measure 51 of 68 - aihw

3.05 Chronic disease management This measure reports on the management of chronic disease among the Aboriginal and Torres Strait Islander population

Introduction This is no. 51 of 68 measures in the Aboriginal and Torres Strait Islander Health Performance Framework 2014 report: detailed analyses. This report provides information on a range of measures of health status, determinants of health and the health system performance relating to Aboriginal and Torres Strait Islander people.

The Framework comprises 3 tiers:

Tier 1—Health status and outcomes

Tier 2—Determinants of health

Tier 3—Health system performance.

The full report, including a comprehensive description of all data sources used in the report, and notes about the data quality is available from <http://www.aihw.gov.au/publication-detail/?id=60129550779>.

Tables referenced are available from <http://www.aihw.gov.au/indigenous-data/health-performance-framework/>.

Measure 51 of 68

http://www.aihw.gov.au/publication-detail/?id=60129550779

Aboriginal and Torres Strait Islander Health Performance Framework 2014 report: detailed analyses

2 Measure 3.05: Chronic disease management

Data sources • Medicare data • Online Services Report data collection • National Key Performance Indicators for Aboriginal and Torres Strait Islander primary

health care data collection • Healthy for Life data collection • Australian Aboriginal and Torres Strait Islander Health Survey • Australian Health Survey. For more information, see ‘Data sources and quality’ at the end of this measure.

Data analyses General Practitioner Management Plans (GPMPs) (MBS item 721) are for patients with a chronic or terminal medical condition who will benefit from a structured approach to management of their care needs. A rebate can be claimed once the patient’s GP has prepared the GP management plan. The recommended frequency of GP management plans is once every 2 years. The GP may be assisted by their practice nurse, Aboriginal health worker or other health professional in the GP’s medical practice or health service. The service must include a personal attendance by the GP with the patient.

Team Care Arrangements (TCAs) (MBS item 723) provide a rebate for a GP to coordinate the preparation of team care arrangements for a patient with a chronic or terminal medical condition who also requires ongoing care from a multidisciplinary team of at least three health care providers. The recommended frequency is once every two years, supported by regular review services.

For more information related to chronic disease, see measures 1.02 (top reasons for hospitalisation) and 1.23 (leading causes of mortality) and for more information on chronic disease management, see measure 3.18 (care planning for chronic disease). See also ‘Other related information’ at the end of this measure.

The following data are presented for this measure:

• MBS services provided and claimed see tables 3.05.1–3 • Aboriginal and Torres Strait Islander primary health care services, see tables 3.05.4–13

and Table 3.18.1 • Self-reported chronic disease management, see tables 3.05.14–16.

MBS services claimed

Current period In 2013–14:

• There were around 53,600 GP management plan claims (76 claims per 1,000 population). After adjusting for age, the rate for Indigenous Australians was 1.6 times as high as for non-Indigenous Australians. The rate difference was 42 claims per 1,000 population.


Measure 3.05: Chronic disease management 3

• There were around 44,400 team care arrangement claims for Indigenous Australians (63 claims per 1,000 population). After adjusting for age, the rate for Indigenous Australians was 1.7 times as high as for non-Indigenous Australians. The rate difference was 38 claims per 1,000 population (Table 3.05.1).

Trend Between 2009–10 and 2013–14: • The age-standardised rate of GP management plans claimed for Indigenous Australians

increased significantly by 98% from 55 per 1,000 to 114 per 1,000. The rate difference increased significantly (Table 3.05.1).

• The age-standardised rate of services for team care arrangements claimed for Indigenous Australians increased significantly by 106% from 44 per 1,000 to 96 per 1,000. The rate difference increased significantly (Table 3.05.1, Figure 3.05.1).

Aboriginal and Torres Strait Islander primary health care services

Current period • As at December 2013, 47% of Indigenous clients of Indigenous primary health care

services had GP management plans for Type 2 diabetes and 44% had team care arrangements for Type 2 diabetes within the last 2 years (Table 3.18.1).

• In 2012–13, 95% of Indigenous primary health care services kept track of clients needing follow-up, and 97% used a patient information and recall system (PIRS) that provides reminders for follow-up and health checks (Table 3.05.4).

• Between June 2013 and December 2013, among Indigenous clients of Indigenous primary health care services with Type 2 diabetes: – 49% had their blood glucose levels tested, with 33% reporting a blood sugar result in

the recommended range – 64% had their blood pressure assessed, with 44% reporting a result in the

recommended range (AIHW 2014). • From 1 January–30 June 2011, among Indigenous clients of Indigenous primary health

care services with coronary heart disease: – 66% had their blood pressure tested within the previous 6 months, 52% of whom

had results in the recommended range (tables 3.05.11–12).

Trend Between December 2012 and December 2013:

• The proportion of Indigenous clients of Indigenous primary health care services with Type 2 diabetes who had a GP management plan increased from 41% to 47% and the proportion who had a team care arrangement increased from 37% to 44% (Table 3.18.1).

Between 2001–02 and 2012–13:

• The proportion of Indigenous primary health care services that kept track of clients needing follow-up increased from 70% to 95%.

• The proportion of Indigenous primary health care services that used a patient information and recall system (PIRS) that provides reminders for follow-up and health



checks increased from 53% to 97%. This represents a significant increase of 73% over the period (Table 3.05.4).

Self-reported chronic disease management

Current period In 2012–13:

• In the previous 12 months, among people with diagnosed current and long term diabetes or high sugar levels: – HbA1C tests were conducted to check diabetes control in 69% of Indigenous

Australians compared with 72% of non-Indigenous Australians. – Feet were checked in 68% of Indigenous Australians compared with 74% of

non-Indigenous Australians (Table 3.05.14). • In the previous 12 months, among people with diagnosed current and long-term heart

and circulatory conditions: – Blood pressure was checked for 86% of Indigenous Australians aged 18–44 years

compared with 82% of non-Indigenous Australians—a gap of over 3 percentage points. Among those aged 45 years and over, a similar proportion of Indigenous and non-Indigenous Australians had their blood pressure checked (95% and 96%, respectively).

– Cholesterol levels were assessed for 56% of Indigenous Australians aged 18–44 years compared with 48% of non-Indigenous Australians—a gap of over 7 percentage points. Among those aged 45 years and over, 78% of Indigenous Australians and 81% of non-Indigenous Australians had their cholesterol levels assessed—a gap of 3 percentage points (Table 3.05.15).



Source: Table 3.05.1.

Figure 3.05.1: Age-standardised rates of MBS services claimed for GP management plans and team care arrangements, by Indigenous status, Australia, 2009–10 to 2013–14

0

20

40

60

80

100

120

2009–10 2010–11 2011–12 2012–13 2013–14

Rate per 1,000 GP management plans Indigenous

Non-Indigenous

0

20

40

60

80

100

120

2009–10 2010–11 2011–12 2012–13 2013–14

Rate per 1,000 Team care arrangements

Indigenous

Non-Indigenous



Table 3.05.1a: VII adjusted, MBS services claimed, GP management plan (GPMP) by Indigenous status, Australia, 2003–04 to 2013–14(a)

Indigenous Australians

Non-Indigenous Australians

Number

Crude rate per

1,000

Age std. rate per 1,000(b)

Number


Rate ratio(c)

Rate difference(d)

2003–04 n.a. n.a. n.a.

n.a. n.a.

n.a. n.a.

2004–05 n.a. n.a. n.a.

n.a. n.a.

n.a. n.a.

2005–06 9,489 16 25

636,393 31

0.8 –5.5

2006–07 11,730 19 30

666,948 32

0.9 –1.9

2007–08 14,523 23 37

816,905 38

1.0 –0.9

2008–09 18,039 28 45

993,285 45

1.0 0.3

2009–10 22,600 35 55

1,089,599 48

1.2 7.2

2010–11 31,199 47 73

1,280,651 55

1.3 18.0

2011–12 40,087 59 90

1,460,968 62

1.5 28.5

2012–13 44,148 64 96

1,549,717 64

1.5 32.1

2013–14 53,623 76 114 1,779,097 72 1.6 41.7

Annual change(e) 2005–06 to 2008–09 2,844.3* 4.0* 6.7*

122,063.3* 4.8*

n.p. 1.9*

% change over time(f) 2005–06 to 2008–09 93.0* 77.4* 83.1* 61.5* 49.1* n.p. n.p.(g)


164,806.2* 5.7*

n.p. 8.3*

% change over time(f) 2009–10 to 2013–14 128.6* 108.8* 98.3* 59.8* 46.7* n.p. 372.8*


146,576.9* 5.3*

n.p. 6.1*


* Represents results with statistically significant differences at the p < 0.05 level.

(a) Numbers and rates have been adjusted for under-identification in the Medicare Australia Voluntary Indigenous Identifier (VII) database.

(b) Directly age-standardised using the 2001 Australian standard population, by 5-year age group up to 75+.

(c) Rate ratio is the rate for Indigenous Australians divided by the rate for non-Indigenous Australians.

(d) Rate difference is the rate for Indigenous Australians minus the rate for non-Indigenous Australians.

(e) Annual change determined using linear regression analysis.

(f) Per cent change based on the annual change over the period.

(g) Regression line crosses zero, so per cent change could not be calculated.

Source: Analysis of Medicare Data by AIHW and Medicare Benefit Division, Department of Health.



Table 3.05.1b: VII adjusted, MBS services claimed, Team care arrangements (TCA) by Indigenous status, Australia, 2003–04 to 2013–14(a)

Indigenous Australians

Non-Indigenous Australians

Number

Crude rate per

1,000


Number


Rate ratio(c) Rate

difference(d)

2003–04 n.a. n.a. n.a.

n.a. n.a.

n.a. n.a.

2004–05 n.a. n.a. n.a.

n.a. n.a.

n.a. n.a.

2005–06 3,982 7 11

250,199 12

0.9 –1.2

2006–07 7,097 12 18

391,955 19

1.0 –0.1

2007–08 9,810 16 25

541,794 25

1.0 0.2

2008–09 13,339 21 34

752,609 34

1.0 –0.4

2009–10 17,642 27 44

868,202 38

1.1 5.5

2010–11 25,374 38 60

1,050,356 45

1.3 14.8

2011–12 33,885 50 77

1,212,557 51

1.5 25.7

2012–13 36,566 53 80

1,249,374 51

1.6 28.8

2013–14 44,360 63 96 1,441,514 58 1.7 37.7


165,706.9* 7.2*

n.p. 0.3



134,564.2* 4.6*

n.p. 7.8*

% change over time(f) 2009–10 to 2013–14 138.7* 120.8* 106.4* 60.1* 46.7* n.p. 462.0*


149,613.2* 5.7*

n.p. 5.1*

% change over time(f) 2005–06 to 2013–14

Significant increase(h)

Significant increase(h)

Significant increase(h) 454.0* 323.6* n.p. n.p.(g)



(b) Directly age-standardised using the 2001 Australian standard population, by 5-year age group up to 75+.

(c) Rate ratio is the rate for Indigenous Australians divided by the rate for non-Indigenous Australians.

(d) Rate difference is the rate for Indigenous Australians minus the rate for non-Indigenous Australians.

(e) Annual change determined using linear regression analysis.

(f) Per cent change based on the annual change over the period.

(g) Regression line crosses zero, so per cent change could not be calculated.

(h) Per cent change more than 1,000 per cent.




Table 3.05.2: VII adjusted, MBS, Chronic Disease Management Package (CDMP) services provided to Indigenous patients (15+)(a)

Prepare GP Management

Plan (721)

Coordinate Team Care

Arrangements (723)

Aboriginal Health Worker Service (linked

to CDM items 721 and 723)

(10950)

Monitoring and support for a person with a

Chronic Disease Care Plan

(10997)


to Health Assessments)

(81300)

2003–04 . . . . . . . . . .

2004–05 . . . . . . . . . .

2005–06 8,680 3,695 n.p. . . . .

2006–07 10,720 6,552 n.p. . . . .

2007–08 13,400 9,041 51 1,651 . .

2008–09 16,717 12,413 225 2,476 27

2009–10 20,940 16,433 226 4,941 280

2010–11 29,121 23,829 532 10,186 905

2011–12 37,313 31,774 802 13,301 1,058

2012–13 40,365 33,757 2,906 20,495 2,198

2013–14 48,465 40,583 2,878 27,927 4,235

Annual change(b) 2005–06 to 2008–09 2,679.1* 2,864.3* . . . . . .

% change over time(c) 2005–06 to 2008–09 96.1* 236.8* . . . . . .

Annual change(b) 2009–10 to 2013–14 6,633.4* 5,822.8* 767.8* 5,628.1* 920.3*

% change over time(c) 2009–10 to 2013–14 88.4* 132.1* n.p.(d) 547.2* n.p.(d)

Annual change(b) 2007–08 to 2013–14 . . . . 515.0* 4,400.9* . .

% change over time(c) 2007–08 to 2013–14 . . . . n.p.(d) n.p.(d) . .

Annual change(b) 2008–09 to 2013–14 . . . . . . . . 769.9*

% change over time(c) 2008–09 to 2013–14 . . . . . . . . n.p.(d)


% change over time(c) 2005–06 to 2013–14 908.2* n.p.(d) . . . . . .



(b) Annual change determined using linear regression analysis.

(c) Per cent change based on the annual change over the period.

(d) Regression line crosses zero, so per cent change could not be calculated.

Note: Excludes Immunisation (10988), and wound management (10989).




Table 3.05.3: VII adjusted, MBS, CDMP Indigenous patient counts (15+)(a)

Prepare GP Management

Plan (721)

Coordinate Team Care

Arrangements (723)


to CDM items 721 and 723)

(10950)

Monitoring and support for a person with a

Chronic Disease Care Plan

(10997)


to Health Assessments)

(81300)

2003–04 . . . . . . . . . .

2004–05 . . . . . . . . . .

2005–06 8,651 3,689 n.p. . . . .

2006–07 10,682 6,531 n.p. . . . .

2007–08 13,303 8,996 29 1,021 . .

2008–09 16,645 12,361 127 1,611 16

2009–10 20,794 16,331 114 3,106 225

2010–11 28,906 23,661 193 6,180 474

2011–12 37,045 31,523 334 8,089 565

2012–13 39,997 33,435 1,063 11,297 1,247

2013–14 48,064 40,282 1,249 15,463 2,419


% change over time(c) 2005–06 to 2008–09 95.8* 235.9* . . . . . .

Annual change(b) 2009–10 to 2013–14 6,567.1* 5,767.6* 314.0* 2,983.1* 516.1*

% change over time(c) 2009–10 to 2013–14 87.9* 131.7* n.p.(e) 417.1* n.p.(e)

Annual change(b) 2007–08 to 2013–14 . . . . 205.4* 2,417.2* . .

% change over time(c) 2007–08 to 2013–14 . . . . n.p.(e) n.p.(e) . .

Annual change(b) 2008–09 to 2013–14 . . . . . . . . 433.5*

% change over time(c) 2008–09 to 2013–14 . . . . . . . . n.p.(e)


% change over time(c) 2005–06 to 2013–14 896.3*

Significant increase(d) . . . . . .



(b) Annual change determined using linear regression analysis.

(c) Per cent change based on the annual change over the period.

(d) Per cent change more than 1,000 per cent.

(e) Regression line crosses zero, so per cent change could not be calculated.




Table 3.05.4: Proportion of Indigenous primary health-care services providing chronic disease management activities, 2001–02 to 2012–13

2001–02 2002–03 2003–04 2004–05 2005–06 2006–07 2007–08 2008–

09 2009–

10 2010–

11 2011–

12 2012–

13 Annual

change(a) Per cent

change(b)

Management of chronic illness(c) 74.0 76.0 78.0 79.0 80.0 88.0 88.0 89.0 87.0 85.0 86.2 n.a. 1.4*(d) 18.2*(d)

Keep track of clients needing follow-up 70.0 69.0 63.0 70.0 57.0 62.0 57.0 70.6 70.9 69.7 74.1 94.6 1.4(e) 25.3(e)

Service maintains health registers 50.0 50.0 51.0 53.0 51.0 62.0 63.0 72.6 73.1 74.4 77.7 n.a. 3.2*(d) 70.5*(d)

Clinical practice guidelines utilised 56.0 52.0 57.0 59.0 55.0 61.0 64.0 74.1 73.1 75.2 73.7 n.a. 2.4*(d) 47.5*(d)

Patient information and recall system (PIRS) 53.0 56.0 54.0 n.a. 53.0 62.0 60.0 63.5 71.6 71.9 76.8 96.6 3.1*(e) 72.7*(e)

* Represents results with statistically significant increases or declines at the p < 0.05 level over the period.

(a) Average annual change determined using linear regression analysis over the period.

(b) Per cent change over the period based on the average annual change over the period.

(c) From 2006–07 the SAR response category ‘Management of chronic illness’ was replaced by the three categories ‘Management of diabetes’, ‘Management of cardiovascular disease’ and ‘Management of other chronic illness’. ‘Management of chronic illness’ represents the percentage of services that provided or facilitated access to any one of those three categories.

(d) Per cent change and annual change calculated over the period 2001–02 to 2011–12.

(e) Per cent change and annual change calculated over the period 2001–02 to 2012–13.

Note: Since 2008–09 OSR data counts all auspice services individually when calculating rates, therefore caution should be exercised when comparing rates with earlier data collection periods.

Source: DoHA Service Activity Report 2007–08, 2006–07, 2005–06, 2004–05, 2003–04, 2002–03, 2001–02, AIHW OSR 2008–09, 2009–10, 2010–11, 2011–12, 2012–13 data collection.



Table 3.05.5: Indigenous regular clients with Type 2 diabetes receiving recommended care from Indigenous primary health care services, by remoteness, December 2013

Major cities Inner regional Outer regional Remote Very remote Australia

HbA1c result recorded in the last 6 months

Remoteness proportion 43.2 49.2 46.8 50.7 52.1 48.9

Organisation median 44.3 47.8 46.7 55.4 73.5 53.1

Upper quartile boundary 55.6 63.6 54.0 62.8 85.5 68.4

Lower quartile boundary 39.5 34.5 33.3 50.7 56.7 39.6

Blood pressure recorded in the last 6 months





Kidney function test recorded in the last 6 months





Source: AIHW National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care data collection.



Table 3.05.6: Chronic disease: management, reporting periods ending 30 June 2009, 2010 and 2011

HfL services had strategies for chronic disease management(a) for their clients with chronic disease that included:

June 2009 June 2010 June 2011

% Yes % No % No

response % Yes % No % No


response

1. A population based approach

a. A condition register used for recall and reminder 81.1 8.1 10.8

86.1 6.3 7.6

82.4 8.2 9.4

b. Use of recognised guidelines 85.1 4.1 10.8

88.6 2.5 8.9

88.2 1.2 10.6

2. A team-based approach 86.5 2.7 10.8

89.9 1.3 8.9

87.1 3.5 9.4

3. Clinical review, behavioural, social and environmental risk assessment

a. Systematic 74.3 14.9 10.8

79.7 11.4 8.9

82.4 8.2 9.4

b. Opportunistic 81.1 5.4 13.5

87.3 3.8 8.9

82.4 4.7 12.9

4. Behavioural risk reduction

a. Smoking

– Brief intervention 85.1 4.1 10.8

88.6 2.5 8.9

83.5 7.1 9.4

– Other advice 83.8 5.4 10.8

87.3 3.8 8.9

85.9 4.7 9.4

b. Nutrition 83.8 4.1 12.2

89.9 1.3 8.9

88.2 0.0 11.8

c. Alcohol

– Brief intervention 85.1 4.1 10.8

88.6 2.5 8.9

81.2 9.4 9.4

– Other advice 81.1 8.1 10.8

83.5 6.3 10.1

77.6 12.9 9.4

d. Physical activity 87.8 1.4 10.8

89.9 1.3 8.9

89.4 0.0 10.6

e. Emotional wellbeing 89.2 0.0 10.8

87.3 1.3 11.4

85.9 3.5 10.6

f. Other 21.6 44.6 33.8

22.8 41.8 35.4

23.5 49.4 27.1

(continued)



Table 3.05.6 (continued): Chronic disease: management, reporting periods ending 30 June 2009, 2010 and 2011


June 2009 June 2010 June 2011

% Yes % No % No



response

5. Care planning (b) (b) (b)

(b) (b) (b)

0.0 0.0 100.0

6. Routine clinical reviews 78.4 6.8 14.9

79.7 10.1 10.1

77.6 9.4 12.9

7. Follow-up of abnormal results

a. Systematic 78.4 8.1 13.5

86.1 5.1 8.9

83.5 3.5 12.9


72.2 15.2 12.7

71.8 12.9 15.3

8. Immunisation

a. Systematic 73.0 12.2 14.9

79.7 10.1 10.1

70.6 16.5 12.9


82.3 5.1 12.7

78.8 7.1 14.1

9. Systematic approach to client self-management

a. Staff training 71.6 13.5 14.9

78.5 12.7 8.9

74.1 12.9 12.9

b. Goal setting 74.3 12.2 13.5

81.0 10.1 8.9

78.8 8.2 12.9

c. Client education 79.7 6.8 13.5

84.8 6.3 8.9

82.4 4.7 12.9

d. Hand held records 37.8 47.3 14.9

45.6 44.3 10.1

49.4 37.6 12.9

e. Support for involvement of family 70.3 13.5 16.2

70.9 16.5 12.7

72.9 10.6 16.5

f. Peer support 41.9 31.1 27.0

59.5 22.8 17.7

54.1 27.1 18.8

10. Health service linkages

a. Hospital admission communication 70.3 14.9 14.9

77.2 12.7 10.1

76.5 8.2 15.3

b. Hospital discharge communication 71.6 13.5 14.9

77.2 12.7 10.1

78.8 5.9 15.3

(continued)



Table 3.05.6 (continued): Chronic disease: management, reporting periods ending 30 June 2009, 2010 and 2011


June 2009

June 2010

June 2011

% Yes % No % No



response

c. Care provided in residential aged care services 43.2 41.9 14.9

53.2 36.7 10.1

49.4 34.1 16.5

11. Social service linkages, referrals and client advocacy

a. Social services 74.3 10.8 14.9

77.2 11.4 11.4

76.5 7.1 16.5

b. Housing 62.2 21.6 16.2

73.4 13.9 12.7

78.8 7.1 14.1

c. Employment 56.8 28.4 14.9

68.4 19.0 12.7

58.8 25.9 15.3

d. Income support 63.5 21.6 14.9

65.8 21.5 12.7

60.0 24.7 15.3

e. Domestic violence 74.3 10.8 14.9

82.3 5.1 12.7

74.1 11.8 14.1

f. Legal aid 60.8 24.3 14.9

70.9 16.5 12.7

64.7 21.2 14.1

g. Other 14.9 40.5 44.6 15.2 46.8 38.0 5.9 55.3 38.8

(a) ‘Management’ includes health promotion, prevention of complications, clinical care and advocacy.

(b) Not collected.

Source: AIHW Healthy for Life data collection.



Table 3.05.7: Number and proportion of Indigenous regular clients(a) who are diagnosed with Type 2 diabetes and HbA1c test in the last 6 months, by remoteness, 1 January–30 June 2011

Major cities

Inner regional

Outer regional Remote

Very remote Total

Per cent

Indigenous regular clients with Type 2 diabetes who had an HbA1c test 39.0

54.0

56.9

54.9

60.9

53.9

Number of Indigenous regular clients with Type 2 diabetes 2,327 1,614 4,593 2,603 2,640 13,777

(a) Indigenous regular clients aged 15 years and over.

Notes

1. Valid data for this indicator were provided by 83 services (11 in Major cities of Australia, 16 in Inner regional Australia, 28 in Outer regional Australia, 13 in Remote Australia and 15 in Very remote Australia).

2. Services used their own definition of regular client.


Table 3.05.8: Average HbA1c result for Indigenous regular clients(a) diagnosed with Type 2 diabetes who had an HbA1c test in the last 6 months, by remoteness 1 January–30 June 2011

Major cities Inner regional Outer regional Remote Very remote Total

Average HbA1c result (%) 8.6 7.9 8.6 8.6 9.0 8.6

Number of Indigenous regular clients with Type 2 diabetes who had an HbA1c test in the last six months 682 788 2,521 1,430 1,607 7,028


Notes




Table 3.05.9: Number and proportion of Indigenous regular clients(a) with Type 2 diabetes who had a blood pressure test in the last six months, by remoteness, 1 January–30 June 2011

Major cities Inner regional Outer regional Remote Very remote Total

Indigenous regular clients with Type 2 diabetes who had a blood pressure test (%) 53.9

70.3

62.2

70.5

72.8

65.4

Number of Indigenous regular clients with Type 2 diabetes 2,327 1,614 4,593 2,603 2,640 13,777


Notes






Table 3.05.10: Number and proportion of Indigenous regular clients(a) with Type 2 diabetes who had a blood pressure test in the last six months with a result less than or equal to 130/80mmHg, by remoteness, 1 January–30 June 2011

Major cities

Inner regional

Outer regional

Remote

Very remote

Total

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

37.3 468/1,254 36.6 415/1,134 40.2 1,148/2,858 49.1 901/1,836 44.4 853/1,922 42.0 3,785/9,004


(b) N (numerator) is the number of Indigenous regular clients with Type 2 diabetes who had a blood pressure test in the last six months with a result less than or equal to 130/80mmHg. D (denominator) is the total number of Indigenous regular clients with Type 2 diabetes who had a blood pressure test in the last six months.

Notes

1. Valid data for this indicator were provided by 83 services (11 in major cities of Australia, 16 in inner regional Australia, 28 in outer regional Australia, 13 in remote Australia and 15 in very remote Australia).


Source: AIHW, Healthy for Life data collection.

Table 3.05.11: Number and proportion of Indigenous regular clients(a) with coronary heart disease who had a blood pressure test in the last six months, by remoteness, 1 January–30 June 2011

Major cities

Inner regional

Outer regional

Remote

Very remote

Total

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

56.1 577/1,029 74.8 514/687 66.4 808/1,216 65.3 543/832 77.1 364/472 66.2 2,806/4,236


(b) N (numerator) is the number of Indigenous regular clients with coronary heart disease who had a blood pressure test in the last six months. D (denominator) is the total number of Indigenous regular clients with coronary heart disease who had a blood pressure test.

Notes



Source: AIHW, Healthy for Life data collection.

Table 3.05.12: Number and proportion of Indigenous regular clients(a) with coronary heart disease who had a blood pressure test in the last six months with a result less than 140/90mmHg, by remoteness, 1 January–30 June 2011

Major cities

Inner regional

Outer regional

Remote

Very remote

Total

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

% N/D(b)

59.8 153/256 37.6 158/420 54.8 324/591 54.1 133/246 65.2 92/141 52 860/1,654


(b) N (numerator) is the number of Indigenous regular clients with coronary heart disease who had a blood pressure test in the last six months with a result less than 140/90mmHg. D (denominator) is the total number of Indigenous regular clients with coronary heart disease who had a blood pressure test in the last six months.

Notes






Table 3.05.13: Number and proportion of Indigenous regular clients(a) with Type 2 diabetes who had an HbA1c test in the last 6 months, by HbA1c result and remoteness, 1 January–30 June 2011

Major cities

Inner regional

Outer regional

Remote

Very remote

Total

HbA1c result % Number

% Number

% Number

% Number

% Number

% Number

≤7% 27.3 186 41.8 329 30.6 771 29.9 427 27.3 439 30.6 2,152

>7% to ≤8% 21.0 143

21.4 169

20.2 509

20.0 286

16.6 266

19.5 1,373

>8% to <10% 27.1 185

23.5 185

23.5 592

23.6 337

22.7 364

23.7 1,663

≥10% 24.6 168

13.3 105

25.7 649

26.6 380

33.5 538

26.2 1,840

Total 100.0 682 100.0 788 100.0 2,521 100.0 1,430 100.0 1,607 100.0 7,028


(b) HbA1c results in the last six months.

Notes



3. Numerator is the number of Indigenous regular clients with Type 2 diabetes who had an HbA1c test in the last six months by HbA1c result and Denominator is the total number of Indigenous regular clients with Type 2 diabetes who had an HbA1c test in the last six months.




Table 3.05.14: Health actions for persons with diagnosed, current and long term diabetes or high sugar levels(a), by Indigenous status and state/territory, 2012–13

NSW Vic Qld

Indigenous Non-

Indigenous Rate

ratio(b) Indigenous Non-

Indigenous Rate


Indigenous Rate

ratio(b)

Per cent

Actions taken to manage diabetes/HSL in last 2 weeks

Currently using insulin 34.4 . . . . 35.1 . . . . 31.9 . . . .

Taken medicine/tablets(c) 66.8 . . . . 59.5 . . . . 61.1 . . . .

Lifestyle action: diet/weight loss/exercise 84.9 . . . . 74.1 . . . . 77.7 . . . .

No action taken(d) 5.9† . . . . 8.0‡ . . . . 7.6† . . . .

Total number persons with current diabetes/HSL(e)(f)(g) 15,834 . . . . 2,781 . . . . 12,576 . . . .

Feet checked in last 12 months(h)

Yes 68.7 75.0 0.9 65.1 71.6 0.9 63.9 72.5 0.9

No (i) 31.3 25.0 1.3 34.9 28.4 1.2 36.1 27.5 1.3

Total number persons with current diabetes/HSL in non-remote areas(f)(g) 14,433 309,036 . . 2,781 239,349 . . 8,912 153,641 . .

Blood glucose checked in last 12 months(h)

Yes 96.4 99.7 1.0 97.6 94.2 1.0 95.4 97.2 1.0


Had HbA1C test in last 12 months(h)

Yes 70.7 77.7 0.9 71.5 57.8 1.2 65.2 78.0 0.8

No (i) 29.3 22.3 1.3 28.5† 42.2 0.7 34.8 22.0 1.6


Total number of persons with current diabetes or HSL(a) 15,834 309,036 . . 2,781 239,349 . . 12,576 159,561 . .

(continued)



Table 3.05.14 (continued): Health actions for persons with diagnosed, current and long term diabetes or high sugar levels(a), by Indigenous status and state/territory, 2012–13

WA SA Tas

Indigenous Non-

Indigenous Rate


Indigenous Rate


Indigenous Rate

ratio(b)

Per cent


Currently using insulin 27.6 . . . . 15.8† . . . . 15.0‡ . . . .

Taken medicine/tablets(c) 66.6 . . . . 64.4 . . . . 48.4 . . . .


No action taken(d) 10.4† . . . . 6.8† . . . . 10.5‡ . . . .

Total number persons with current diabetes/HSL(e)(f)(g) 7,375 . . . . 2,647 . . . . n.p. . . . .


Yes 78.9 73.0 1.1 76.2 76.2 1.0 64.6 80.5 0.8

No (i) 21.1† 27.0 0.8 23.8† 23.8 1.0 35.4† 19.5† 1.8

Total number persons with current diabetes/HSL in non-remote areas(f)(g) 3,468 88,972 . . 2,044 77,680 . . n.p. 22,135 . .


Yes 86.6 95.2 0.9 96.9 98.7 1.0 94.3 98.9 1.0



Yes 69.4 74.6 0.9 60.2 76.9 0.8 67.0 83.1 0.8

No (i) 30.6 25.4 1.2 39.8 23.1 1.7 33.0† 16.9† 2.0


Total number of persons with current diabetes or HSL(a) 7,375 91,734 . . 2,647 80,343 . . n.p. 22,398 . .

(continued)



Table 3.05.14 (continued): Health actions for persons with diagnosed, current and long term diabetes or high sugar levels(a), by Indigenous status and state/territory, 2012–13

ACT NT Australia

Indigenous Non-

Indigenous Rate


Indigenous Rate


Indigenous Rate

ratio(b)

Per cent


Currently using insulin 10.6‡ . . . . 23.9 . . . . 30.0 . . . .

Taken medicine/tablets(c) 48.8† . . . . 66.2 . . . . 64.2 . . . .


No action taken(d) 7.9‡ . . . . 3.6† . . . . 7.0 . . . .

Total number persons with current diabetes/HSL(e)(f)(g) n.p. . . . . 5,852 . . . . 48,062 . . . .


Yes 72.8 71.5 1.0 51.2 62.4 0.8 68.0 73.6 0.9

No (i) 27.2† 28.5 1.0 48.8 37.6† 1.3 32.0 26.4 1.2

Total number persons with current diabetes/HSL in non-remote areas(f)(g) n.p. 14,091 . . 1,210† 3,375 . . 33,810 908,278 . .


Yes 100.0 92.6 1.1 95.3 100.0 1.0 95.2 97.2 1.0



Yes 82.1 67.8 1.2 73.5 77.8 0.9 68.7 72.1 1.0

No (i) 17.9‡ 32.2 0.6 26.5 22.2† 1.2 31.3 27.9 1.1


Total number of persons with current diabetes or HSL(a) n.p. 14,091 . . 5,852 5,254 . . 48,062 921,766 . .

(continued)



Table 3.05.14 (continued): Health actions for persons with diagnosed, current and long term diabetes or high sugar levels(a), by Indigenous status and state/territory, 2012–13 † Estimate has a relative standard error between 25% and 50% and should be used with caution.

‡ Estimate has a relative standard error greater than 50% and is considered too unreliable for general use.

(a) Health actions for diabetes or high sugar levels data has been limited to persons who reported that they had been told by a doctor or nurse that they have diabetes or high sugar levels and that it was current and long term.

(b) Rate ratio is calculated by dividing the crude rate for Aboriginal and Torres Strait Islander people by the crude rate for non-Indigenous people.

(c) Excludes insulin, vitamins or herbal medicines.

(d) Includes ‘not known if action taken’.

(e) Includes ‘Taken vitamin/mineral supplements’, ‘Taken natural/herbal/bush medicine’, and ‘Other actions taken’.

(f) Excludes persons who stated their diabetes was not current and those with gestational diabetes.

(g) Multiple response item, sum of components may be greater than total.

(h) Non-remote only.

(i) Includes ‘don’t know’.

Notes

1. Per cent calculated within columns. Estimates have been rounded and discrepancies may occur between sums of the component items and totals.

2. Data excludes ‘not stated’ responses.

3. Populations identified for condition specific data items collected within the condition modules are based on responses as reported to the questions in the module. As respondents may identify conditions in some modules which are not later coded as an applicable condition to that module, or may identify conditions relevant to that module in other sections of the survey, the data populations achieved in the items may not match those identified using the ICD10 coded condition responses.

Source: ABS and AIHW analysis of 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey (NATSIHS component) and 2011–12 Australian Health Survey (National Health Survey component).



Table 3.05.15: Health actions for persons with diagnosed, current and long-term heart and circulatory conditions(a), by Indigenous status, persons aged 18 years and over, 2012–13

Indigenous Non-Indigenous Rate ratio(b) Rate difference(c)

18–44 years

45+ years Total

18–44 years

45+ years Total

18–44 years

45+ years

18–44 years

45+ years

Whether had cholesterol checked in last 5 years (d)

Yes 73.3 91.3 84.5 . . . . . . . . . . . . . .

No 26.7 8.7 15.5 . . . . . . . . . . . . . .

Total (e) 17,198 28,232 45,429 . . . . . . . . . . . . . .

Whether had cholesterol checked in last 12 months

Yes 55.5 77.9 68.3 48.1 81.1 75.9 1.2 1.0 7.4 –3.2

No (f) 44.5 22.1 31.7 51.9 18.9 24.1 0.9 1.2 –7.4 3.2

Total (e) 25,498 34,256 59,754 529,327 2,798,442 3,327,769 . . . . . . . .

Whether had blood pressure checked in last 2 years(d)

Yes 94.7 97.8 96.5 . . . . . . . . . . . . . .

No 4.7† 1.9† 3.0† . . . . . . . . . . . . . .

Total(g) 20,240 28,647 48,888 . . . . . . . . . . . . . .

Whether had blood pressure checked in last 12 months

Yes 85.5 95.3 91.1 82.3 96.4 94.1 1.0 1.0 3.2 –1.1

No (h) 12.4 4.3† 7.8 16.9 2.9 5.1 0.7 1.5 –4.5 1.4

Total (g) 26,770 35,424 62,195 552,807 2,867,525 3,420,332 . . . . . . . .

Whether used aspirin daily for heart or circulatory condition

Yes 14.1 36.0 26.7 6.4 32.5 28.3 2.2 1.1 7.7 3.5

No 85.9 64.0 73.3 93.6 67.5 71.7 0.9 0.9 –7.7 –3.5

Total (e) 26,286 35,396 61,681 552,496 2,844,889 3,397,385 . . . . . . . .

(continued)



Table 3.05.15 (continued): Health actions for persons with diagnosed, current and long-term heart and circulatory conditions(a), by Indigenous status, persons aged 18 years and over, 2012–13

Indigenous Non-Indigenous Rate ratio(b) Rate difference(c)

18–44 years

45+ years Total

18–44 years

45+ years Total

18–44 years

45+ years

18–44 years

45+ years

Whether taken any medicine or tablets for heart or circulatory condition in last 2 weeks

Yes 36.6 69.1 55.3 . . . . . . . . . . . . . .

No 63.4 30.9 44.7 . . . . . . . . . . . . . .

Total 26,286 35,396 61,681 . . . . . . . . . . . . . .

† Estimate has a relative standard error between 25% and 50% and should be used with caution.


(a) Health actions for heart and circulatory conditions data has been limited to persons who reported they had been told by a doctor or nurse that they had a heart or circulatory condition, and that it was current and long-term.


(c) Rate difference is calculated by subtracting the crude rate for non-Indigenous people from the crude rate for Aboriginal and Torres Strait Islander people.

(d) Persons living in non-remote areas.

(e) Total excludes ‘don’t know’ responses.

(f) Includes non-remote persons with current heart/circulatory conditions who reported that they did not have their cholesterol checked in the last 5 years.

(g) Total includes ‘don’t know’ responses.

(h) Includes non-remote persons with current heart/circulatory conditions who reported that they did not have their blood pressure checked in the last 5 years.

Notes

1. Per cent calculated within columns. Estimates have been rounded and discrepancies may occur between sums of the component items and totals.


3. Populations identified for condition specific data items collected within the condition modules are based on responses as reported to the questions in the module. As respondents may identify conditions in some modules which are not later coded as an applicable condition to that module, or may identify conditions relevant to that module in other sections of the survey, the data populations achieved in the items may not match those identified using the ICD10 coded condition responses.




Table 3.05.16: Health actions for persons not reporting diabetes or high sugar levels, by age group, by Indigenous status, 2012–13(a)

Age-group (years)

50+ years

0–14 15–24 25–34 35–44 45–54 55+ Total Indigenous Non-

Indigenous Rate

ratio(b)

Per cent

Whether tested for diabetes/high sugar levels in the last 3 years

Yes 10.2 23.8 44.3 48.4 56.7 70.1 29.3

66.7 54.6 1.2*

No(c) 89.8 76.2 55.7 51.6 43.3 29.9 70.7

33.3 45.4 0.7

Total number of persons not reporting diabetes or high sugar levels 227,133 122,226 78,981 64,791 43,697 33,058 569,885 51,286 5,733,309 . .

* Represents statistically significant differences at the p < 0.05 level. Comparison was between Indigenous and non-Indigenous for 50+ years, for ‘Yes’.

† Estimate has a relative standard error between 25% and 50% and should be used with caution.


(a) Data relates to persons who did not report having diabetes or high sugar levels.


(c) Includes ‘not known’ responses.

Notes

1. Percentages add within columns. Estimates have been rounded and discrepancies may occur between sums of the component items and totals.





Data sources and quality

Medicare data

Standard Indigenous status question Medicare seeks Indigenous status information in its enrolment forms, including the general enrolment application form and the Aboriginal and Torres Strait Islander Medicare enrolment form. These forms include the national standard Indigenous identification question. Indigenous Australians can also complete a specific Voluntary Indigenous Identification form. Indigenous status information is held in Medicare records as the Voluntary Indigenous Identifier (VII).

Under-identification The coverage of Indigenous Australians in the VII database is not complete. There were around 415,730 people who had identified as Aboriginal and/or Torres Strait Islander in this database at June 2014; around 58% of the estimated Indigenous population. There has been a rapid expansion in the number of enrolees who identified as Indigenous, from 47,200 people in August 2004.

Readers should note the following caveats to the Medicare Voluntary Indigenous Identifier (VII) adjustment methodology:

• Estimates generated by the adjustment methodology for a given period will vary according to the point in time at which they are calculated, as the adjustment factors will be updated regularly to account for the ongoing change in the population coverage of the VII sample.

• There are inherent uncertainties in the current ABS Indigenous population estimates, and they are therefore described by the ABS as ‘experimental estimates and projections’. The ABS Indigenous population estimates after 2011 are experimental projections, based on a number of assumptions about future levels of fertility, mortality and migration. The projections are not predictions or forecasts, but are illustrations of the growth and change in population that would occur if these assumptions were to prevail over the projection period. There can be no certainty that any particular outcome will be realised, or that future outcomes will necessarily fall within the projected ranges.

• The propensity to identify as Indigenous is influenced by numerous factors including the context, how the question is asked and by whom, motivations of the individual and perceived uses of the data in question. For example, it is possible that there are some Indigenous Australians who are registered with the VII but who do not identify as Indigenous for the purposes of the Census, or vice versa.

• PBS and MBS data do not give a comprehensive picture of actual service delivery for Indigenous Australians, as some service delivery (especially in Remote areas) is not part of these systems. For example, s.100 medication delivery in Remote locations takes place outside of, and is not recorded by, the PBS. Likewise state and territory primary health care providers are generally not eligible to bill Medicare.

• In some areas, particularly Remote and Very remote areas, there is a portion of the Indigenous population that does not ever use the Medicare system. It is therefore



possible that the adjustment methodology could overestimate Medicare use by the Indigenous population.

• As participation in the VII sample is voluntary, 100% coverage is unlikely. There could be biases in the data that are not addressed by the adjustment methodology.

Online Services Report data collection The OSR collects organisation-level information from Aboriginal and Torres Strait Islander health organisations that received Australian Government funding in 2012–13.

Data were collected using a web-based reporting tool designed specifically to capture information on inputs and health processes at primary health-care organisations funded to deliver care to Indigenous Australians.

AIHW examined all data submissions to identify missing data and data quality issues. The most common data quality issues were inaccurate recording (for example, staff were reported in terms of their total number rather than in full-time equivalent positions), and discrepancies between 2 or more questions (for example, the number of clients exceeded the number of episodes of care).

Where needed, AIHW staff contacted the relevant health organisation to follow up on data quality issues and to request additional or corrected data. The AIHW detected at least 1 issue for follow-up in around 239 (92%) of organisations. Of these, 207 (87%) resubmitted data. Data with remaining significant quality issues were excluded from national analyses.

From 2012–13 a new online questionnaire started. Major questions (for example, around episodes of care, clients and contacts) remained the same. Some other questions were revised or restructured.

For more information see <http://meteor.aihw.gov.au/content/index.phtml/itemId/561251>.

Healthy for Life data collection For the July 2010 to June 2011 reporting period, 85 services submitted data as part of the Healthy for Life (HfL) Program.

Services started submitting their data through an electronic interface (OSCAR) for the February 2008 reporting period. This has improved the quality of data submitted.

Not all of the services were able to provide data for all of the essential indicators and service profile questions included in the HfL data collection. The number of services that were able to provide data varies across the qualitative and quantitative indicators.

There has been an upward trend in the proportion of services that reported on each of the indicators over time, particularly compared with the first reporting period ending June 2007.

In general, the data quality improved noticeably between the periods ending in June 2008 and June 2009. The overall level of data quality remained similar in the period ending in June 2010, while further improvements occurred in the period ending in June 2011. In the period ending in June 2011, the most common data quality issues were related to missing data (20% of services) and data out of the expected range (11% of services).

The Healthy for Life data collection was discontinued at the end of June 2011.



Australian Aboriginal and Torres Strait Islander Health Survey The 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) included a sample of 12,000 Indigenous Australians for the core sample and sub-samples for various components of the survey such as voluntary biomedical data for adults. The AATSIHS sample was specifically designed to select a representative sample of Indigenous Australians and therefore overcome the problem inherent in most national surveys (that is, small and unrepresentative Indigenous samples).

Survey results are subject to sampling errors as only a small proportion of the population is used to produce estimates that represent the whole population. Non-sampling errors may occur where there is non-response to the survey or questions in the survey, misunderstanding of questions or errors in recording, coding or processing the survey. Information recorded in this survey is ‘as reported’ by respondents. Responses may be affected by imperfect recall or individual interpretation of survey questions. Any data that are self-reported are also likely to under-estimate circumstances about which the respondent is unaware, or may be reluctant to report (for example, certain health conditions, weight, drug use).

Selected non-Indigenous comparisons are available from the 2011–13 Australian Health Survey (AHS). The AHS was conducted in Major cities, Regional and Remote areas, but Very remote areas were excluded from the sample.

Further information on AATSIHS data quality issues can be found in the user guide for the survey (ABS 2013). Time series comparisons for some indicators are available from the 2004–05 NATSIHS, 2008 NATSISS, 2002 NATSISS, 2001 NHS and the 1994 National Aboriginal and Torres Strait Islander Survey (NATSIS).

Australian Health Survey The Australian Health Survey (AHS) combines the existing ABS National Health Survey (NHS) and the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) together with 2 new elements: a National Nutrition and Physical Activity Survey (NNPAS) and a National Health Measures Survey (NHMS).

For more information see:

• National Health Survey <http://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4363.0.55.001Main+Features12011-13?OpenDocument>.

• National Aboriginal and Torres Strait Islander Health Survey <http://www.abs.gov.au/ausstats/[email protected]/mf/4715.0/>.

• National Nutrition and Physical Activity Survey <http://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/4364.0.55.007~2011-12~Main%20Features~About%20the%20National%20Nutrition%20and%20Physical% 20Activity%20Survey~731>.

• National Health Measures Survey <http://www.abs.gov.au/ausstats/[email protected]/Lookup/4364.0.55.005Chapter1102011-12>.



National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care data collection The nKPI data are collected from over 200 primary health-care organisations that receive funding from the Australian Government Department of Health to provide services primarily to Indigenous Australians.

The quality and completeness of the data submitted by organisations are important determinations of the quality of the national analyses. Data may be incomplete for a number of reasons:

• Internal inconsistency (numerator is greater than denominator, numbers not matching between linked indicators, subgroup totals not adding up to the total, and so on).

• Organisations commenting when submitting data that their data are incomplete or incorrect and could not be corrected.

• Organisations indicating that they did not provide a particular service so no data are available (for example, health assessments were not part of an organisation’s regular service).

• An organisation sharing an information recording system with another organisation and hence unable to separate its clients from all clients of the combined organisations.

• Auspiced organisations that collect data from a number of organisations often sharing a single patient information recall system and a single governance body. The data for individual organisations are combined and include duplicate clients.

This means that data for some indicators must be excluded for organisations if unresolved data quality issues remain. This results in different numbers of organisations with valid data for different indicators. For example, if 200 organisations submitted data for all reporting periods and all organisations provided valid data for PI01, PI01 will have 200 organisations contributing data. Some of the same 200 organisations may not have valid data for PI03 and this will result in fewer organisations contributing data to that indicator (see AIHW 2014, Table A3.1 for the number of organisations contributing valid data for each indicator for the December 2013 collection period).

In addition, when analysing and presenting data at the national level:

• There are some paired indicators where the numerator for 1 is the denominator for the other (for example, PI05 and PI06, PI09 and PI10, and PI23 and PI24); if data for 1 indicator in a pair are excluded due to data quality issues, data from the other indicator in the pair are also excluded.

• Some jurisdictions have an insufficient number of organisations to perform meaningful analysis. Therefore, Tasmanian data are combined with Victorian data, and data from the Australian Capital Territory are combined with data from New South Wales.

• It should be noted that some organisations (like the Queensland Aboriginal and Islander Health Council) use nKPI data to issue their own reports. These data may be reported differently because of different data ‘cleaning’ processes.

More information on nKPI data quality can be found on the AIHW’s METeOR website <http://meteor.aihw.gov.au/content/index.phtml/itemId/593841>.



List of symbols used in tables n.a. not available

. . not applicable

n.p. not available for publication but included in totals where applicable, unless otherwise indicated

* represents results with statistically significant differences at the p < 0.05 level, between the categories specified in table footnotes

† estimate has a relative standard error between 25% and 50% and should be used with caution

‡ estimate has a relative standard error greater than 50% and is considered too unreliable for general use



List of tables Table 3.05.1a: VII adjusted, MBS services claimed, GP management plan (GPMP) by Indigenous

status, Australia, 2003–04 to 2013–14 ..................................................................................... 6

Table 3.05.1b: VII adjusted, MBS services claimed, Team care arrangements (TCA) by Indigenous status, Australia, 2003–04 to 2013–14 ..................................................................................... 7

Table 3.05.2: VII adjusted, MBS, Chronic Disease Management Package (CDMP) services provided to Indigenous patients (15+) ................................................................................... 8

Table 3.05.3: VII adjusted, MBS, CDMP Indigenous patient counts (15+) ............................................... 9

Table 3.05.4: Proportion of Indigenous primary health-care services providing chronic disease management activities, 2001–02 to 2012–13......................................................................... 10

Table 3.05.5: Indigenous regular clients with Type 2 diabetes receiving recommended care from Indigenous primary health care services, by remoteness, December 2013 ..................... 11

Table 3.05.6: Chronic disease: management, reporting periods ending 30 June 2009, 2010 and 2011 ........................................................................................................................................... 12

Table 3.05.7: Number and proportion of Indigenous regular clients who are diagnosed with Type 2 diabetes and HbA1c test in the last 6 months, by remoteness, 1 January–30 June 2011 ........................................................................................................... 15

Table 3.05.8: Average HbA1c result for Indigenous regular clients diagnosed with Type 2 diabetes who had an HbA1c test in the last 6 months, by remoteness 1 January–30 June 2011 ........................................................................................................... 15

Table 3.05.9: Number and proportion of Indigenous regular clients with Type 2 diabetes who had a blood pressure test in the last six months, by remoteness, 1 January–30 June 2011 ........................................................................................................... 15

Table 3.05.10: Number and proportion of Indigenous regular clients with Type 2 diabetes who had a blood pressure test in the last six months with a result less than or equal to 130/80mmHg, by remoteness, 1 January–30 June 2011 ..................................................... 16

Table 3.05.11: Number and proportion of Indigenous regular clients with coronary heart disease who had a blood pressure test in the last six months, by remoteness, 1 January–30 June 2011 ........................................................................................................... 16

Table 3.05.12: Number and proportion of Indigenous regular clients with coronary heart disease who had a blood pressure test in the last six months with a result less than 140/90mmHg, by remoteness, 1 January–30 June 2011 ..................................................... 16

Table 3.05.13: Number and proportion of Indigenous regular clients with Type 2 diabetes who had an HbA1c test in the last 6 months, by HbA1c result and remoteness, 1 January–30 June 2011 ........................................................................................................... 17

Table 3.05.14: Health actions for persons with diagnosed, current and long term diabetes or high sugar levels, by Indigenous status and state/territory, 2012–13 ............................. 18

Table 3.05.15: Health actions for persons with diagnosed, current and long-term heart and circulatory conditions, by Indigenous status, persons aged 18 years and over, 2012–13 ..................................................................................................................................... 22

Table 3.05.16: Health actions for persons not reporting diabetes or high sugar levels, by age group, by Indigenous status, 2012–13 .................................................................................. 24



List of figures Figure 3.05.1: Age-standardised rates of MBS services claimed for GP management plans and

team care arrangements, by Indigenous status, Australia, 2009–10 to 2013–14 ............... 5

References ABS (Australian Bureau of Statistics) 2013. Australian Aboriginal and Torres Strait Islander Health Survey: users’ guide, 2012–13. ABS cat no. 4727.0.55.002. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2014. National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results from December 2013. National key performance indicators for Aboriginal and Torres Strait Islander primary health care. Cat. no. IHW 146. Canberra: AIHW.

Other related information ABS 2015. Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012–13 (cat. no. 4727.0.55.003) Table no. 14.3. Viewed 31 March 2015 <http://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/4727.0.55.0032012-13?OpenDocument>.

AIHW 2014. National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results from December 2013. National key performance indicators for Aboriginal and Torres Strait Islander primary health care. Cat. no. IHW 146. Canberra: AIHW.

AIHW 2015. Healthy Futures—Aboriginal Community Controlled Health Services: report card. Cat. no. IHW 150. Canberra: AIHW.

Bailie RS, Si D, Robinson GW, Togni SJ & d’Abbs PH 2004. A multifaceted health-service intervention in remote Aboriginal communities: 3-year follow-up of the impact on diabetes care. Medical Journal of Australia 181:195–200.

Bailie R, Si D, Dowden M & Lonergan K 2007. Audit and Best Practice for Chronic Disease Project: Final Report. Darwin: Menzies School of Health Research.

Bodenheimer T, Lorig K, Holman H & Grumbach K 2002. Patient self-management of chronic disease in primary care. JAMA: the Journal of the American Medical Association 288:2469.

Hoy W, Kelly A, Jacups S, McKendry K, Baker P, MacDonald S et al. 1999. Stemming the tide: reducing cardiovascular disease and renal failure in Australian Aborigines*. Internal Medicine Journal 29:480–3.

Hoy W, Baker P, Kelly A & Wang Z 2000. Reducing premature death and renal failure in Australian Aboriginals. Medical Journal of Australia 172:473–8.

McDermott R, Tulip F, Schmidt B & Sinha A 2003. Sustaining better diabetes care in remote indigenous Australian communities. British Medical Journal 327:428–30.

National Health Priority Action Council 2006. National Chronic Disease Strategy. Canberra: Commonwealth Department of Health and Ageing.



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