Report on Government Services 2015

Chapter 10, Volume E

Primary and community health

The Primary and community health chapter (chapter 10) of the Report on Government Services reports on primary and community healthcare services, with a particular focus on general practice, primary healthcare services for Aboriginal and Torres Strait Islander people, public dental services, drug and alcohol treatment, maternal and child health, the Pharmaceutical Benefits Scheme (PBS) and a range of other community health services.

The primary and community health sector is the part of the healthcare system most frequently used by Australians. It is important in preventative healthcare as well as in the detection and management of illness and injury — through direct service provision and through referral to acute (hospital) or other healthcare services, as appropriate.

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Key Facts
Indicator Framework
Indicator Results

Total expenditure by all governments on primary and community health, including public health, was around $30.2 billion in 2012-13.

Australian Government expenditure on general practice in Australia was $7.9 billion in 2013-14. Of this, $7.3 billion, or $299 per person, comprised fee-for-service expenditure.

Australian Government expenditure on the PBS was around $7.3 billion, or $313 per person, in 2013-14.

Primary and community health services aim to support and improve the health of Australians by:

providing a universally accessible point of entry to the healthcare system
promoting health and preventing illness
providing timely and high quality healthcare that meets individual needs, throughout the lifespan — directly, and/or by facilitating access to the appropriate service(s)
coordinating service provision to ensure continuity of care where more than one service type, and/or ongoing service provision, is required to meet individuals’ healthcare needs
ensuring that primary and community health service interventions are based on best practice evidence and delivered 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 2015 Report.

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 Pharmaceutical Benefits Scheme (PBS) medicines

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of total PBS prescriptions filled at concessional rate (per cent), 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	89.7	89.9	89.1	85.6	90.8	92.2	79.2	79.7	89.3

Source: Attachment tables 10A.11-10A.32.

Equity of access to general practitioners (GPs)

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Full time workload equivalent GPs by remoteness area per 100 000 people, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Major cities, rate	109.1	101.7	107.4	78.6	107.6	..	72.5	..	102.2
Outer regional, rate	84.3	96.7	97.9	84.0	102.1	82.8	..	78.9	91.4

Legend: .. Not applicable
Source: Attachment tables 10A.11-10A.32.

Availability of female GPs per 100 000 females, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	72.1	66.1	69.4	49.6	60.0	66.4	61.0	62.7	66.3

Source: Attachment tables 10A.11-10A.32.

Availability of male GPs per 100 000 males, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	140.8	135.9	136.3	102.9	148.1	119.1	83.2	81.0	132.9

Source: Attachment tables 10A.11-10A.32.

Availability of public dentists

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Per 100 000 people, 2013.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	6.6	6.2	8.5	7.2	8.3	5.9	5.0	10.0	7.1

Source: Attachment tables 10A.11-10A.32.

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

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of Older Aboriginal and Torres Strait Islander Australians who received a health assessment, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	28.1	17.4	37.5	32.7	20.8	12.9	20.4	39.8	30.4

Source: Attachment tables 10A.11-10A.32.

Developmental health checks

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Children receiving a fourth year developmental health check, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	64.8	27.5	78.1	49.7	52.5	56.8	41.4	69.9	55.6

Source: Attachment tables 10A.11-10A.32.

Effectiveness — Access indicators

Effectiveness of access to GPs

Most recent data for this indicator are comparable and complete (subject to caveats) for some but not all measures (chapter 10).

Bulk billing rates for non-referred patients, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	87.9	83.2	83.1	75.7	82.2	77.7	57.2	82.8	83.6

Source: Attachment table 10A.33-10A.46.

GP waiting times for urgent appointment, 2013-14 — less than 4 hours.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	64.7	63.4	65.4	65.2	64.7	51.8	58.3	78.4	64.2

Source: Attachment table 10A.33-10A.46.

People deferring treatment due to cost, 2013-14 — deferring visits to GPs.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	3.5	5.0	5.8	6.2	4.5	6.9	6.9	5.6	4.9

Source: Attachment table 10A.33-10A.46.

Selected potentially avoidable GP-type presentations to emergency departments, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
'000	709.3	572.4	381.4	272.9	113.4	61.2	50.5	39.3	2200.4

Source: Attachment table 10A.33-10A.46.

Financial barriers to PBS medicines

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of people deferring treatment due to cost, 2013–14 — deferring purchase of prescribed medicines.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	7.0	6.3	9.9	8.4	7.5	8.0	6.7	6.2	7.6

Source: Attachment tables 10A.33–10A.46.

Public dentistry waiting times

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of waiting times less than 1 month, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	27.6	17.8	27.2	19.7	18.4	26.2	32.5	24.4	23.4

Source: Attachment tables 10A.33–10A.46.

Effectiveness — Appropriateness indicators

GPs with vocational registration

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of GPs with vocational registration, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	90.6	85.5	88.0	89.5	89.5	90.8	91.8	69.8	88.5

Source: Attachment tables 10A.47-10A.67

Management of upper respiratory tract infections

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Prescriptions for oral antibiotics used to treat upper respiratory tract infections (URTI) per 1000 people, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	319.1	324.8	292.3	187.8	310.0	314.9	175.5	92.2	295.2

Source: Attachment tables 10A.47-10A.67.

Proportion of GP encounters for the management of acute URTI where systemic antibiotics were prescribed or supplied, April 2009 to March 2014.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	33.0	27.4	33.1	25.6	26.7	26.3	25.7	20.9	30.5

Source: Attachment tables 10A.47-10A.67.

Chronic disease management

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Uptake by Practices in the Practice Incentives Program (PIP) of the PIP Diabetes Incentive, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	48.6	42.1	54.3	47.8	35.4	36.4	57.7	72.7	47.3

Source: Attachment tables 10A.47-10A.67.

People with asthma who have a written asthma action plan, 2011-12.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	26.6	25.3	18.4	24.5	29.3	22.6	24.3	33.7	24.6

Source: Attachment tables 10A.47-10A.67.

Use of pathology tests and diagnostic imaging

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Medicare benefits for diagnostic imaging, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$ per person	72.9	58.2	69.8	51.5	53.4	53.6	51.1	42.9	63.8

Source: Attachment tables 10A.47-10A.67.

Effectiveness — Quality — Safety indicators

Electronic health information systems

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

General practices using electronic systems, May 2014.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	85.7	89.0	86.0	83.0	86.7	86.0	84.5	78.2	86.3

Source: Attachment tables 10A.68-10A.70.

Effectiveness — Quality — Responsiveness indicators

Patient satisfaction

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of people who saw a practitioner in the previous 12 months where the practitioner always or often: listened carefully to them, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
GP (%)	91.2	91.3	89.8	88.6	90.9	91.3	89.1	84.8	90.6
Dental Practitioner (%)	94.8	94.5	92.9	96.5	96.5	93.7	95.4	94.5	94.6

Source: Attachment table 10A.71-10A.75.

Effectiveness — Quality — Continuity indicators

Health assessments for older people

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of older people assessed, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	30.52	28.84	35.69	30.75	30.20	34.28	23.21	31.60	31.06

Source: Attachment table 10A.76.

Efficiency indicators

Cost to government of general practice per person

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Fee-for-service expenditure per person (age standardised rate [ASR]), 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$ per person	314.8	301.2	314.2	238.6	295.6	272.5	230.7	241.4	298.6

Source: Attachment tables 10A.2.

Outcome indicators

Child immunisation coverage

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Proportion of children aged 60 to 63 months fully immunised, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	92.2	92.5	92.3	89.8	91.0	92.7	92.7	91.4	92.0

Source: Attachment tables 10A.94.

Notifications of selected childhood diseases

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Measles notifications per 100 000 children, 2013-14.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	2.1	2.5	2.2	2.1	3.4	–	–	33.4	2.6

Legend: – Nil or rounded to zero
Source: Attachment tables 10A.77-10A.94.

Participation for women in breast cancer screening

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Participation rates for women in breast cancer screening, Ages 50-69, 1 January 2012 to 31 December 2013.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	50.9	54.6	57.3	56.8	53.0	57.8	54.4	41.0	54.3

Source: Attachment tables 10A.77-10A.94.

Participation for women in cervical screening

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10).

Participation rates for women in cervical screening, Ages 20-69 (ASR), 1 January 2012 to 31 December 2013.
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	57.4	61.6	56.4	55.9	59.0	57.4	58.0	55.1	58.2

Source: Attachment tables 10A.77-10A.94.

Selected potentially preventable hospitalisations

Most recent data for this indicator are comparable and complete, subject to caveats, except for the measure potentially preventable hospitalisations for diabetes (chapter 10).

Separations for selected potentially preventable hospitalisations, 2012-13, per 1000 people.

Vaccine-preventable
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	0.7	0.8	1.1	1.0	1.1	1.0	0.8	3.7	0.9

Source: Attachment tables 10A.77-10A.94.

Acute conditions excluding dehydration and gastroenteritis
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	10.8	10.2	13.8	13.6	13.6	9.9	9.3	20.5	11.8

Source: Attachment tables 10A.77-10A.94.

Chronic conditions excluding additional diagnoses of diabetes complications
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	10.4	10.8	12.9	11.3	11.9	10.1	8.3	22.1	11.3

Source: Attachment tables 10A.77-10A.94.