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Report on Government Services 2017

Volume E, Chapter 10

Primary and community health

This chapter reports on the performance of primary and community health services, which include general practice, pharmaceutical services, dentistry, allied health services, maternal and child health, alcohol and other drug treatment and other services.

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  • Key Facts
  • Indicator Framework
  • Indicator Results
  • Indigenous Data

Total expenditure by all governments on primary and community health was around $29.9 billion in 2014-15.

Australian Government total recurrent expenditure on general practice in Australia was $8.7 billion or $365 per person in 2015‑16.

Australian Government expenditure on the PBS was around $8.3 billion, or $332 per person, in 2015-16.

Primary and community health services aim to promote health and prevent illness, and to manage illness and injury effectively in the community, by providing universal access to primary healthcare that is:

  • timely, affordable and accessible
  • appropriate and responsive to meet the needs of individuals throughout their lifespan and communities
  • high quality and safe
  • well co-ordinated to ensure continuity of care where more than one service type, and/or ongoing service provision is required
  • sustainable in terms of workforce, infrastructure, innovation and capacity to respond to emerging needs.

Governments aim for primary and community health services to meet these objectives in an equitable and efficient manner.

The performance indicator framework provides information on equity, efficiency and effectiveness, and distinguishes the outputs and outcomes of health services. The performance indicator framework shows which data are complete and comparable in the 2017 Report.

Indicator framework

An overview of the Primary and community health performance indicator results are presented. Information to assist the interpretation of these data can be found in the indicator interpretation boxes in the Primary and community health chapter and attachment tables.

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Equity — Access indicators

Availability of PBS medicines

PBS prescriptions filled at concessional rate, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 91.8 92.2 91.6 89.0 93.1 93.7 83.7 81.0 91.7
Source: Attachment table 10A.10

Equity of access to GPs

Availability of FSE GPs per 100 000 people, by region, 2015-16 (number)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Major cities 101.8 98.6 107.3 84.5 103.5 .. 73.9 .. 99.4
Outer regional, remote and very remote areas np np 90.7 70.2 76.4 74.8 .. 48.7 83.5
Source: Attachment tables 10A.21

Availability of GPs by sex, 2015-16

FSE Female GPs per 100 000 females

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
no. 73.4 69.4 73.2 57.4 63.1 71.2 62.6 66.8 69.6
Source: Attachment tables 10A.22.

FSE Male GPs per 100 000 males

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
no. 125.6 126.5 132.8 105.1 137.4 106.7 82.6 84.7 124.3
Source: Attachment tables 10A.23

Availability of public dentists

FTE Dentists by region, per 100 000 people, 2014 (number)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Major cities 6.1 6.3 6.9 6.7 8.6 .. 7.0 .. 6.6
Remote and very remote np 10.8 6.5 3.3 np .. 9.6 7.9
Source: Attachment tables 10A.24

Early detection and early treatment for Aboriginal and Torres Strait Islander Australians

Older Aboriginal and Torres Strait Islander Australians who received a health assessment, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 33.6 22.2 43.0 36.8 24.4 21.5 30.2 42.7 35.5
Source: Attachment tables 10A.28

Effectiveness — Access indicators

Effectiveness of access to GPs

Bulk billing rates, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 88.9 84.9 85.0 80.7 84.0 77.4 60.3 89.1 85.4
Source: Attachment table 10A.33

People deferring visits to GPs due to financial barriers, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 3.5 ± 0.8 3.8 ± 0.7 4.8 ± 0.7 4.9 ± 1.0 3.9 ± 0.9 6.1 ± 1.0 8.1 ± 1.0 2.0 ± 0.9 4.1 ± 0.4
Source: Attachment table 10A.34.

GP waiting times for urgent appointment, 2015-16 — less than 4 hours

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 66.2 ± 4.6 61.1 ± 7.0 65.1 ± 5.0 63.2 ± 6.2 65.6 ± 6.9 55.4 ± 0.7 40.4 ± 13.3 89.5 ± 8.6 63.6 ± 3.3
Source: Attachment table 10A.36

Financial barriers to PBS medicines

People deferring treatment due to financial barriers, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 7.4 ± 1.0 7.2 ± 0.9 8.4 ± 1.0 7.5 ± 1.5 7.7 ± 1.1 6.9 ± 1.4 7.8 ± 1.8 4.3 ± 1.5 7.6 ± 0.5
Source: Attachment tables 10A.39

Public dentistry waiting times

Median time waited for public dental care, 2015-16

Most recent data for this measure are neither comparable or complete. Data are available in attachment tables 10A.41–48

Effectiveness — Appropriateness indicators

Chronic disease management

Uptake by Practices in the Practice Incentives Program (PIP) of the PIP Diabetes Incentive, May 2016

Most recent data for this measure comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 57.4 50.1 62.7 57.3 42.8 44.5 61.4 84.5 55.8
Source: Attachment tables 10A.53

Effectiveness — Quality — Safety indicators

GPs with vocational registration

GPs with vocational registration, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 82.7 77.1 79.2 80.8 81.0 80.0 86.5 61.2 80.1

Source: Attachment tables 10A.50

Electronic health information systems

General practices using electronic systems, May 2016

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 90.5 92.3 90.2 88.9 91.6 89.1 87.1 91.4 91.0
Source: Attachment tables 10A.62

Effectiveness — Quality — Responsiveness indicators

Patient satisfaction

Proportion of people who saw a GP in the previous 12 months where the practitioner always or often listened carefully to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 91.2 ± 0.7 91.5 ± 0.8 91.9 ± 0.3 92.9 ± 0.8 91.9 ± 0.9 92.0 ± 1.5 90.1 ± 1.9 87.6 ± 2.9 91.6 ± 0.4
Source: Attachment table 10A.64

Proportion of people who saw a dental practitioner in the previous 12 months where the practitioner always or often listened carefully to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 96.7 ± 1.1 94.6 ± 1.1 96.1 ± 1.4 96.1 ± 1.9 96.6 ± 0.5 96.0 ± 1.6 95.6 ± 1.7 94.7 ± 2.0 95.5 ± 0.6
Source: Attachment table 10A.67

Effectiveness — Quality — Continuity indicators

Continuity of chronic disease management

Proportion of GPs who used the MBS chronic disease management items for care planning or case conferencing at least once during a 12 month period, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 97.7 97.5 96.4 96.5 97.3 98.4 95.6 94.5 97.2
Source: Attachment table 10A.59

Efficiency indicators

Cost to government of general practice per person

Expenditure per person on general practice, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 378.1 362.9 386.0 301.1 380.1 362.8 270.2 328.2 365.0
Source: Attachment table 10A.2

Outcome indicators

Child immunisation coverage

Children aged 60 to 63 months who were fully immunised, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 93.4 93.3 92.7 91.3 92.3 93.8 93.5 91.9 92.9
Source: Attachment table 10A.72

Notifications of selected childhood diseases

Notifications of measles per 100 000 children aged 0–14 years, 2015-16

Most recent data for this measure comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
no. np 1.0 np 1.7 0.5
Source: Attachment table 10A.73

Participation for women in breast cancer screening

Participation for women aged 50–74 years in breast cancer screening, 1 January 2014 to 31 December 2015 (ASR)

Most recent data for this measure comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 50.6 52.2 56.6 54.8 57.6 56.7 54.4 35.8 53.2
Source: Attachment tables 10A.76

Participation for women in cervical screening

Participation for women aged 20–69 years in cervical screening, 1 January 2014 to 31 December 2015 (ASR)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 55.8 59.9 54.8 56.1 58.9 57.3 56.2 54.3 56.9
Source: Attachment table 10A.80

Selected potentially preventable hospitalisations

Separations for selected potentially preventable hospitalisations for vaccine-preventable, acute and chronic conditions, 2014-15, per 1000 people

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
no. 22.7 23.9 29.8 24.3 26.6 22.5 19.0 50.2 25.2
Source: Attachment tables 10A.84

Notes

These data and caveats for these data are available in chapter 10 and attachment 10A.

Some percentages reported in these tables include 95 per cent confidence intervals (for example, 80 per cent ± 2.7 per cent).

.. Not applicable. Nil or rounded to zero. np Not published.

Performance indicator data for Aboriginal and Torres Strait Islander people in this chapter are available in the attachment tables listed below. Contextual data and further supporting information can be found in the chapter.

Indigenous primary and community health data
Table number Table title
Table 10A.18 Approved providers of PBS medicines by PhARIA area as at 30 June 2016
Table 10A.27 Annual health assessments for older people by Indigenous status (per cent)
Table 10A.28 Older Aboriginal and Torres Strait Islander people who received an annual health assessment (per cent)
Table 10A.29 Aboriginal and Torres Strait Islander people who received a health check or assessment, by age (per cent)
Table 10A.31 Proportion of children receiving a fourth year developmental health check, by type of health check (per cent)
Table 10A.35 Aboriginal and Torres Strait Islander people deferring access to GPs due to cost, 2012-13 (per cent)
Table 10A.40 Aboriginal and Torres Strait Islander people deferring access to prescribed medication due to cost, 2012-13 (per cent)
Table 10A.41 Waiting time for public dental care, NSW (days)
Table 10A.42 Waiting time for public dental care, Victoria (days)
Table 10A.43 Waiting time for public dental care, Queensland (days)
Table 10A.44 Waiting time for public dental care, WA (days)
Table 10A.45 Waiting time for public dental care, SA (days)
Table 10A.46 Waiting time for public dental care, Tasmania (days)
Table 10A.47 Waiting time for public dental care, ACT (days)
Table 10A.48 Waiting time for public dental care, NT (days)
Table 10A.57 Proportion of people with asthma with a written asthma plan, by Indigenous status, by age, 2011–13
Table 10A.58 Proportion of people with asthma with a written asthma plan, by Indigenous status
Table 10A.66 Client experience of GPs by remoteness, Aboriginal and Torres Strait Islander people, Australia, 2012-13
Table 10A.77 Participation rates for Aboriginal and Torres Strait Islander women screened by BreastScreen Australia (24 month period) (first and subsequent rounds) (per cent)
Table 10A.81 Cervical screening rates among Aboriginal and Torres Strait Islander women aged 20 to 69 years, who reported having a Pap smear at least every 2 years (per cent)
Table 10A.83 Proportion of Aboriginal and Torres Strait Islander people aged 50 years or over who were fully vaccinated against influenza and pneumococcal disease
Table 10A.85 Separations for selected potentially preventable hospitalisations by Indigenous status (per 1000 people)
Table 10A.87 Separations for selected potentially preventable hospitalisations by Indigenous status and remoteness, Australia (per 1000 people)
Table 10A.88 Separations for selected vaccine preventable conditions by Indigenous status, 2014-15 (per 1000 people)
Table 10A.89 Separations for selected acute conditions by Indigenous status, 2014-15 (per 1000 people)
Table 10A.90 Separations for selected chronic conditions by Indigenous status, 2014-15 (per 1000 people)
Table 10A.91 Ratio of separations for Aboriginal and Torres Strait Islander people to all Australians, diabetes, 2014-15