To evaluate whether the health system is meeting adequately the needs of Aboriginal and Torres Strait Islander people, it is important to understand the use of and access to quality care, including primary health care, and specialists and hospital services. This page presents an overview of Indigenous Australians’ use of these health services, both Indigenous-specific and mainstream.

Indigenous Australians’ use of health services is also affected by the cultural safety of health services. For more information see Culturally safe health care for Indigenous Australians.

Indigenous-specific primary health care services

The Australian Government and state and territory governments fund Indigenous-specific services. Indigenous-specific primary health care services offer prevention, diagnosis and treatment of ill health in a range of health settings. These services are available through community clinics, Aboriginal Community Controlled Health Services and other health care facilities. Indigenous-specific services are also offered in some public hospitals.

In 2017–18, 198 Indigenous-specific primary health care services reported to the AIHW’s Online services report: a total of 3.6 million episodes of care were delivered to around 483,000 clients, 81% of whom were Indigenous. Of the Indigenous-specific primary health care services reporting to the Online services report:

  • around 7 in 10 (71% or 140 organisations) were Aboriginal Community Controlled Health Services
  • around 3 in 10 (29%) consisted of 48 government-run organisations (36 of these were Northern Territory Government-run clinics) and 10 other non-government-run organisations (AIHW 2019d).

See Primary health care.

Medicare services

In 2017–18, an estimated 9.5 million health and allied services claims were made by around 650,000 Indigenous patients through the Medicare Benefits Schedule (MBS). Of these claims, 4.2 million were non-referred general practitioner (GP) services (AIHW 2020 forthcoming).

In 2017–18, MBS claim rates for non-referred GP visits for Indigenous Australians were 15% higher than for non-Indigenous Australians (age-standardised rates of 6,912 and 5,986 per 1,000 respectively). However MBS claim rates for specialist services by Indigenous Australians were 44% lower (age-standardised rates of 598 and 1,070 per 1,000 respectively). This large difference may reflect difficulties in accessing specialist services for many Indigenous Australians.

There was little difference in the claim rates for Indigenous Australians compared with non-Indigenous Australians for other services such as pathology and allied health (Figure 1).
 

Age-standardised rates for Medicare services are reported for 6 types of services by Indigenous status. These age-standardised rates for Medicare services are always higher for non-Indigenous Australians except for non-referred GP services. Medicare claim rates for specialist services by Indigenous Australians were much lower (age-standardised rates of 598 and 1,070 per 1,000 respectively).

Aboriginal and Torres Strait Islander people can receive an Indigenous-specific health check or assessment from their GP through Medicare (MBS item 715), as well as referrals for Indigenous-specific follow-up services. In 2018–19 there were 249,000 Indigenous-specific health checks/assessments claimed through Medicare (AIHW 2020, forthcoming).

More detailed data on individuals available for 2017–18 show that around 29% (230,000 individuals) of the total Indigenous population claimed an Indigenous-specific health check/assessment. Around 59% of Indigenous Australians had at least 1 Indigenous-specific health check or assessment over the 5-year period to June 2018 (AIHW 2019c).

Since 2006–07, both the number of claims and the number of individuals claiming MBS item 715 have increased steadily from a base of around 23,000 total health checks or assessments. In particular the rate of Indigenous Australians undergoing MBS 715 health checks or assessments, as a proportion of the total Indigenous population, nearly tripled from 11% to 29% between 2010–11 and 2017–18 (AIHW 2019c).

The number and rate of MBS item 715 health checks or assessments among Indigenous Australians increased steadily from 2006–07 to 2017–18 across all age groups (Figure 2). The increase was highest among Indigenous Australians aged 55 and over, with a rate increase from 70 per 1,000 in 2006–07 to 396 per 1,000 in 2018–19.
 

The rate of MBS health checks of Indigenous Australians has risen rapidly since 2006–07 across all age groups. The increase was highest among Indigenous Australians aged 55+, which rose from 70 per 1,000 in 2006–07 to 396 per 1,000 in 2018–19.

Based on ABS survey data for 2018–19, an estimated 86% of Indigenous Australians reported having visited a GP or specialist in the previous 12 months—higher in Non-remote areas (87%) than in Remote areas (79%) (ABS 2019).

Preventative health services

Data on the use of various other health services by Indigenous Australians are available across administrative collections and ABS Indigenous-specific health surveys. Recent data on some additional service use measures show that:

  • among Indigenous mothers who gave birth in 2017 (13,600 women), 63% attended at least 1 antenatal visit in the first trimester (an increase from 50% in 2012) (AIHW 2019a)
  • 88% of Indigenous mothers who gave birth at 21 weeks or more attended at least 5 antenatal visits (AIHW 2019a)
  • in December 2018, the proportion of Indigenous children who were fully vaccinated was slightly lower than for non-Indigenous children at ages 1 and 2 (92% compared with 94%, and 88% compared with 91%, respectively), while 97% of Indigenous children aged 5 were fully vaccinated, compared with 95% of other children of the same age (AIHW 2019e)
  • in 2017–2018, 37% of Indigenous women aged 50–69 (age-standardised) participated in a BreastScreen program, compared with 54% of non-Indigenous women (AIHW 2020, forthcoming). The proportion of Indigenous women participating in this age group has increased from 25% in 1996–97 (AIHW 2019b).
  • in 2018–19, 90% of Indigenous women aged 20–69 reported ever having a pap smear test; of whom 68% also reported having a pap smear regularly (AIHW 2020, forthcoming)
  • in 2018–19, 23% of Indigenous men aged 50–74 and 20% of Indigenous women aged 50–74 had ever been tested for bowel cancer (AIHW 2020, forthcoming).

See Health of mothers and babies, Immunisation and vaccination and Cancer screening and treatment.

Hospitalisations

In the 2-year period July 2015–June 2017, the hospitalisation rate for Indigenous Australians was 2.3 times the rate for non-Indigenous Australians (based on age-standardised rates). A large part of this difference, however, was due to the substantially higher rate of hospitalisation for dialysis among Indigenous Australians (11 times higher than for non-Indigenous Australians, after age adjustments) (AIHW 2020, forthcoming).

The leading cause of hospitalisations between July 2015 and June 2017 for Indigenous Australians (excluding dialysis and pregnancy or childbirth) was Injury, poisoning and certain other consequences of external causes. Among all 5 leading causes of hospitalisations for Indigenous Australians (Figure 3), the age-standardised hospitalisation rate per 1,000 population was higher than the corresponding non-Indigenous rate in 4 causes, with the exception being for diseases of the digestive system.
 

This is a figure that lists the 5 leading causes hospitalisations of Indigenous people, and it then compares the age-standardised rates of hospitalisation for each of these causes between Indigenous and non-Indigenous people. The most common hospitalisations of Indigenous people was for Injury and poisoning and other consequences of external causes. The other 4 leading causes were: Symptoms, signs and abnormal clinical findings, not elsewhere classified, Diseases of the respiratory system, Diseases of the digestive system, and Diseases of the circulatory system.

The rates of hospitalisation were higher for Indigenous Australians for 4 out these 5 leading causes, with the exception being hospitalisations for diseases of the digestive system.

In 2017–18, Indigenous Australians accounted for 6.7% (or 535,000 episodes) of total public hospital emergency department presentations (AIHW 2018).

See Hospital care.

Where do I go for more information?

For more information on Indigenous Australians’ use of health services, see:

Visit Indigenous Australians for more on this topic.

References

ABS (Australian Bureau of Statistics) 2019. National Aboriginal and Torres Strait Islander Health Survey, 2018–19. ABS cat. no. 4715.0. Canberra: ABS.

AIHW 2018. Emergency department care 2017–18: Australian hospital statistics. Health services series no. 89. Cat. no. HSE 216. Canberra: AIHW.

AIHW 2019a. Australia’s mothers and babies 2017—in brief. Perinatal statistics series no. 35. Cat. no. PER 100. Canberra: AIHW.

AIHW 2019b. BreastScreen Australia monitoring report 2019. Cat. no. CAN 128. Canberra: AIHW.

AIHW 2019c. Indigenous health checks and follow-ups. Cat. no. IHW 209. Canberra: AIHW.

AIHW 2019d. Aboriginal and Torres Strait Islander health organisations: Online services report—key results 2017–18. Cat. no. IHW 212. Canberra: AIHW.

AIHW 2019e. Tracking progress against the Implementation Plan goals for the Aboriginal and Torres Strait Islander Health Plan 2013–2023. Web report. Cat. no. IHW 201. Canberra: AIHW.

AIHW 2020, forthcoming. Aboriginal and Torres Strait Islander Health Performance Framework report 2020. Canberra: AIHW.