Report on Government Services 2024

Primary and community health services are delivered by a range of health and allied health professionals in various private, not‑for‑profit and government service settings. Definitions for common health terms are provided in the 'Explanatory material' tab.

General practice

General practice is a major provider of primary healthcare in Australia. General practice services include preventative care and the diagnosis and treatment of illness and injury, through direct service provision and/or referral to acute (hospital) or other healthcare services, as appropriate.

The Australian Government provides the majority of general practice income, through Services Australia – mainly as fee for service payments via the Medicare Benefits Schedule (MBS) – and the Department of Veterans’ Affairs (DVA). Additional funding is provided to influence the supply, regional distribution and quality of general practice services, and support engagement of the health workforce in primary health care settings, through initiatives such as the Practice Incentives Program (PIP), the Workforce Incentive Program (WIP), and Primary Health Networks (PHNs) (Services Australia 2021). State and territory governments also provide some funding for such programs, mainly to influence the availability of GPs in rural and remote areas. The remainder comes primarily from insurance schemes (for example, workers compensation schemes and traffic accident schemes that cover medical expenses in certain circumstances) and patient contributions.

Pharmaceutical services

The Commonwealth funds the Pharmaceutical Benefits Scheme (PBS), which subsidises the cost of many medicines in Australia. The PBS schedule sets a price for listed medicines and a maximum co-payment amount that people contribute towards the cost of these medicines. The Commonwealth incurs the expense of any difference where the listed price exceeds the patient co-contribution (whether for general or concessional patients).

Around 69% of PBS prescriptions dispensed in 2022-23 were above the co-payment threshold, meaning patients paid the relevant co-payment and the remaining cost was subsidised by the Australian Government. Around 31% of PBS prescriptions dispensed in 2022-23 were under the co-payment threshold, meaning the patient paid the full cost with no government subsidy (AIHW unpublished). Co-payments contribute to a patient’s safety net threshold that, once reached, provides eligibility to receive PBS medicines at a lower cost or free of charge (Department of Health and Aged Care 2021).

The Repatriation Pharmaceutical Benefits Scheme (RPBS) provides subsidised pharmaceutical medicines, dressings and other items to war veterans and war widows. The RPBS is administered by the DVA.

Dental services

Australia has a mixed system of public and private dental services. State and territory governments deliver public dental services, which are primarily available to children and disadvantaged adults. The Australian Government works with state and territory governments to fund dental services. Since 2013, the Australian Government has increased funding for public dental services via National Partnership Agreements and Federal Funding Agreements with states and territories and the Child Dental Benefits Schedule. The private sector receives funding to provide some public dental services, from the Australian Government through the DVA and the Child Dental Benefits Schedule, and from state and territory governments through dental voucher systems. Under the COAG Health Council, Australian governments developed the National Oral Health Plan 2015 to 2024 that sets out priorities to improve dental health across Australia (COAG 2015). Data on dental service expenditure in 2021-22 is presented in table 10A.6.

Allied health services

Allied health services include, but are not limited to, physiotherapy, psychology, occupational therapy, podiatry and osteopathy. They are delivered mainly in the private sector. Some government funding of private allied health services is provided through insurance schemes and the private health insurance rebate. The Australian Government makes some allied health services available under the MBS to patients with particular needs – for example, people with chronic conditions and complex care needs. The Australian Government also funds the Workforce Incentive Program (WIP) – Practice Steam, which supports general practices, Aboriginal Medical Services and Aboriginal Community Controlled Health Services with the cost of engaging eligible allied health professionals. Data on the number of Medicare rebated allied health services used per person and the availability of public allied health professionals by region is presented in tables 10A.10 and 10A.22, respectively.

Community health services

Community health services generally comprise multidisciplinary teams of health and allied health professionals who provide targeted health promotion, prevention and management services. Their aim is to protect the health and wellbeing of local populations, particularly people who have or are at risk of the poorest health and/or have the greatest economic and social needs, while taking pressure off the acute care health system. Governments (including local governments) provide community health services directly or indirectly by funding local health services and community organisations. There is no national strategy for community health services and there is considerable variation in the services provided across jurisdictions.

State and territory governments are responsible for most community health services. Those serving Aboriginal and Torres Strait Islander communities are mainly the responsibility of the Australian Government (state and territory governments provide some funding).

Maternal and child health services

Maternal and child health services are funded by state and territory governments. They provide services including: parenting support (including antenatal and postnatal programs); early childhood nursing programs; disease prevention programs (including childhood immunisations); and early intervention and treatment programs related to child health and development. Some jurisdictions also provide specialist programs through child health services, including hearing screening programs, and mothers and babies residential programs.

Alcohol and other drug treatment

Alcohol and other drug treatment activities range from a brief intervention to long term residential treatment. Types of treatment include withdrawal management, pharmacological treatment, counselling and rehabilitation. Selected data on these services is available in table 10A.13.

• $11.4 billion for community health services (36.1% by the Australian Government and 63.9% by state, territory and local governments)
• $2.3 billion for dental services (57.5% by the Australian Government and 42.5% by state, territory and local governments) (table 10A.6).

Where more recent data is available, for 2022-23, Australian Government expenditure was:

• $11.0 billion on general practice (table 10A.2)
• $11.9 billion through the PBS and RPBS on Section 85 prescription medicines filled at pharmacies (table 10A.3)
• $53.9 million on funding of PBS medicines to Aboriginal and Torres Strait Islander primary health services in remote and very remote areas (table 10A.5)
• $903.2 million on Aboriginal and Torres Strait Islander primary health services (table 10A.7).

Nationally in 2022, there were 38,881 GPs – 29,921 on a full-time equivalent (FTE) basis, equating to 115.2 per 100,000 people (table 10A.8), a decrease from 120.9 in 2021 (table 10A.8).

Nationally, rates of GP-type services used per person decreased between 2021-22 (7.6 services per person) and 2022-23 (6.6 services per person) (table 10A.9). GP-type services disaggregated by in-person attendances and telehealth appointments are reported in table 10A.9. Nationally in 2022-23, 1.2 telehealth GP-type services were used per person (figure 10.1).

Around 220 million services (8.3 per person) were subsidised under Section 85 of the PBS in 2022-23 – with 89.6% concessional. A further 7.1 million services were subsidised under the RPBS (tables 10A.11-12).

Nationally in 2021-22 there were:

• 211 Aboriginal and Torres Strait Islander primary health services which provided 4.0 million episodes of healthcare (table 10A.14). Data by remoteness is presented in table 10A.15 and health service staffing numbers are provided in table 10A.16.
• 1,274 alcohol and other drug treatment agencies (31.6% identified as government providers) with a reported 228,451 closed treatment episodes (27.1% identified as government provided) (table 10A.13).

The most recent available data on public dental service usage is for 2013 and showed that nationally, around 97.8 per 1,000 people accessed public dental services that year (AIHW unpublished).

‘Availability of primary healthcare services’ is an indicator of governments’ objective to provide access to primary healthcare services in an equitable manner.

‘Availability of primary healthcare services’ is defined by four measures:

• PBS medicines by region, defined as the ABS census population divided by the number of approved suppliers of PBS medicines, by metropolitan/rural and remote location under the Modified Monash Model (MMM) classification
• General Practitioners (GPs) by region, defined as the number of FTE GPs per 100,000 people, by region
• GPs by sex, defined as the number of FTE GPs per 100,000 population, by sex
• Public dentists by region, defined as the number of full time equivalent (FTE) public dentists per 100,000 people based on clinical hours worked in the public sector, by region.

A similar rate across regions is desirable as it indicates equity of access by location. A similar rate by sex is desirable as it means patients who prefer to visit GPs of their own sex are more likely to have their preference met. A low rate of GPs of either sex could be associated with increased waiting times to see a GP, for patients who prefer to visit GPs of their own sex.

Measures on GPs by region and sex, and public dentists by region do not provide information on whether people are accessing services or whether the services are appropriate for the needs of the people receiving them.

Measure 1: Nationally, at 30 June 2023, there were 4,106 people per approved PBS provider in metropolitan areas and 3,263 people per approved PBS supplier in rural and remote areas (figure 10.2a). These numbers have decreased in metropolitan and rural and remote areas following a peak in 2017 (table 10A.18). Data is also available for pharmacy suppliers only (table 10A.18) and by MMM area (table 10A.17).

Measures 2-3: Nationally in 2022, the number of FTE GPs per 100,000 people decreased as remoteness increased (118.1 GPs per 100,000 people in major cities compared to 88.9 GPs per 100,000 people in outer regional, remote and very remote areas) (table 10A.19). Nationally in 2022, there were 95.1 FTE female GPs per 100,000 females and 135.6 FTE male GPs per 100,000 males (figure 10.2b).

Measure 4: Nationally in 2022, the rate of FTE public dentists per 100,000 people was higher in outer regional areas (5.8 per 100,000 people) compared to other areas (4.9 – 5.5 per 100 people) (figure 10.2c). Data on FTE public dentists and allied dental practitioners are presented in table 10A.22.

‘Health checks for Aboriginal and Torres Strait Islander people’ is an indicator of governments’ objective to provide access to primary and community healthcare in an equitable manner.

‘Health checks for Aboriginal and Torres Strait Islander people’ is defined as the number of Aboriginal and Torres Strait Islander people who had an MBS health check that is Aboriginal and Torres Strait Islander-specific, by assessment location divided by the number of Aboriginal and Torres Strait Islander people, and is presented as a rate per 1,000 people.

An increase over time in the proportion of Aboriginal and Torres Strait Islander people who received a health check is desirable as it indicates improved access to these services.

This indicator provides no information about health checks provided outside Medicare (predominantly used by Aboriginal and Torres Strait Islander people in remote and very remote areas). Accordingly, this indicator understates the proportion of Aboriginal and Torres Strait Islander people who received health check services.

Nationally in 2022-23, 269.7 per 1,000 Aboriginal and Torres Strait Islander people had an Indigenous-specific health check, reversing the downward trend from the peak in 2018-19 (287.7 per 1,000 people) (figure 10.3). Nationally in 2022-23, Aboriginal and Torres Strait Islander people mainly received Indigenous-specific health checks at health facilities or residential aged care (99%), with 1% obtaining checks via telehealth.

Data by age group is reported in table 10A.25.

‘Affordability of primary healthcare services’ is an indicator of governments’ objective to provide primary healthcare services that are affordable.

‘Affordability of primary healthcare’ is defined by two measures:

• People delaying or not seeing a GP due to cost, defined as the proportion of people who delayed seeing or did not see a GP when needed at any time in the previous 12 months due to cost.
• People delaying or not filling prescription medication due to cost, defined as the proportion of people who delayed filling or did not fill a prescription when needed at any time in the previous 12 months due to cost.

A low or decreasing proportion of people deferring visits to GPs or filling prescription medication due to cost indicates more widely affordable access to GPs and medicines.

Data is sourced from the ABS Patient Experience Survey (PEx) of people aged 15 years and over. The PEx does not include people living in discrete Indigenous communities, which affects the representativeness of the Northern Territory results. Approximately 20% of the resident population of the Northern Territory live in discrete Indigenous communities as of 2020-21.

Measure 1: Nationally in 2022-23, 7.0% of respondents who needed to see a GP reported that they delayed or did not see a GP in the last 12 months due to cost, double the proportion of respondents in 2021-22 (3.5%) and the highest over the reported time series (figure 10.4a).

Contextual information on bulk billing and out-of-pocket costs are provided to assist interpretation of this indicator. Bulk billing information is available for both patients and services (one patient may have more than one service in a given year). Bulk billing rates for non-referred GP and specialist services, by jurisdiction, region and age are available in tables 10A.27-30. Nationally in 2022-23, 80.2% of non-referred GP services and 30.2% of specialist services were bulk billed. Information on the proportion of non-referred GP patients who were fully bulk billed are available in table 10A.31. Nationally in 2022-23, 51.7% of patients were fully bulk billed, a decrease from 65.8% in 2021-22. Data on average patient out-of-pocket costs are reported in table 10A.32. Nationally in 2022-23, out-of-pocket costs were highest for specialists ($108), followed by allied health services ($65) and non-referred GPs ($43).

Measure 2: Nationally in 2022-23, 7.6% of respondents who needed a prescription for medication reported that they delayed filling or did not fill a prescription in the last 12 months due to cost, an increase from 2021-22 (5.6%) (figure 10.4b).

‘Timeliness of primary healthcare services’ is an indicator of governments’ objective to ensure primary healthcare services are provided in a timely manner.

‘Timeliness of primary healthcare services’ is defined by two measures:

• Public dentistry waiting times, defined as the number of days waited at the 50th (median) and 90th percentiles between being placed on a selected public dentistry waiting list and either being offered dental care or receiving dental care
• GP waiting times for urgent medical care, defined as the proportion of people who, in the previous 12 months, saw a GP for urgent medical care within specified times from making the appointment. Specified waiting times are less than 4 hours, 4 to less than 24 hours, 24 hours or more.

A shorter time waited to see a dental professional indicates more timely access to public dental services. A high or increasing proportion of people who saw a GP within 4 hours for urgent medical care indicates more timely access to GPs.

Public dental waiting times only include records on persons eligible for public dental services who were aged 18 years or over. It excludes those on jurisdictional priority client schemes and those who access the service but pay full price. Data is reported by Aboriginal and Torres Strait Islander status, remoteness area of residence, and Socio-Economic Indexes for Areas (SEIFA) of residence.

The ABS Patient Experience Survey of people aged 15 years and over does not include people living in discrete Indigenous communities, which affects the representativeness of the Northern Territory results for the GP waiting times measure. Approximately 20% of the estimated resident population of the Northern Territory live in discrete Indigenous communities as of 2020-21.

Measure 1: Data for the time waited at the 50th and 90th percentiles by people on selected public dental waiting lists are presented for states and territories (figure 10.5a).

Measure 2: Nationally in 2022-23, for people who saw a GP for urgent care:

• 41.5% waited less than 4 hours, down from 49.7% in 2021-22
• 12.7% waited from 4 to less than 24 hours, up from 10.9% in 2021-22
• 45.6% waited for 24 hours or more, up from 39.1% in 2021-22 (figure 10.5b).

Overall, 29.6% of people who saw a GP for their own health waited longer than they felt was acceptable to get an appointment, an increase on 2021-22 (23.4%) and the highest proportion over the reported time series (table 10A.44).

‘Potentially avoidable presentations to emergency departments’ (also known as ‘GP-type presentations’) is an indicator of governments’ objective for primary and community healthcare to be accessible.

Potentially avoidable presentations to emergency departments (interim measure) are defined as the number of selected ‘GP‑type presentations’ to emergency departments, where selected GP‑type presentations are emergency presentations:

• allocated to triage category 4 (semi‑urgent) or 5 (non‑urgent); and
• not arriving by ambulance, with police or corrections; and
• not admitted or referred to another hospital; and
• who did not die.

Potentially avoidable presentations to emergency departments are presentations for conditions that could be appropriately managed in the primary and community health sector. In some cases, this can be determined only retrospectively and presentation to an emergency department is appropriate. Factors contributing to GP‑type presentations at emergency departments include perceived or actual lack of access to GP services, the proximity of emergency departments and trust in emergency department staff.

Once a suitable denominator for this measure is agreed, a low or decreasing rate/proportion of potentially avoidable presentations to emergency departments can indicate better access to primary and community health care. Currently, the number of potentially avoidable presentations to emergency departments are reported for this indicator. In future, this indicator will be reported as a proportion (for example, the number of potentially avoidable GP-type presentations to emergency departments, as a proportion of all presentations to emergency departments), subject to the identification of a suitable denominator.

Nationally in 2022-23, there were around 2.8 million GP-type presentations to public hospital emergency departments, a decrease of 7.2% from 2021-22 (table 10.1). Results varied across jurisdictions.

‘Developmental health checks’ is an indicator of governments’ objective to ensure that services are appropriate and responsive to the needs of children.

‘Developmental health checks’ are defined as the proportion of preschool-aged children who received a developmental health assessment.

A high or increasing proportion of preschool-aged children receiving developmental health checks is desirable.

This indicator is currently under development for reporting in the future.

‘Chronic disease management’ is an indicator of governments’ objective to ensure that primary and community health services are appropriate and responsive to meet the needs of individuals throughout their lifespan.

‘Chronic disease management’ is defined by two measures:

• Rate of chronic disease care services (under Team Care Arrangements (TCAs) and GP Management Plans (GPMPs))
• Management of asthma, defined as the proportion of people with asthma who have a written asthma action plan.

A high or increasing proportion for each measure is desirable.

Measure 1 focuses on patients who had a GP Management Plan (GPMP) prepared or a Team Care Arrangements (TCA) co-ordination service. These are the two most highly used chronic disease management services available on the Medicare Benefits Schedule (MBS) for people with a chronic or terminal medical condition.

Claiming patterns of chronic disease management services vary by demographic characteristics, jurisdiction, remoteness and socioeconomic areas. MBS data does not give a comprehensive picture of actual service delivery and data does not include chronic disease care services provided under other arrangements that do not attract an MBS claim.

The ABS National Health Survey does not include people living in very remote areas and discrete Indigenous communities, which affects the representativeness of the Northern Territory results for the asthma measure. Approximately 20% of the estimated resident population of the Northern Territory live in very remote areas and discrete Indigenous communities as of 2020-21.

Measure 1: Nationally in 2022-23, the rate of patients claiming for GPMP services was 122.3 per 1,000 people. The rate of patients claiming for TCAs was 104.3 per 1,000 people (Figure 10.6a).

Measure 2: Nationally in 2022, the age-standardised proportion of people with asthma reporting that they have a written asthma action plan was 35.4% (figure 10.6b), compared to 32.3% in 2017-18. In all jurisdictions, the proportion was higher for children aged 0–14 years than for other age groups (nationally, 71.5%) (table 10A.46).

Biomedical data on the management of diabetes is available in earlier reports.

‘Immunisation coverage’ is an indicator of governments’ objective to ensure primary and community health services are appropriate and responsive to meet the needs of individuals throughout their lifespan and communities.

‘Immunisation coverage’ is defined by four measures:

• Proportion of children aged 12<15 months who are fully immunised (at this age, against diphtheria, tetanus, pertussis (whooping cough), polio, hepatitis b, Haemophilus influenzae type b and pneumococcal)
• Proportion of children aged 24<27 months who are fully immunised (at this age, against diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b, hepatitis B, measles, mumps and rubella (MMR), meningococcal C and varicella)
• Proportion of children aged 60<63 months who are fully immunised (at this age, against diphtheria, tetanus, pertussis (whooping cough), polio, and to the quarter ending 31 December 2017, including measles, mumps and rubella (MMR))
• Proportion of people aged 65 years and over who have been vaccinated against seasonal influenza.

High or increasing proportions of immunisation coverage are desirable.

Measures 1-3: Nationally, the proportion of children fully immunised in 2022-23 was: 93.4% for children aged 12 to less than 15 months; 91.3% for children aged 24 to less than 27 months; and 94.1% for children aged 60 to less than 63 months (figure 10.7a). Contextual data on vaccinations supplied to children under seven years of age, by type of provider is reported in table 10A.47.

Measure 4: Nationally, in 2023, 61.0% of people aged 65 years and over were vaccinated against seasonal influenza, with the proportion slightly higher for non-Indigenous people (61.1%) compared to Aboriginal and Torres Strait Islander people (58.4%) (figure 10.7b).

‘Cancer screening’ is an indicator of governments’ objective to ensure primary and community health services are appropriate and responsive to meet the needs of individuals throughout their lifespan and communities.

‘Cancer screening’ is defined by three measures:

• Participation in breast cancer screening, defined as the proportion of women aged 50–74 years who are screened in the BreastScreen Australia Program over a 24‑month period
• Participation in cervical screening, is defined as the number of people aged 25–74 years screened in a five-year period as a percentage of females in the population.
  • A new National Cervical Screening Program commenced in December 2017, at which time cervical screening changed from two-yearly Pap tests to five-yearly Cervical Screening Tests. Participation data for 2018-2022 is the first to show a five-year participation rate in the new program.
• Participation in bowel cancer screening, defined as people aged 50–74 years who were invited to participate in the National Bowel Cancer Screening Program over a 24‑month period and returned a completed test kit within six months of the end of that period, divided by the number of invitations issued minus those people who opted out or suspended without completing their screening test.

High or increasing screening participation rates are desirable.

Measure 1: The national age-standardised BreastScreen participation rate for women aged 50–74 years for 2021–2022 was 49.6% (figure 10.8a), an increase from 2020–2021 (47.0%). While screening rates have increased, they have not returned to pre-pandemic levels (54.2% in 2018-19). For 2021–2022, the participation rate for Aboriginal and Torres Strait Islander women aged 50–74 years was 36.7%, also an increase from 2020–2021 (35.1%) (table 10A.51).

Measure 2: For the five-year period 2018-2022, the national aged-standardised participation rate for people aged 25-74 years in cervical cancer screening was 68.4% (table 10.3).

Data collected under the previous cervical cancer screening program (to June 2017) is available in earlier reports.

Measure 3: For 2021-2022, the national participation rate for people aged 50–74 years in bowel cancer screening was 40.0%, a decrease from 40.9% in 2020–2021, a continued downward trend from 2019-2020 (43.8%) (figure 10.8b).

‘General practices with accreditation’ is an indicator of governments’ objective to ensure primary and community health services are high quality and safe.

‘General practices with accreditation’ is defined as the number of general practices in Australia that are accredited as a rate per 100 general practices. Accreditation is a voluntary process of independent third‑party peer review that assesses general practices against a set of standards developed by the Royal Australasian College of General Practitioners.

A high or increasing rate of practices with accreditation can indicate an improvement in the capability of general practice to deliver high quality services. However, general practices without accreditation may deliver services of equally high quality. For a particular general practice, the decision to seek accreditation might be influenced by perceived costs and benefits unrelated to its quality standards.

Nationally in 2019, 83.8 general practices were accredited per 100 general practices (figure 10.9).

While rates are not available from 2020 onwards (as the total number of general practices (denominator) was not available), the number of accredited general practices at 30 June 2023 was 7,135, a decrease from 7,219 at 30 June 2022 (table 10A.54). The Australian Government is developing a method to source the total number of general practices. Data is expected to be available for the 2025 Report.

‘Patient satisfaction’ is an indicator of governments’ objective that primary and community health services are high quality.

‘Patient satisfaction’ is defined as the quality of care as perceived by the patient. It is measured as patient experience of aspects of care that are key factors in patient outcomes and can be readily modified. Two measures of patient experience of communication with health professionals – a key aspect of care – are reported:

• the proportion of people who needed to and saw a GP in the previous 12 months who reported the GP always or often:
  • listened carefully to them
  • showed respect
  • spent enough time with them
• the proportion of people who needed to and saw a dental professional in the previous 12 months who reported the dental professional always or often:
  • listened carefully to them
  • showed respect
  • spent enough time with them.

High or increasing proportions can indicate improved satisfaction with the quality of care from the patient’s perspective.

The ABS Patient Experience Survey of people aged 15 years and over does not include people living in discrete Indigenous communities, which affects the representativeness of the Northern Territory results. Approximately 20% of the resident population of the Northern Territory live in discrete Indigenous communities as of 2020-21.

Measure 1: Nationally in 2022-23, the majority of respondents who needed to and saw a GP reported that the GP always or often:

• listened carefully (90.7%)
• showed respect (94.1%)
• spent enough time with them (87.5%) (figure 10.10a) (tables 10A.55-56).

Measure 2: Nationally in 2022-23, the majority of respondents who needed to and saw a dental professional reported that the dental professional always or often:

• listened carefully (96.3%) (figure 10.10b)
• showed respect (97.1%).
• spent enough time with them (96.9%) (tables 10A.57-58).

Data by remoteness for measures 1 and 2 is presented in tables 10A.55-58.

‘Continuity of care’ is an indicator of governments’ objective to ensure that services are well co-ordinated when more than one service type and/or ongoing service provision is required.

‘Continuity of care’ is defined by three measures:

• the proportion of GP management plans and team care assessment plans that have been reviewed in the last 12 months
• the proportion of people who saw three or more health professionals in the last 12 months for the same condition and who reported that a health professional helped coordinate their care and that this coordination of care helped to a large extent
• the proportion of people who saw three or more health professionals in the last 12 months for the same condition and who reported that issues were caused by a lack of communication between the health professionals.

For the first measure, proportions are calculated by dividing the number of MBS subsidised GP management plans and team care assessment plans reviewed (Medicare item no. 732), by the total number of MBS subsidised GP management plans (Medicare item no. 721) and team care assessment plans (Medicare item no. 723), multiplied by 100.

A high or increasing proportion of GP management and team care assessment plans reviewed is desirable.

The second and third measures are enumerated using data from the ABS Patient Experience Survey (PEx) of people aged 15 years and over. The PEx does not include people living in discrete Indigenous communities, which affects the representativeness of the Northern Territory results for both measures. Approximately 20% of the estimated resident population of the Northern Territory live in discrete Indigenous communities as of 2020-21.

For the second measure, a high or increasing proportion of patients who saw three or more different health professionals in the past 12 months for the same condition and who reported that a health professional helped coordinate their care and that this coordination of care helped to a large extent is desirable.

For the third measure, a low or decreasing proportion of patients who saw three or more different health professionals in the past 12 months for the same condition and who reported that issues were caused by a lack of communication between health professionals is desirable.

Measure 1: Nationally in 2022-23, 69.8% of MBS subsidised GP management plans and team care assessment plans were reviewed. This is lowest for the seven years of reported data and reflects a continuing decrease since the peak in 2018-19 (74.1%) (figure 10.11a).

Measures 2-3: Nationally in 2022-23, the proportion of people who saw three or more health professionals in the last 12 months for the same condition and who reported that:

• a health professional helped coordinate their care and that this coordination of care helped to a large extent was 68.4% (figure 10.11b)
• issues were caused by a lack of communication between the health professionals was 14.5% (figure 10.11c).

‘Workforce sustainability’ is an indicator of governments’ objective to provide sustainable primary and community healthcare services.

‘Workforce sustainability’ is defined by two measures:

• the proportion of full-time equivalent (FTE) GPs in ten-year age brackets
• the attrition rate of FTE GPs who exit the workforce as a proportion of the number of FTE GPs by age bracket.

A high or increasing percentage of the workforce that are new entrants and/or low or decreasing proportions of the workforce that are close to retirement is desirable. A low or decreasing rate of workforce attrition is desirable.

The attrition rate is measured as the proportion of GPs who were in scope in 2021, but not in scope in 2022. In scope is defined as Primary Care GPs, being GPs working in the treatment of non‑admitted patients in the community. GPs who ‘exited’ (i.e., were no longer in scope) in 2022 might still be in the medical workforce and practicing as a GP but are classified as an exit as they are no longer Primary Care GPs.

Measure 1: Nationally in 2022, 26.6% of FTE general practitioners were aged 60 years or older, compared to 2.4% who were less than 30 years of age (figure 10.12). This is the highest proportion of GPs aged 60 years or older and the lowest proportion of GPs who were less than 30 years old across the reported eight-year time series.

Measure 2: Nationally in 2022, the proportion of general practitioners who exited the GP workforce was 1.3%, with the proportion highest for those 60 years and over (2.5%) (table 10.4).

‘Cost to government of general practice per person’ is an indicator of governments’ objective to provide primary and community health services in an efficient manner.

‘Cost to government of general practice per person’ is defined as the cost to government of general practice per person in the population.

This indicator should be interpreted with care. A low or decreasing cost per person can indicate higher efficiency, provided services are equally or more effective. It can also reflect service substitution between primary healthcare and hospital or specialist services – potentially at greater expense.

Cost to government of general practice does not capture the costs of salaried GP service delivery models, used particularly in rural/remote areas. Salaried GP service models involve the delivery of primary healthcare services by salaried GPs in community health settings, emergency departments, and Aboriginal and Torres Strait Islander primary healthcare services. Therefore, costs are understated for jurisdictions where a larger proportion of the population live in rural and remote areas.

Nationally in 2022-23, total expenditure per person on general practice was $420 per person, a decrease in real terms from $461 in 2021-22 (figure 10.13).

‘Notifications of selected childhood diseases’ is an indicator of governments’ objective for primary and community health services to promote health and prevent illness.

‘Notifications of selected childhood diseases’ is defined as the number of notifications of measles, pertussis and invasive Haemophilus influenzae type b reported to the National Notifiable Diseases Surveillance System by state and territory health authorities for children aged 0–14 years, per 100,000 children in that age group.

A low or reducing notification rate for the selected diseases indicates that the immunisation program is more effective.

Measles, pertussis (whooping cough) and invasive Haemophilus influenzae type b are nationally notifiable vaccine preventable diseases, and notification to the relevant state or territory authority is required on diagnosis.

Nationally in 2022-23, the rate of notifications for children aged 0–14 years was:

• 0.2 per 100,000 children for Haemophilus influenzae type b
• 0.2 per 100,000 children for measles
• 3.6 per 100,000 children for pertussis (whooping cough) (figure 10.14 and table 10A.64).

‘Selected potentially preventable hospitalisations’ is an indicator of governments’ objective for primary and community health services to promote health, prevent illness and to support people to manage their health issues in the community.

‘Selected potentially preventable hospitalisations’ is defined as hospital admissions that may be avoided by effective management of illness and injury in the primary and community healthcare sector or, in some cases, by preventing illness and injury altogether. Two measures of selected potentially preventable hospitalisations are reported by jurisdiction of residence:

• Potentially preventable hospitalisations for selected vaccine preventable, acute and chronic conditions
• Potentially preventable hospitalisations for diabetes (Type 2 diabetes mellitus as principal diagnosis).

Low or decreasing separation rates for selected potentially preventable hospitalisations can indicate more effective management of selected conditions in the primary and community healthcare sector and/or more effective preventative programs. Factors outside the control of the primary and community healthcare sector also influence hospitalisation rates for these conditions. For example, the underlying prevalence of conditions, patient compliance with management and older people’s access to aged care services and other support.

Measure 1: Nationally in 2021-22, the age-standardised hospital separation rate for selected vaccine preventable, acute and chronic conditions was 23.1 per 1,000 people, the lowest rate reported over the past ten years (table 10.5). Rates were higher for Aboriginal and Torres Strait Islander people (65.4 per 1,000 people) than other Australians (22.0 per 1,000 people).

Measure 2: Nationally in 2021-22, the age-standardised hospital separation rate for diabetes was 124.2 separations per 100,000 people (table 10.6).

The age-standardised separation rate for Aboriginal and Torres Strait Islander people (excluding separations for diabetes complications as an additional diagnosis) was 2.7 times the rate for all Australians (table 10A.72).

The most serious complication of Type 2 diabetes most commonly leading to hospitalisation in 2021-22 was circulatory complications, with an age standardised rate of 17.1 per 100,000 people (table 10A.73). Serious circulatory complications of diabetes can necessitate lower limb amputation. In 2021-22, there were 20.1 age-standardised hospital separations per 100,000 people for lower limb amputations where Type 2 diabetes mellitus was a principal or additional diagnosis (table 10A.75).