Allied health professionals apply specific skills and knowledge to prevent, diagnose and treat health conditions and illnesses. They provide services directly to patients either individually or as part of a multidisciplinary team, and work in a variety of settings.

While there is no universally accepted understanding of which specific disciplines are considered to be allied health professionals, they can include: audiologists, chiropractors, occupational therapists, optometrists, osteopaths, physiotherapists, podiatrists, psychologists and speech pathologists (see, for example, AHPA 2019). Allied health professionals are required to be registered with the Australian Health Practitioner Regulation Agency or their relevant professional body for self-regulating professions.

Dental professionals provide preventive, diagnostic and restorative dental services. They can include dentists, dental prosthetists, dental hygienists, oral health therapists and dental therapists (Dental Board of Australia 2018). While dentists are not usually ascribed to allied health, dental therapists and hygienists are sometimes included within that term. Access arrangements for dental professionals have many similarities to the provision of allied health services. All dental professionals must be registered to practise in Australia.

See Health workforce.

Allied health services

Australians can access allied health services through many channels, including Medicare, the Department of Veterans’ Affairs (DVA), the National Disability Insurance Scheme (NDIS), community health services, public and private hospitals or privately by paying for the service out-of-pocket.

Those who purchase services privately and have private health insurance general treatment (‘ancillary’ or ‘extras’) cover may have part of the cost subsidised by their insurance provider. In 2017–18, private health insurers subsidised 52.4 million allied health and related services (including the supply of aids and equipment such as prescription glasses and prostheses, AIHW 2019a).

In public hospitals, admitted patients recorded 5.1 million allied health interventions in 2017–18 (AIHW 2019b) and outpatient clinics at public hospitals recorded almost 1.3 million physiotherapy visits, almost 500,000 occupational therapy visits, 300,000 nutrition and dietetics visits, and a range of other allied health visits (AIHW 2019c).

Australia’s national health insurance scheme, Medicare, can also subsidise access to some types of allied health services. This section describes allied health care that Australians receive outside of hospital under these arrangements. See Primary health care for details on allied health services subsidised by private health insurers.

What are Medicare-subsidised allied health services?

Under Medicare arrangements, subsidised allied health services are delivered by the following health professionals: audiologists, chiropractors, diabetes educators, dietitians, exercise physiologists, occupational therapists, optometrists, orthoptists, osteopaths, physiotherapists, podiatrists, psychologists, social workers and speech pathologists (Department of Health 2019b). In addition, Medicare subsidises services delivered by Aboriginal and Torres Strait Islander health practitioners and mental health nurses under its allied health service arrangements. While these professionals are not always considered to be allied health professions, they are treated as such in the Medicare arrangements and are included in the relevant data analyses presented on these pages.

With the exception of optometry services, Medicare-subsidised allied health services are available only to patients who are referred by a medical practitioner (usually a general practitioner (GP)). Common referral pathways include GP Management plans for people with a chronic health condition (previously known as Enhanced Primary Care GP services) and GP Mental Health Treatment plans for people with a mental health condition under the Better Access Scheme, which provides access to psychologists, occupational therapists and social workers.

Types of services

In total, 9 million patients (37% of people) received 23 million Medicare-subsidised allied health services in a non-hospital setting in 2017¬–18. Table 1 shows the range of Medicare-subsidised allied health services provided in 2017–18, including: 

  • 29% of people received optometry services under Medicare, which was the most common allied health service accessed, with each patient receiving on average 1.3 services
  • 5.1% of people received mental health care provided by a Medicare-eligible allied health practitioner, with each patient receiving on average 4.5 services—the highest number of services per patient for the allied health professions.
Table 1: Use of Medicare-subsidised allied health services, 2017–18

Type of service (non-hospital)

Number of services (million)

Proportion of people receiving a service (%)

Number of services per patient

Optometry

9.4

29.3

1.3

Mental health care(a)

5.6

5.1

4.5

Physical health care(b)

3.5

4.3

3.3

Podiatry

3.3

4.3

3.1

Other

0.9

1.7

2.2

Total allied health

22.7

36.6

2.5

  1. Mental health care provided to a person with an assessed mental disorder by a Medicare-eligible health practitioner, including: psychologists, occupational therapists and social workers as well as mental health nurses and Aboriginal health workers. The analysis does not report on mental health services provided by other health practitioners, such as general practitioners and psychiatrists. For information on all Medicare-subsidised mental health services see the Mental Health Services page.

  2.  ‘Physical health care’ includes physiotherapy, exercise physiology, chiropractic and osteopathy services.

Sources: AIHW analysis of MBS claims data; ABS 2018.

Trends

Overall, the number of patients receiving Medicare-subsidised allied health services in a non-hospital setting increased markedly over the past decade—from 5.6 million in 2008–09 (25% of people) to 9.0 million in 2017–18 (37% of people). After adjusting for differences in the age structure of the population, the number of services per 100 people has increased from 49 in 2008–09 to 88 in 2017–18 (Figure 1).

A range of factors may have affected the supply and demand for Medicare-subsidised allied health services, including increasing rates of chronic illness, increasing patient awareness of chronic conditions and Medicare-subsidised treatments, and new Medicare items which provide Medicare-subsidised allied health services for an expanded range of patient circumstances. These include, for example, the Better Access Initiative items introduced in 2006 for treatment of common mental disorders including anxiety and depression (Department of Health 2019a), and in 2017 the introduction of telehealth psychological therapy items to provide a Medicare subsidy for mental health services delivered through video conferencing.
 

Between 2008–09 and 2017–18, the number of Medicare-subsidised non-hospital allied health services per 100 people has increased nationally (49 to 88 (age standardised)) and by individual states and territories. In 2008–09 and 2017–18, the number of services per 100 people was highest in Victoria compared to other states and territories (54 and 94 services respectively).

Patient characteristics

In 2017–18, 66% of Australians aged 65 or over received a Medicare-subsidised non-hospital allied health service, whereas 31% of Australians aged 64 or under received a service.

A higher proportion of females (42%) accessed services than males (31%).

The proportion of Australians who received services varied depending on where they lived. The proportions were similar for residents of Inner regional areas and Major cities (39% and 37% respectively), but decreased with increasing remoteness to 17% of people living in Very remote areas. Lower use of Medicare-subsidised allied health services in remote and very remote areas may be partly attributed to these populations relying more on general practitioners (GPs) to provide health care services (AIHW 2019d) or reflect that services may be accessed through other arrangements that are not captured in the Medicare statistics (e.g.  Aboriginal medical services).

Spending

In 2017–18, $1.7 billion was spent on Medicare-subsidised allied health services outside of hospitals. This comprised:

  • $1.43 billion in Medicare benefits paid by the Australian Government
  • $0.24 billion in patient out-of-pocket costs.

Almost three-quarters of spending was on mental health care ($0.77 billion, 46%) and optometry ($0.45 billion, 27%) services combined.

In 2017–18, 17.2 million Medicare-subsidised allied health services (76%) were bulk-billed (indicating that patients did not incur costs for these services). The remaining 24% of services were patient-billed (that is, the patient incurred out-of-pocket costs).

For those who did incur out-of-pocket costs (18% of patients—1.6 million people), the average out-of-pocket cost per patient was $152 in the year. By service type:

  • 5.7% of optometry patients paid out-of-pocket costs; these patients paid $34 in out-of-pocket costs (on average) in 2017–18 
  • 54% of patients who received mental health care from an eligible allied health practitioner under Medicare paid out-of-pocket costs; these patients paid $274 in out-of-pocket costs (on average) in 2017–18.   

Dental services

As for many of the allied health professions, dental services are funded, and can be accessed, in a number of ways—privately or through public dental clinics or DVA (based on eligibility). For those who purchased services privately, some may have had all or part of the costs of the service subsidised. In 2018–19:

  • 42.9 million dental services were subsidised by private health insurance providers (APRA 2019)
  • 5.4 million services were subsidised under the Australian Government’s Child Dental Benefits Schedule (Department of Health 2019a) which supports provision of basic dental services to eligible children aged 2–17.

Data on dental services provided in Australia are limited, especially in relation to services provided in the private sector, as no comprehensive national data sources are available. The most complete information about Australians’ use of dental services is available via national population surveys.

Dental visits

The National Child Oral Health Study 2012–14 (Brennan et al. 2016) found that for children aged 5–14, it is estimated that:

  • most (57%) had made their first dental visit before the age of 5
  • the majority (87%) first visited a dental professional for a check-up (rather than for a problem)
  • the majority (81%) had last visited a dental professional in the 12 months prior to the survey and most (57%) had last visited a private dental service
  • 1 in 9 (11%) had never visited a dental provider
  • the proportion of children who last visited a dental professional for a check-up (which reflects a favourable visiting pattern) varied by household income. Nearly 9 in 10 children (88%) living in households with high income last visited the dentist for a check-up, compared with 7 in 10 children (71%) from households with low income.

The Patient Experience Survey 2018–19 (ABS 2019) found that for people aged 15 and over, it is estimated that:

  • nearly half (49%) visited a dental professional in the last 12 months
  • of those who needed to and saw a dental professional, the majority (58%) visited more than once in the last 12 months
  • around 1 in 8 (12%) people who saw a dental professional received public dental care
  • around 3 in 10 (28%) who needed to see a dental professional delayed seeing or did not see one at least once in the previous 12 months—and around 2 in 10 (18%) reported that cost was a reason for delaying or not seeing a dental professional.

Spending

In 2017–18, around $10.5 billion was spent on dental services in Australia. The majority of this cost (around $6.0 billion, or 57%) was paid by patients directly, with individuals spending on average $243 on dental services over the 12-month period, not including premiums paid for private health insurance (AIHW 2019e). Private health insurance providers financed around $2.0 billion (19%) of total expenditure for dental services (AIHW 2019e). See Health expenditure.

Where do I go for more information?

For more information on allied health and dental services, see:

References

ABS (Australian Bureau of Statistics) 2011. ABS Australian demographic statistics, Jun 2011. ABS cat. no. 3101.0. Canberra: ABS.

ABS 2018. ABS Australian demographic statistics, Jun 2018 . ABS cat. no. 3101.0. Canberra: ABS.

ABS 2019. Patient experiences in Australia: summary of findings, 2018–19. cat. no. 4839.0. Canberra: ABS.

AHPA (Allied Health Professions Australia) 2019. Allied health accreditation. Viewed 11 November 2019.

AIHW 2019a. Medicare-subsidised GP, allied health and specialist health care across local areas: 2013–14 to 2017–18. Cat. no. PHE 254 Canberra: AIHW.

AIHW 2019b. Procedures data cubes. Cat. no. WEB 216. Canberra: AIHW.

AIHW 2019c. Non-admitted patient care 2017–18: Australian hospital statistics. Cat. no. HSE 234 Canberra: AIHW.

AIHW (Australian Institute of Health and Welfare) 2019d. Rural & remote health. Cat. no. PHE 255. Canberra: AIHW. Viewed 29 May 2020.

AIHW (Australian Institute of Health and Welfare) 2019e. Health expenditure Australia 2017–18. Cat. no. HWE 077. Canberra: AIHW.

APRA (Australian Prudential Regulation Authority) 2019. Private health insurance benefits trends: ancillary benefits. Sydney: APRA.

Brennan DS, Ju X, Amarasena N, Dooland M, Peres KG, Mejia GC et al. 2016. Patterns of dental services use by Australian children. In: Do LG & Spencer AJ (eds). Oral health of Australian children: the National Child Oral Health Study 2012–14. Adelaide: University of Adelaide Press.

Dental Board of Australia 2018. Registration. Melbourne: Australian Health Practitioner Regulation Agency. Viewed 5 November 2019.

Department of Health 2019a. Annual Medicare statistics—financial year 1984–85 to 2018–19. Canberra: Department of Health. Viewed 26 November 2019.

Department of Health 2019b. Chronic disease management—individual allied health services under Medicare. Canberra: Department of Health. Viewed 26 November 2019.