845)
  • From May 2020, the number of health checks provided increased steadily—corresponding with the staggered easing of restrictions across Australia. In June, generally a similar number of health checks were provided compared with the same time the previous year (before the COVID-19 pandemic), especially for older age groups.

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. 

In all states and territories, the number of health checks in June 2020 was similar to or higher than the number in June 2019. 

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 to February from 2018–19 to 2019–20. In June 2020, older age groups were more likely than younger age groups to have exceeded the number of checks provided in the same month in 2019.

From July 2020, Victoria experienced an increase in community transmission of COVID-19, resulting in an increase of restrictions across the state. As more data become available, the impact of this on the number of health checks can be explored.

Number of Indigenous-specific MBS health checks for Aboriginal and Torres Strait Islander people, by age group, month of processing, 2018–19 and 2019–20

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Why is it important to monitor the impacts of COVID-19 on Indigenous-specific health checks?

The aim of the Indigenous-specific health check 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).

If a health check is delayed or missed, it is possible that a condition may go undetected and progress to a more advanced stage—which may be more difficult to treat, with an increased risk of complications. This in turn may lead to poorer outcomes than if the condition had been identified at an earlier stage.

It is not yet known what the long-term impacts of delayed or missed health care, including Indigenous-specific health checks, will be on the health outcomes of the population. Therefore, it is important to continue to monitor the impacts of COVID-19 on health service delivery and use in the future.

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.

Health (Department of Health) 2020a. Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 18 March 2020. Canberra: DoH. Viewed 15 October 2020.

Health 2020b. COVID-19 Temporary MBS Telehealth Services. Canberra: DoH. Viewed 15 October 2020.

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