Primary care is often the first contact a person has with the health system and can be delivered in a range of settings, by a range of providers. It may be provided by general practitioners (GPs) within general practice or in an aged care or community setting, by public or private service providers. Nursing care, midwifery, pharmacy, dentistry, Aboriginal health services, and allied health care are also examples of primary care services.
This page has information on:
- primary care service use
- patients experiences of primary care
- spending on primary care services
- primary health care data development.
Data on primary care services are limited, but good sources include claims information relating to Medicare-subsidised health services claimed through a GP or for allied health, nursing, midwifery and Aboriginal Health Worker services. Information on this page comes from these sources.
Primary care service use
In 2021–22, there were around 270 million Medicare-subsidised primary care services in Australia, including, but not limited to:
- GP attendances (189 million)
- allied health attendances (25 million)
- services provided by nurses, midwives and Aboriginal health workers (4.1 million) (AIHW 2022a).
General practice
A GP is often the first point of contact in the health system.
Between 2015–16 and 2019–20, around 87–88% of Australians received at least one Medicare-subsidised GP service. This figure dropped to 85% in 2020–21 as COVID-19 restrictions were introduced in response to the pandemic. In 2021–22, it increased to 90% of Australians, with the expansion and uptake of Medicare-subsidised telehealth and COVID-19 vaccination (AIHW 2020a, 2020b, 2021, 2022a).
In Australia in 2021–22:
- Females (92%) were more likely to see a GP than males (87%) and received more Medicare-subsidised GP services per person (8.3, compared with 6.3 for males).
- The number of Medicare-subsidised GP services per person increased with age and was highest for those aged 80 and over (18.6 services per person).
- A higher proportion of people living in metropolitan Primary Health Network (PHN) areas had a Medicare-subsidised GP attendance after hours (20%), compared with regional PHN areas (10%) (AIHW 2022a).
Of the 189 million GP attendances in 2021–22, the most common type of attendance was a Level B consultation (a standard consultation that lasts less than 20 minutes) (108 million attendances).
There is currently no data to describe the reasons why a patient visited a GP or the actions taken by a GP to assist them.
Allied health
The allied health sector comprises a range of services provided by health practitioners who are generally university qualified and with specialised expertise in preventing, diagnosing and treating a range of conditions and illnesses. Examples of allied health professions include psychologists, optometrists and physiotherapists. The associated data tables also include data on other Medicare-subsidised allied health professionals.
In 2021–22, 37% of Australians received at least one Medicare-subsidised allied health service (AIHW 2022a).
In Australia in 2021–22:
- Females (43%) were more likely to see an allied health professional than males (32%) and received more Medicare-subsidised services per person (1.2, compared with 0.8 for males).
- The number of allied health Medicare-subsidised services per person increased with age and was highest for those aged 80 and over (2.4 services per person).
- People living in metropolitan PHN areas received more Medicare-subsidised allied health services for mental health care (0.3 per person), than those living in regional PHN areas (0.2 per person) (AIHW 2022a).
Of the 25 million Medicare-subsidised allied health services provided in 2021–22:
- The most common type of service was optometry (9.9 million).
- Psychology accounted for around 6.6 million services, Podiatry 3.5 million, and Physiotherapy 2.8 million services (AIHW 2022a).
In addition to Medicare-subsidised services, allied health services are accessed and funded through many arrangements, such as those subsidised by private health insurance or the Department of Veterans’ Affairs.
Nursing, midwifery and Aboriginal health workers
This section includes information on Medicare-subsidised services provided in non-admitted patient settings by:
- nurse practitioners: registered nurses with experience in a clinical specialty
- midwives: registered health professionals who care for women's health and wellbeing during pregnancy and childbirth
- practice nurses/Aboriginal health workers: registered or enrolled nurses, Aboriginal and Torres Strait Islander health practitioners, or Aboriginal health workers employed in general practice.
In 2021–22, 8.1% of Australians received at least one Medicare-subsidised nursing, midwifery or practice nurse/Aboriginal health worker service (AIHW 2022a).
In Australia in 2021–22 the following Medicare-subsidised services were provided:
- Nurse practitioners provided more than 860,000 services (3.4 per 100 people), up from around 750,000 services (2.9 per 100 people) in 2020–21 and 660,000 (2.6 per 100 people) in 2019–20.
- There were over 210,000 midwifery services, increasing from 170,000 in 2020–21.
- There were 3.1 million practice nurse/Aboriginal health worker services provided, representing 12 services per 100 people.
COVID-19 and primary care service use
Primary care has played a central role in the health care response to COVID-19, and the pandemic has changed the way primary care services are delivered. In 2020–21:
- The proportion of people who reported that they delayed or did not use a GP service or an after-hours GP service when needed due to COVID-19 was 9.8% and 7.3%, respectively (ABS 2021).
- Females were more likely to delay or not use GP services when needed due to COVID-19 than males (13% and 6.8%, respectively). This was the same for after-hours GP services (8.5% and 5.4%, respectively) (ABS 2021).
- In March 2020 Medicare-subsidised telehealth items were introduced in response to the pandemic. Following this, more than one-third (36%) of GP services were delivered via telephone or video-conference in April 2020, up from 8.0% in March 2020 (AIHW 2020a).
As at 20 January 2023, 64% of COVID-19 vaccine doses in Australia were administered in primary care settings (Department of Health and Aged Care 2023).
Australians may delay or not use a GP service due to cost, service availability and waiting times (ABS 2022).
In 2021–22:
- 25% of people delayed seeing a GP for reasons such as service availability or waiting time. This was an increase from 2020–21 (21%).
- 23% of people felt they waited longer than acceptable for a GP appointment (ABS 2022).
- 3.5% of people who needed to see a GP delayed or did not see a GP due to cost. This was an increase from 2020–21 (2.4%).
- 3.9% of people with a long-term health condition who needed to see a GP delayed or did not see a GP due to cost. This was higher than for those without a long-term health condition (3.0%) and higher in regional remote areas compared to those in major cities (5% and 3.1%, respectively).
In 2020–21, approximately one-third of all health spending in Australia was for primary care ($73.4 billion) (AIHW 2022b). Of this:
- $13.2 billion was for unreferred medical services (mainly general practice)
- $12.5 billion was for subsidised pharmaceuticals
- $12.2 billion was for other medications.
In 2021–22, $17 billion were paid in Medicare benefits for primary care services, including GP, allied health and other primary care attendances (AIHW 2022a).
The majority of this expenditure was for:
- GP attendances ($9.1 billion, or 53%)
- diagnostic imaging ($4.0 billion, or 23%)
- specialist attendances ($2.3 billion, or 13%)
- allied health ($1.8 billion, or 10%).
Although primary health care is an important component of Australia’s health care system, the availability of primary health care data remains limited.
This page focuses on Medicare-subsidised primary care services and the ABS Patient Experience Survey as data sources with national coverage. However, these sources do not provide complete nor comprehensive insight into primary health care in Australia. For example, information from private health insurance sources, state and territory funded community health data and data from Aboriginal health services are out of scope for this page.
The AIHW is leading the development of processes for the governance, standardisation, collection, analysis and reporting of primary health care data within Australia to support the collection of data from primary health care settings to form a National Primary Health Care Data Collection. This work program aims to improve primary health care data and address information gaps relating to why a patient went to a primary health care provider, what occurred during the consultation, what actions were recommended and taken, and with what outcome (PHCAG 2015).
The AIHW also releases information from the newly established national Practice Incentives Program Quality Improvement (PIPQI) Eligible Data Set, bringing together data provided by Primary Health Networks from general practices across 10 Quality Improvement Measures.
Ongoing work to improve primary health care data, including establishing linked primary health care data, will enhance the evidence for policy, planning, research and practice.
For more information on primary health care, see:
Visit Primary health care for more on this topic.
References
ABS (Australian Bureau of Statistics) (2022) Patient experiences in Australia: summary of findings, 2021–22, ABS website, accessed 25 January 2023.
ABS (2021) Patient experiences in Australia: summary of findings, 2020–21, ABS website, accessed 25 January 2023.
AIHW (Australian Institute of Health and Welfare) (2020a) Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use, AIHW website, accessed 11 February 2022.
AIHW (2020b) Medicare-subsidised GP, allied health and specialist health care across local areas: 2013–14 to 2018–19, AIHW website, accessed 18 November 2022.
AIHW (2021) Medicare-subsidised GP, allied health and specialist health care across local areas: 2019–20 to 2020–21, AIHW website, accessed 18 November 2022.
AIHW (2022a) Medicare-subsidised GP, allied health and specialist health care across local areas: 2021–22, AIHW website, accessed 18 November 2022.
AIHW (2022b) Health Expenditure Australia 2020–21, AIHW website, accessed 8 March 2023.
Department of Health and Aged Care (2023) COVID-19 vaccination – vaccination data, Department of Health and Aged Care website, accessed 25 January 2023.
PHCAG (Primary Health Care Advisory Group) (2015) Better outcomes for people with chronic and complex health conditions, PHCAG, accessed 06 December 2022.
