Comparison of the uptake of health assessment items for Aboriginal and Torres Strait Islander people and other Australians: Implications for policy

Abstract

BackgroundHealth Assessment (HA) items were introduced in 1999 for Aboriginal and Torres Strait Islander people aged at least 55 years and all Australians aged over 75 years. In 2004 a new item was introduced for HAs among adult Aboriginal and Torres Strait Islander people aged 15–54 years. The new item has been applauded as a major policy innovation however this enthusiasm has been tempered with concern about potential barriers to its uptake. In this study we aim to determine whether there are disparities in uptake of HA items for Aboriginal and Torres Strait Islander people compared to other Australians.MethodThe analysis was based on Health Insurance Commission data. Indigenous status was ascertained based on the item number used. Logistic regression was used to compare uptake of HA items for older people among Aboriginal and Torres Strait Islander people compared to other Australians. Adjustments were made for dual eligibility. Uptake of the HA items for older people was compared to the uptake of the new item for Aboriginal and Torres Strait Islander people aged 15–44 years.ResultsOur analyses suggest a significant and persistent disparity in the uptake of items for older patients among Aboriginal and Torres Strait Islander people compared to other Australians. A similar disparity appears to exist in the uptake of the new adult Aboriginal and Torres Strait Islander HA item.ConclusionFurther engagement of primary care providers and the community around the uptake of the new HA items may be required to ensure that the anticipated health benefits eventuate.

Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service

“…A policy implication of our findings is the need to strengthen implementation of CVD risk assessment for Indigenous Australians [24]. Reliance upon the AHC as the only vehicle for CVD risk assessment may be inadequate because of the low uptake of the item [25]. …”

Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

“…Studies in Indigenous communities in Queensland (QLD) [ 7 , 8 ] have not included data on the proportion of community members who received health checks. A national study using Medicare data showed that 3% of Indigenous Australians aged 55 years or over attending GPs had documented use of specific Medicare items for health checks [ 9 ]. However, the study appeared to underestimate the uptake of preventive health checks as many Indigenous primary care services do not use Medicare items when delivering services to clients.…”

The barriers and enablers of older person health assessments in Australian primary care: clinician and patient perspectives

“…Data to date suggests that Aboriginal and Torres Strait Islander people were significantly less likely to have HAs than the rest of the community 10 . Although the uptake of IHAs has been increasing, there is a high degree of regional variation in delivery and many Sydney-based health professionals interviewed by Schutze and colleagues (2016) 11 still unaware of the IHA.…”