Overview: Health services used by humanitarian entrants
Health services provided by general practitioners (GPs), medical specialists and other allied health providers are integral to supporting and improving the health of humanitarian entrants.
However, humanitarian entrants face many barriers to accessing timely and appropriate health care, and this may include one or more of the following:
- limited English proficiency
- financial constraints
- low educational achievement
- varying degrees of health literacy
- varying cultural and health beliefs
- competing settlement priorities (Griswold et al. 2018; Timlin et al. 2020).
A systematic review that included studies from Australia and other countries found that many humanitarian entrants may be reluctant to seek health care assistance when needed due to a range of complex factors including psychological trauma and cultural beliefs (Iqbal et al. 2022).
Health seeking behaviour for mental ill health is low despite high levels of symptoms. This is largely driven by poor mental health literacy, cultural understandings of mental illness and associated stigma (Tomasi et al. 2022). Older adults, females and those with better English proficiency are more likely to seek professional help (Byrow et al. 2020). Additionally, it has been shown that a longer time spent in the host country is associated with higher levels of professional help-seeking (Markova et al. 2020).
In Australia, there are culturally responsive and specialised health services and programs to meet the needs of people from humanitarian backgrounds. Some refugee health services and programs provide initial health assessments and facilitate access to mainstream primary health care such as GP. Free interpreters are also available for GPs and medical specialists providing Medicare-rebateable services. These health services and programs for humanitarian entrants vary by state and territory. For more information on health services and programs for humanitarian entrants in each state or territory, see the following websites:
- Australian Capital Territory: Companion House
- New South Wales Department of Health: Refugee Health Plan 2022–2027
- Northern Territory: Melaleuca refugee health services
- Queensland Health: Refugee Health and Wellbeing Policy and Action Plan 2022–2027
- South Australian Health: Refugee health service
- Tasmanian government: Multicultural specific services
- Victoria Department of Health: Refugee and asylum seeker health and wellbeing information
- Western Australian Department of Health: Humanitarian entrant health service.
This section of the report presents data on the use of Medicare subsidised health care services in 2021 using data from the Medicare Benefits Schedule (MBS) available in Person-Level Integrated Data Asset (PLIDA). Data are presented on:
- Health service use by broad type of service (BTOS)
- Bulk-billing rates of health services
- GP attendances
- GP mental health treatment plans
- Non-hospital specialist consultations
- Interactive data visualisation: Health service use by age and sex
MBS data only includes details of services for which benefits were paid by Services Australia. They do not include services provided to public inpatients and public outpatients of hospitals and public Accident and Emergency Departments of hospitals, and services funded directly under other Australian government programs or state/territory government programs. This web report is the first stage of the AIHW’s Refugee and humanitarian entrant health project and data on hospitalisations will be included in release of findings from the second stage of the project.
Additionally, many Allied Health services do not attract a Medicare rebate. Generally, Medicare subsidised allied health services are only available to patients with chronic, mental, developmental, and/or complex health conditions with a referral from a GP or specialist medical practitioner. These are the only allied health services captured in the other allied health BTOS data presented in this report. For further information on what services do not attract a Medicare rebate and therefore are not captured in this data, see Technical notes.
The COVID-19 pandemic impacted health service access, use and delivery, especially in New South Wales, Victoria and the Australian Capital Territory which had extensive lockdowns restricting services throughout this period (AIHW 2022). For example, the number of GP attendances and pathology services increased in 2021 compared to the previous year and optometry services had the biggest decrease. For more detail on the impact of COVID-19 on health care service utilisation see Impact on MBS service utilisation.
It is expected that the restrictions on health service use are consistent across the humanitarian entrant and the comparison population groups (other permanent migrant group and the rest of the Australian population) and data have been compared between the population groups, where appropriate.
Australian Institute of Health and Welfare (2022) Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme: quarterly data, AIHW, Australian Government, accessed 5 July 2023.
Byrow Y, Pajak R, Specker P, and Nickerson, A (2020) Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: A systematic review, Clinical Psychology Review, 75, 101812, doi:10.1016/j.cpr.2019.101812.
Griswold KS, Pottie K, Kim I, Kim W and Lin L (2018) Strengthening effective preventive services for refugee populations: toward communities of solution, Public health reviews, 39, 3, doi:10.1186/s40985-018-0082-y.
Iqbal MP, Walpola R, Harris-Roxas B, Li J, Mears S, Hall J and Harrison R (2022) Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches, Health expectations : an international journal of public participation in health care and health policy, 25(5), 2065–2094, doi:10.1111/hex.13365.
Markova V, Sandal GM and Pallesen S (2020) Immigration, acculturation, and preferred help-seeking sources for depression: Comparison of five ethnic groups, BMC Health Services Research, 20(1), 1–11, doi:10.1186/s12913-020-05478-x.
Timlin M, Russo A and McBride J (2020) Building capacity in primary health care to respond to the needs of asylum seekers and refugees in Melbourne, Australia: the GP Engagement, Australian journal of primary health, 26(1), 10–16, doi:10.1071/PY18190.
Tomasi A, Slewa-Younan S, Narchal R and Rioseco P (2022) Understanding the mental health and help-seeking behaviours of refugees, Australian Institute of Family Studies website, accessed 24 May 2023.