This report on Aboriginal Community Controlled Health Services (ACCHS) presents information sourced from a variety of data sets, but mostly from two main data collections:
- the Online Services Report (OSR) collection for 2012-13, which provides information on staffing, clients and episodes of care provided at primary health services funded to provide care to Indigenous Australians
- the National Key Performance Indicators (nKPIs) for Aboriginal and Torres Strait Islander primary health care collection, covering the period December 2012 to December 2013. Indicator-related information is collected on chronic disease prevention and management, and maternal and child health. The nKPIs aim to improve the delivery of primary health care services by supporting continuous quality improvement activity among service providers.
In 2012-13, 141 ACCHS participated in OSR data collection processes. During the year, these ACCHS:
- provided services to over 316,000 clients, about 252,000 of whom were Indigenous
- provided over 2.4 million episodes of care nationally, with around 2.1 million of these being for Indigenous Australians. An episode of care is a visit to the health service, and may include contacts with multiple health workers
- made 3.7 million client contacts, including contacts with health staff and drivers who facilitate access to primary care, and referrals to other health services where ACCHS provided transport services.
In December 2013, ACCHS saw an estimated 212,679 Indigenous regular clients. ACCHS providing nKPI data saw more regular clients in December 2013 than they did one year before. There were 124 ACCHS that provided valid data on the number of Indigenous regular clients in December 2012, June 2013 and December 2013. At these ACCHS, the number of clients increased by 6%, over the period from 183,435 in December 2012 to 194,521 in December 2013.
The Aboriginal and Torres Strait Islander primary health care nKPIs are aimed at improving the delivery of primary health care services by supporting continuous quality improvement activity among service providers. The nKPIs include 16 indicators that measure 'processes of care' performed for clients (such as tests, procedures or Medicare- claimable services), and 5 outcome measures.
'Processes of care' are largely under the control of health services, and indicate good practice in primary health care. In the December 2013 period, the proportion of clients who received processes of care rose for 10 indicators out of 16, covering: antenatal visits prior to 13 weeks of pregnancy; birthweight recorded; those aged 0-4 and 25 and over with a Medicare Benefits Schedule (MBS) health assessment; those with type 2 diabetes or Chronic Obstructive Pulmonary Disease (COPD) who were immunised against influenza; smoking status or alcohol consumption recorded; and those with type 2 diabetes who received a General Practice Management Plan or Team Care Arrangement. For the remaining six indicators, the number of Indigenous regular clients who received processes of care rose, but the number of eligible clients also rose. As a result, the proportion of clients who received the care did not increase.
ACCHS showed improvement for 2 of the 5 outcome indicators:
- the proportion of clients with BMI recorded who were not overweight or obese
- the proportion of clients with type 2 diabetes whose HbA1c result was less than or equal to 7%.
The proportion remained stable for the remaining three outcome indicators: babies with normal birthweight, clients who have never smoked, and clients with type 2 diabetes with blood pressure less than or equal to 130/80 mmHg.
Health outcomes are influenced by the work of primary health care; however, they are also influenced by a range of other factors such as education, employment, income and housing.