Health checks
Background
Aboriginal and Torres Strait Islander (First Nations) people can receive an annual health check, designed specifically for First Nations people and funded through Medicare (Department of Health and Aged Care 2022a). This health check was introduced in recognition that First Nations people, as a group, experience some particular health risks (see Timeline of major developments in health check implementation).
The aim of these health checks is to encourage early detection and treatment of common conditions that cause ill health and early death – for example, diabetes and heart disease.
During the health check, a General Practitioner (GP) – or a multidisciplinary team led by a GP – will assess a person’s physical, psychological and social wellbeing (Department of Health and Aged Care 2022a). The GP can then provide the person with health-related information, advice and care.
The GP may also refer the person to other health care professionals for follow-up care, as needed – for example, physiotherapists, podiatrists or dietitians (see Follow-up services overview and Health checks resulting in a follow-up).
Example health check templates for 5 different life stages can be downloaded from the Royal Australian College of General Practitioners website.
As part of the Australian Government’s COVID‑19 response, telehealth items were introduced in March 2020 to help reduce the risk of community transmission of COVID‑19 and provide protection for patients and health care providers (Department of Health and Aged Care 2022b). Telehealth consultations may be used for gathering information, but physical examination components are requirements of all health checks (RACGP 2020).
Following a decade of annual growth, the uptake of health checks was disrupted by the COVID-19 pandemic, particularly during 'lockdown' periods (AIHW 2023). Uptake has more recently resumed an upward trajectory.
The uptake of health checks has varied substantially between different regions since their introduction, including stark differences even within some major cities. The high contribution that Aboriginal Community Controlled Health Services (ACCHSs) make to the overall delivery of health checks (see National use of health checks) means that access to ACCHSs and other healthcare services with a focus on First Nations people is likely to be one of the key determinants of health check uptake. Here, access means not only the proximity to services, but also the availability of required healthcare professionals such as GPs and health workers who may assist GPs. It is also important to note that while health checks are free for patients at ACCHSs and bulk-billing clinics, there may be out-of-pocket costs for patients using other health clinics. The duration of health checks may also discourage some patients from seeking these services.
Previous research has shown that First Nations people with better self-assessed health tend to have lower uptake of health checks than those with poorer self-assessed health (Butler et al. 2022). This suggests that people with poorer health may perceive more benefit in undertaking health checks, or that health promotion has more influence on people with existing health conditions.
This chapter presents information on the use of the following MBS items:
MBS item no. | Description | Mode of delivery |
|---|---|---|
715 | Health check provided by a GP | Face-to-face |
228 | Health check provided by a medical practitioner other than a GP (available from 1 July 2018) | Face-to-face |
92004 | Health check provided by a GP (available from 30 March 2020) | Videoconference |
92016 | Health check provided by a GP (available from 30 March 2020 to 30 June 2021) | Telephone |
92011 | Health check provided by a medical practitioner other than a GP (available from 30 March 2020) | Videoconference |
92023 | Health check provided by a medical practitioner other than a GP (available from 30 March 2020 to 30 June 2021) | Telephone |
Note: Outside of MBS item descriptions for health checks, the term 'GP' is used as a generic reference to all medical practitioners providing primary health care services.
The data include health checks billed to Medicare by Aboriginal Community Controlled Health Services (ACCHSs) or other health services aimed at First Nations people, as well as by mainstream GPs.
Note that the data are limited to MBS items billed to Medicare, and do not provide a complete picture of health checks provided to First Nations people. For example, First Nations people may receive similar care through: mainstream MBS items (that is, items that are not specific to First Nations people); through MBS items delivered in residential aged care; through the Child Health Check Initiative (CHCI) under the Northern Territory Emergency Response (NTER) that ended in June 2012; or through a health care provider who is not eligible to bill Medicare. Those have not been included in this report.
The minimum time allowed between health checks is 9 months. People can therefore receive more than one health check in a year.
- Throughout the report, ‘health check’ is used to refer to the specific MBS items in Table 2 to assist readability.
- People who received a Medicare service are referred to as ‘patients’.
- All people who received a health check are assumed to be First Nations people.
- To show the proportions of First Nations people who received a health check within a 12-month period, or ‘health check uptake’, the number of patients was divided by population data based on the Australian Bureau of Statistics’ (ABS) Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 2006 – 2031 (ABS 2019).
- In this report, uptake was calculated by counting those patients who had a health check in the year ending on either 30 June or 31 December, then dividing that number by the estimated population on the respective date.
- Uptake is presented by reference month – that is, the month at the end of the 12-month period. Uptake ending in June corresponds to uptake over the financial year, while uptake ending in December corresponds to uptake over the calendar year.
- Population estimates for 31 December were approximated by averaging 30 June estimates from consecutive years.
- Series B projections, based on the 2016 Census of Population and Housing and 2016 Post Enumeration Survey, were used for years following the 2016 Census. Backcast population data were used for years before the 2016 Census.
- For Primary Health Networks (PHN), Remoteness Areas, Statistical Areas Level 4 (SA4), and Statistical Areas Level 3 (SA3), projections have been approximated by the AIHW using ‘iterative proportional fitting’, supported by 2016 Census counts. This technique produces estimates that match the ABS’ published outputs when summed back up to larger areas.
- The ABS does not produce estimates of non-demographic changes over time, such as changes in whether a person identifies as Aboriginal and/or Torres Strait Islander between Censuses. However, due to non-demographic changes, population estimates based on the 2016 Census may be considerably lower than those based on the 2021 Census, meaning many of the proportions presented in this report may be overestimated. For example, the ABS estimates that there were 984,000 Aboriginal and/or Torres Strait Islander people on 30 June 2021 based on the 2021 Census (ABS 2023), compared with a projected 879,000 people on 30 June 2021, based on the 2016 Census (ABS 2019).
- Population estimates from the ABS represent the population at a point in time (a stock measure), while patients in the MBS data are counted over a period of time (a flow measure). This mismatch can lead to bias since the population estimate may not accurately reflect the population able to receive a Medicare service throughout the entire period. For example, people may receive a Medicare service then die or move away from the geographic region before the end of the period.
- MBS health checks in this chapter are reported based on the date of service, which was not necessarily the date that the service was processed by Services Australia. MBS services in this chapter were processed on or before 31 March 2024.
ABS (Australian Bureau of Statistics) (2019) Estimates and projections, Aboriginal and Torres Strait Islander Australians, 2006 – 2031, ABS website, Australian Government, accessed 10 August 2023.
ABS (2023) Estimates of Aboriginal and Torres Strait Islander Australians, 30 June 2021, ABS website, Australian Government, accessed 31 August 2023.
AIHW (Australian Institute of Health and Welfare) (2021) Tracking progress against the Implementation Plan goals for the Aboriginal and Torres Strait Islander Health Plan 2013–2023, AIHW, Australian Government, accessed 10 August 2023.
Butler DC, Agostino J, Paige E, Korda RJ, Douglas KA, Wade V and Banks E (2022) 'Aboriginal and Torres Strait Islander health checks: Sociodemographic characteristics and cardiovascular risk factors', Public health research & practice, 32(1):1-9, https://doi.org/10.17061/phrp31012103.
Department of Health and Aged Care (2022a) Annual health checks for Aboriginal and Torres Strait Islander people, Department of Health and Aged Care website, Australian Government, accessed 10 August 2023.
Department of Health and Aged Care (2022b) COVID-19 temporary MBS telehealth services, Department of Health and Aged Care website, Australian Government, accessed 10 August 2023.
RACGP (Royal Australian College of General Practitioners) (n.d.) Resources to support health checks for Aboriginal and Torres Strait Islander people, RACGP website, accessed 10 August 2023.
RACGP (2020) Telehealth – considerations for an effective Aboriginal and Torres Strait Islander health check, RACGP, accessed 10 August 2023.