Report on Government Services 2018

Part 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, community health services, maternal and child health and alcohol and other drug treatment.

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Key Facts
Indicator Framework
Indicator Results
Indigenous Data

Total expenditure by all governments on primary and community health was around $32.1 billion in 2015-16.

Australian Government total recurrent expenditure on general practice in Australia was $9.1 billion or $371 per person in 2016‑17.

Australian Government expenditure on the PBS was around $8.8 billion, or $363 per person, in 2016-17.

Primary and community health services aim to promote health, prevent illness and to support people to manage their health issues in the community, by providing services that are:

timely, affordable and accessible to all
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.

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 2018 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 primary healthcare services

PBS prescriptions filled at concessional rate, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	92.2	92.6	92.1	90.0	93.5	94.1	84.4	81.8	92.1

Source: Attachment table 10A.10

Availability of FSE GPs by region, 2016-17 (rate per 100 000 population)

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Major cities	110.7	107.3	118.6	94.8	113.2	..	81.8	..	108.8
Inner Regional	113.0	110.5	113.0	88.9	94.2	103.1	np	..	109.3
Outer regional, remote & very remote	np	np	99.0	79.1	82.4	82.1	..	53.8	91.6

Source: Attachment tables 10A.19

Availability of FSE GPs by sex, 2016-17 (rate per 100 000 population)

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Females	82.6	76.8	82.3	67.3	73.5	77.7	70.0	80.5	78.5
Males	135.1	132.2	144.5	120.3	145.4	119.7	88.1	92.2	133.8

Source: Attachment tables 10A.20–21

FTE dentists by region, 2016 (rate per 100 000 population)

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Major cities	5.3	5.5	6.2	6.1	6.4	–	4.7	–	5.7
Inner regional	4.5	4.2	7.1	5.8	3.3	11.3	–	–	5.5
Outer regional	1.9	6.0	9.7	5.5	4.0	2.8	–	10.1	6.1

Source: Attachment tables 10A.22

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

Older Aboriginal and Torres Strait Islander Australians who received a health assessment, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	36.3	22.8	46.1	37.0	26.6	22.7	31.0	40.3	37.3

Source: Attachment tables 10A.25

Effectiveness — Access indicators

Affordability of primary healthcare services

People deferring visits to GPs due to cost, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	3.7 ± 0.5	4.5 ± 0.8	4.5 ± 0.5	4.0 ± 0.9	3.5 ± 0.7	7.5 ± 1.5	7.1 ± 1.6	2.3 ± 0.8	4.1 ± 0.3

Source: Attachment table 10A.27

People deferring buying prescribed medicines due to cost, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	7.0 ± 0.9	7.6 ± 1.1	8.0 ± 1.2	7.0 ± 1.1	7.5 ± 1.0	7.1 ± 1.5	5.6 ± 1.5	2.9 ± 1.5	7.3 ± 0.5

Source: Attachment table 10A.30

Timelessness of primary healthcare services

Median time waited for public dental care, 2016-17

Most recent data for this measure are not comparable or complete, subject to caveats. Data are available in attachment tables 10A.32–39.

GP waiting times for urgent appointment — less than 4 hours, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	63.4 ± 4.8	60.9 ± 2.1	70.3 ± 6.6	63.2 ± 5.9	57.5 ± 4.4	54.3 ± 6.0	53.9 ± 11.0	59.6 ± 7.2	62.9 ± 1.2

Source: Attachment tables 10A.40

Potentially avoidable presentations to emergency departments

Selected potentially avoidable presentations to emergency departments, 2016-17

Most recent data for this measure are not comparable but are complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
no.	1 122 982	632 612	413 635	332 654	158 004	59 068	54 208	57 192	2 830 355

Source: Attachment tables 10A.31

Effectiveness — Appropriateness indicators

Chronic disease management

Proportion of people aged 18 to 69 years with known diabetes who have a HbA1c (glycated haemoglobin) level less than or equal to 7.0 per cent, by sex, 2011-12

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	56.7 ± 14.9	35.5 ± 32.4	46.4 ± 13.9	61.3 ± 20.1	52.1 ± 29.1	69.9 ± 15.7	44.3 ± 26.9	47.7 ± 29.3	50.5 ± 8.7

Source: Attachment tables 10A.43

People with asthma who have a written asthma action plan, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	32.8 ± 5.1	26.9 ± 4.7	26.0 ± 5.5	23.2 ± 7.0	35.8 ± 7.1	22.4 ± 5.4	32.8 ± 7.0	34.0 ± 13.8	28.4 ± 2.3

Source: Attachment tables 10A.44

Immunisation coverage

Children aged 60 to 63 months who were fully immunised, 2016-17

Most recent data for this measure are comparable but are not complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	93.6	94.0	93.9	91.7	93.5	94.0	93.9	93.1	93.6

Source: Attachment tables 10A.48

Cancer screening

Participation rates for women in breast cancer screening, 1 January 2015 to 31 December 2016

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	52.5	53.7	56.3	55.2	58.7	57.1	56.7	36.6	54.4

Source: Attachment tables 10A.49

Participation rates for women in cervical screening, 1 January 2015 to 31 December 2016 (ASR)

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	55.9	58.7	53.9	55.4	57.9	56.7	56.9	54.0	56.3

Source: Attachment tables 10A.51

Participation rates for persons in bowel cancer screening, 1 January 2015 to 31 December 2016

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	38.2	41.9	40.4	42.9	47.0	46.4	43.6	28.4	40.9

Source: Attachment tables 10A.52

Effectiveness — Quality — Safety indicators

General practices with accreditation

Number of general practices with accreditation, 2017

Most recent data for this measure are comparable but are not complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
no.	2 104	1 560	1 351	591	447	144	82	89	6 368

Source: Attachment tables 10A.53

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, 2016-17

Most recent data for this measure comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	91.9 ± 0.7	91.4 ± 1.1	91.3 ± 0.9	92.3 ± 1.3	91.9 ± 0.9	91.0 ± 1.6	92.6 ± 2.5	86.0 ± 2.4	91.6 ± 0.5

Source: Attachment tables 10A.54

Proportion of people who saw a dental practitioner in the previous 12 months where the practitioner always or often listened carefully to them, 2016-17

Most recent data for this measure comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	96.1 ± 4.3	95.7 ± –	95.5 ± 1.3	96.9 ± –	96.2 ± 4.7	94.3 ± 2.6	95.9 ± 1.5	95.8 ± 2.1	95.9 ± 2.4

Source: Attachment tables 10A.56

Efficiency indicators

Cost to government of general practice per person

Expenditure per person on general practice, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$	381.1	361.4	396.3	326.0	386.8	370.1	280.8	347.3	371.4

Source: Attachment table 10A.2

Outcome indicators

Notifications of selected childhood diseases

Notifications of measles per 100 000 children aged 0–14 years, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	0.6	0.6	np	1.6	np	–	np	np	0.7

Source: Attachment tables 10A.58

Selected potentially preventable hospitalisations

Separations for selected potentially preventable hospitalisations, 2015-16 (per 1000 people)

Most recent data for this measure are comparable and complete, subject to caveats
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
Rate	23.7	25.3	31.5	25.1	27.0	22.9	21.2	54.6	26.4

Source: Attachment tables 10A.61

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.

Aboriginal and Torres Strait Islander primary and community health data
Table number	Table title
Table 10A.17	Approved providers of PBS medicines by PhARIA area at 30 June 2017
Table 10A.18	Approved providers of PBS medicines by geolocation, at 30 June
Table 10A.25	Annual health assessments for older people by Indigenous status (per cent)
Table 10A.26	Aboriginal and Torres Strait Islander people who received a health check or assessment, by age (per cent)
Table 10A.32	Median waiting time for public dental care, NSW (days)
Table 10A.33	Median waiting time for public dental care, Victoria (days)
Table 10A.34	Median waiting time for public dental care, Queensland (days)
Table 10A.35	Median waiting time for public dental care, WA (days)
Table 10A.36	Median waiting time for public dental care, SA (days)
Table 10A.37	Median waiting time for public dental care, Tasmania (days)
Table 10A.38	Median waiting time for public dental care, ACT (days)
Table 10A.39	Median waiting time for public dental care, NT (days)
Table 10A.50	Participation rates for Aboriginal and Torres Strait Islander women screened by BreastScreen Australia (24 month period) (first and subsequent rounds) (per cent)
Table 10A.62	Separations for selected potentially preventable hospitalisations by Indigenous status (per 1000 people)
Table 10A.64	Separations for selected potentially preventable hospitalisations by Indigenous status and remoteness, Australia (per 1000 people)
Table 10A.65	Separations for selected vaccine preventable conditions by Indigenous status, 2015-16 (per 1000 people)
Table 10A.66	Separations for selected acute conditions by Indigenous status, 2015-16 (per 1000 people)
Table 10A.67	Separations for selected chronic conditions by Indigenous status, 2015-16 (per 1000 people)
Table 10A.68	Ratio of separations for Aboriginal and Torres Strait Islander people to all Australians, diabetes, 2015-16