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Report on Government Services 2016

Chapter 10, Volume E

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.

The primary and community health sector is important in the prevention of ill health as well as the detection and management of illness and injury — by direct service provision and/or referral to acute (hospital) or other healthcare services, as appropriate.

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

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.

The primary and community health sector is important in the prevention of ill health as well as the detection and management of illness and injury — by direct service provision and/or referral to acute (hospital) or other healthcare services, as appropriate.

  • Total expenditure by all governments on primary and community health was around $29.0 billion in 2013-14.
  • Australian Government expenditure on general practice in Australia was $8.3 billion in 2014 15. Of this, $7.7 billion, or $328 per person, comprised fee-for-service expenditure.
  • Australian Government expenditure on the PBS was around $7.1 billion, or $299 per person, in 2014-15.

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
  • the equitable and efficient delivery of best practice evidence-based interventions.

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 2016 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 Pharmaceutical Benefits Scheme (PBS) medicines

PBS prescriptions filled at concessional rate, 2014-15

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 91.2 91.4 90.8 87.8 92.3 93.2 84.6 82.5 90.9
Source: Attachment table 10A.12

Equity of access to general practitioners (GPs)

Availability of FSE GPs per 100 000 people, by region, 2014-15

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
Major cities 98.7 95.3 102.2 78.8 99.8 .. 69.2 .. 95.4
Outer regional, remote and very remote areas 77.4 85.9 87.2 68.5 92.2 77.6 .. 70.6 80.9
Source: Attachment tables 10A.24

Availability of GPs by sex, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
FSE Female GPs per 100 000 females/Rate 69.0 65.6 68.5 51.9 59.7 66.1 58.9 60.8 65.2
Source: Attachment tables 10A.25.
Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
FSE Male GPs per 100 000 males/ no. 124.4 124.0 127.7 100.5 133.7 106.0 78.4 79.0 121.3
Source: Attachment tables 10A.26

Availability of public dentists

FTE Dentists by region, per 100 000 people, 2014

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
Major cities rate 6.1 6.3 6.9 6.7 8.6 -- 7.0 -- 6.6
Remote and very remote rate np 10.8 6.5 3.3 np -- 9.6 7.9
Source: Attachment tables 10A.27

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

Older Aboriginal and Torres Strait Islander Australians who received a health assessment, 2014-15

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 30.8 19.8 39.9 35.0 23.8 18.2 24.1 38.4 32.7
Source: Attachment tables 10A.31

Developmental health checks

Children receiving a fourth year developmental health check, 2014-15

Most recent data for this indicator are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 70.9 28.6 79.8 53.3 57.7 53.3 49.3 66.9 58.9
Source: Attachment tables 10A.34

Effectiveness — Access indicators

Effectiveness of access to GPs

Bulk billing rates, 2014-15

Most recent data for this indicator are comparable and complete (subject to caveats) for some but not all measures (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 88.4 84.2 84.1 78.3 83.2 77.9 58.1 86.4 84.6
Source: Attachment table 10A.36

People deferring visits to GPs due to financial barriers, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 3.2 ± 0.6 5.6 ± 0.8 5.4 ± 0.8 7.0 ± 1.3 5.5 ± 1.0 7.0 ± 1.5 9.7 ± 2.2 4.1 ± 1.8 5.0 ± 0.3
Source: Attachment table 10A.37.

GP waiting times for urgent appointment, 2014-15 — less than 4 hours

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10).
  NSW Vic Qld WA SA Tas ACT NT Aust
% 67.2 ± 3.2 65.7 ± 3.9 61.7 ± 7.8 58.1 ± 7.6 58.2 ± 8.4 53.3 ± 8.6 53.2 ± 10.6 74.1 ± 7.4 63.9 ± 2.4
Source: Attachment table 10A.39

Financial barriers to PBS medicines

People deferring treatment due to financial barriers, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10).
  NSW Vic Qld WA SA Tas ACT NT Aust
% 6.9 ± 0.9 7.5 ± 0.9 8.5 ± 0.9 8.0 ± 1.4 8.6 ± 1.3 7.9 ± 1.2 7.4 ± 2.2 6.0 ± 2.2 7.6 ± 0.5
Source: Attachment tables 10A.43

Public dentistry waiting times

Median time waited for public dental care, 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 10). Data are available in attachment tables 10A.45-10A.52

Effectiveness — Appropriateness indicators

GPs with vocational registration

GPs with vocational registration, 2014-15

Most recent data for this measure are comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 83.8 77.9 80.9 82.7 81.6 80.8 87.9 59.0 81.2
Source: Attachment tables 10A.54

Management of upper respiratory tract infections (URTI)

Proportion of GP encounters for the management of acute URTI where systemic antibiotics were prescribed or supplied, April 2010 to March 2015

Most recent data for this measure are comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
Rate 31.5 ± 1.9 26.9 ± 2.1 34.5 ± 2.6 27.5 ± 4.4 27.8 ± 3.9 26.1 ± 6.3 27.6 ± 8.9 22.7 ± 9.4 30.2 ± 1.1
Source: Attachment tables 10A.59

Prescriptions for oral antibiotics used to treat upper respiratory tract infections per 1000 people, 2014-15

Most recent data for this measure comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
rate 326.4 334.3 307.7 197.5 321.2 324.2 177.2 90.1 305.2
Source: Attachment tables 10A.57

Management of chronic disease

Uptake by Practices in the Practice Incentives Program (PIP) of the PIP Diabetes Incentive, 2014-15

Most recent data for this measure comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 53.2 45.7 58.2 52.1 38.9 41.7 60.6 79.3 51.5
Source: Attachment tables 10A.61

Effectiveness — Quality — Safety indicators

Electronic health information systems

General practices using electronic systems, May 2015

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 89.3 91.5 89.1 87.6 90.8 89.0 87.3 86.2 89.6
Source: Attachment tables 10A.73

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, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 90.9 ± 0.6 90.2 ± 0.4 89.8 ± 0.3 89.5 ± 1.0 90.9 ± 1.3 88.6 ± 1.7 89.8 ± 2.8 89.2 ± 2.0 90.3 ± 0.1
Source: Attachment table 10A.76

Proportion of people who saw a dental practitioner in the previous 12 months where the practitioner always or often listened carefully to them, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 94.6 ± 1.3 94.3 ± 1.1 94.5 ± 2.0 94.6 ± 1.0 93.2 ± 2.3 94.2 ± 0.7 94.7 ± 2.0 95.6 ± 1.5 94.5 ± 0.4
Source: Attachment table 10A.79

Efficiency indicators

Cost to government of general practice per person

Age standardised fee-for-service expenditure per person on general practice, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
$ 326.1 314.3 331.1 256.8 307.9 280.5 242.4 268.9 312.3
Source: Attachment table 10A.3

Outcome indicators

Child immunisation coverage

Children aged 60 to 63 months who were fully immunised, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 92.7 92.6 92.3 90.6 90.9 92.6 93.2 92.4 92.3
Source: Attachment table 10A.84

Notifications of selected childhood diseases

Notifications of measles per 100 000 children aged 0-14 years, 2014-15

Most recent data for this measure comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
rate 0.4 2.0 1.5 1.8 np 8.2 np 1.4
Legend: – Nil or rounded to zero
Source: Attachment table 10A.86

Participation for women in breast cancer screening

Participation rates for women in breast cancer screening, 1 January 2013 to 31 December 2014

Most recent data for this measure comparable and complete (subject to caveats) (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 50.2 54.2 57.0 54.0 54.8 56.4 53.9 39.3 53.7
Source: Attachment tables 10A.88

Participation for women in cervical screening

Participation rates for women in cervical screening, 1 January 2013 to 31 December 2014 (ASR)

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 57.0 60.3 56.4 56.1 59.4 57.9 57.9 55.2 57.8
Source: Attachment table 10A.93

Influenza vaccination coverage for older people

Influenza vaccination coverage for people aged 65 years or over, 2009)

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
Rate 72.7 75.0 74.6 72.9 81.3 77.5 78.0 69.3 74.6
Source: Attachment table 10A.95

Separations for selected potentially preventable hospitalisations

Separations for selected potentially preventable hospitalisations, 2013-14, per 1000 people

Most recent data for this measure are comparable and complete, subject to caveats (chapter 10)
  NSW Vic Qld WA SA Tas ACT NT Aust
Rate 22.4 22.9 27.9 24.6 25.6 22.0 18.5 48.9 24.4
Source: Attachment tables 10A.98

Legend

na Not available.

.. Not applicable.

- Nil or rounded to zero.

np Not published.

Source: Chapter 10 and Attachment 10A

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.20 Approved providers of PBS medicines by PhARIA area, 2015
Table 10A.30 Annual health assessments for older people by Indigenous status (per cent)
Table 10A.31 Older Aboriginal and Torres Strait Islander people who received an annual health assessment (per cent)
Table 10A.32 Aboriginal and Torres Strait Islander people who received a health check or assessment, by age (per cent)
Table 10A.34 Proportion of children receiving a fourth year developmental health check, by type of health check (per cent)
Table 10A.38 Aboriginal and Torres Strait Islander people deferring access to GPs due to cost, 2012-13 (per cent)
Table 10A.44 Aboriginal and Torres Strait Islander people deferring access to prescribed medication due to cost, 2012-13 (per cent)
Table 10A.45 Median waiting time for public dental care, NSW (days)
Table 10A.46 Median waiting time for public dental care, Victoria (days)
Table 10A.47 Median waiting time for public dental care, Queensland (days)
Table 10A.48 Median waiting time for public dental care, WA (days)
Table 10A.49 Median waiting time for public dental care, SA (days)
Table 10A.50 Median waiting time for public dental care, Tasmania (days)
Table 10A.51 Median waiting time for public dental care, ACT (days)
Table 10A.52 Median waiting time for public dental care, NT (days)
Table 10A.66 Proportion of people with asthma with a written asthma plan, by Indigenous status, by age, 2011-13
Table 10A.67 Proportion of people with asthma with a written asthma plan, by Indigenous status
Table 10A.74 Practices in the Practice Incentives Program (PIP) using computers for clinical purposes
Table 10A.75 Practices in the Practice Incentives Program (PIP) using computers for clinical purposes, by region
Table 10A.76 Practices in the Practice Incentives Program (PIP) using computers for clinical purposes, by region, 2010 to 2012
Table 10A.77 Client experience of GPs by remoteness, States and Territories
Table 10A.78 Client experience of GPs by remoteness, Australia
Table 10A.79 Client experience of GPs by remoteness, Aboriginal and Torres Strait Islander people, Australia, 2012-13
Table 10A.91 Participation rates for Aboriginal and Torres Strait Islander women screened by BreastScreen Australia (24 month period) (first and subsequent rounds) (per cent)
Table 10A.95 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.98 Proportion of Aboriginal and Torres Strait Islander people aged 50 years or over who were fully vaccinated against influenza and pneumococcal disease
Table 10A.100 Separations for selected potentially preventable hospitalisations by Indigenous status (per 1000 people)
Table 10A.102 Separations for selected potentially preventable hospitalisations by Indigenous status and remoteness, Australia (per 1000 people)
Table 10A.103 Separations for selected vaccine preventable conditions by Indigenous status, 2013-14 (per 1000 people)
Table 10A.104 Separations for selected acute conditions by Indigenous status, 2013-14 (per 1000 people)
Table 10A.105 Separations for selected chronic conditions by Indigenous status, 2013-14 (per 1000 people)
Table 10A.106 Ratio of separations for Aboriginal and Torres Strait Islander people to all Australians, diabetes, 2013-14