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Indigenous Better Cardiac Care measure: 1.1-Annual health assessments, 2016

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this term1.1-Annual health assessments, 2016
METeOR identifier:Help on this term657009
Registration status:Help on this termHealth, Standard 17/08/2017
Description:Help on this term

Number and percentage of Aboriginal and Torres Strait Islander people who have received a Medicare Benefits Schedule (MBS) health assessment within a 12-month period.

Rationale:Help on this term

This measure falls within Priority area 1 of the Better Cardiac Care project—early cardiovascular risk assessment and management. This priority area is based on the premise that all Aboriginal and Torres Strait Islander people who have no known cardiac disease should receive:

  • an annual cardiovascular risk assessment
  • appropriate management and follow-up of identified risk factors
  • lifestyle modification advice appropriate to their absolute cardiovascular risk level, as per current guidelines (NACCHO & RACGP 2012).

Primary prevention in the form of early and consistent risk factor identification and management will improve long-term outcomes for Indigenous Australians, reduce the population burden of chronic cardiac disease and improve the appropriate delivery of care by the health-care system.

Health assessments aim to increase preventative health opportunities, detect chronic disease risk factors, better manage existing chronic disease and reduce inequities in access to primary care for Indigenous Australians. Early detection and management of the risk factors for cardiac disease (such as smoking, physical inactivity and high blood pressure) can reduce the incidence of cardiac disease and lessen its severity.

Indicator set:Help on this termBetter Cardiac Care measures for Aboriginal and Torres Strait Islander people (2016) Health, Standard 17/08/2017

Collection and usage attributes

Computation description:Help on this term

Number of Aboriginal and Torres Strait Islander people who received:

  • an MBS item 715 health assessment
  • a general MBS health assessment (MBS items 701, 703, 705 and 707) within a 12-month period.

Data are presented separately for MBS 715 health assessments and for general MBS health assessments.

Data are presented as a number and percentage.

For analysis of change over time, age-standardised rates are also calculated.

Data are based on financial years.

Computation:Help on this term

Number: Numerator

Crude rate: (Numerator ÷ Denominator) x 100

Age-standardised rate: calculated using the direct method, and the Australian standard population as at 30 June 2001.

Numerator:Help on this term

Number of Indigenous Australians who received an MBS health assessment within the financial year.

Numerator data elements:Help on this term
Data Element / Data SetService event—Medicare Benefits Schedule (MBS) item identifier, NN[NNN]
Data Source
Medicare (MBS) data
Guide for use

Data source type: Administrative by-product data.


Data Element / Data SetPerson—Medicare personal identifier number, N[N(8)]
Data Source
Medicare (MBS) data
Guide for use

Used to uniquely identify and count individuals who have accessed a Medicare claimable service event.

Data source type: Administrative by-product data


Data Element / Data SetData Element

PersonIndigenous status


Data Source
Medicare (MBS) data
Guide for use

For health assessments which relate to services that can be claimed irrespective of Indigenous status (MBS items 701, 703, 705 and 707), Indigenous status is determined using the Voluntary Indigenous Identifier (VII) (see 'Comments' section for details). In contrast, MBS item 715 is an Indigenous-specific health assessment—thus, in the calculations for this type of health assessment, it is assumed that all people who receive an MBS item 715 are Indigenous.

Data source type: Administrative by-product data


Data Element / Data SetService event—Medicare Benefits Schedule (MBS) processing date, DDMMYYYY
Data Source
Medicare (MBS) data
Guide for use

Used to identify claims processed in the financial year.

Data source type: Administrative by-product data


Denominator:Help on this term

Estimated population at the middle of the financial year, calculated from the average of the population estimates/projections at 30 June at the beginning and end of the financial year.

Denominator data elements:Help on this term
Data Element / Data SetData Element

Person—estimated and projected Indigenous resident population


Data Source
ABS Indigenous estimates and projections (2011 Census-based)
Guide for use

Data source type: Census-based plus administrative by-product data


Disaggregation:Help on this term

Current period (2014–15), Indigenous Australians, by:

  • MBS item type (715 versus general health assessments).

Current period (2014–15), Indigenous Australians, MBS item 715 health assessments by:

  • sex and age group (0–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65+)
  • state/territory
  • remoteness area.

Time series (2004–05 to 2014–15), Indigenous Australians, MBS Item 715 health assessments by:

  • age group (<15, 15–54, 55+, crude total and age-standardised total).
Disaggregation data elements:Help on this term
Data Element / Data SetPerson—sex, code A
Data Source
Medicare (MBS) data
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetPerson—date of birth, DDMMYYYY
Data Source
Medicare (MBS) data
Guide for use

Used together with 'processing date' to calculate age. Age is calculated as at the date of processing for the last service processed for that individual within the financial year.

Data source type: Administrative by-product data


Data Element / Data SetAddress—Australian postcode, Australian postcode code (Postcode datafile) {NNNN}
Data Source
Medicare (MBS) data
Guide for use

Used to disaggregate data by state/territory and remoteness area. This data item is based on the individual's Medicare enrolment address, as at the date of processing for the last service processed for that individual within the financial year.

Data source type: Administrative by-product data


Data Element / Data SetService event—Medicare Benefits Schedule (MBS) processing date, DDMMYYYY
Data Source
Medicare (MBS) data
Guide for use

Used together with 'date of birth' to calculate age. Age is calculated as at the date of processing for the last service processed for that patient within the financial year.

Data source type: Administrative by-product data


Comments:Help on this term

General:

The numerator for this measure is drawn from MBS data. For 2016 reporting, the most recent data available are for 2014–15. MBS data reflect MBS claims processed and not necessarily all services rendered. For example, a person may be provided with equivalent care from a health-care provider who is not eligible to bill Medicare.

The data are based on the date of processing of claims. The claim may have been made by the patient (or their representative) or by the health-care provider. If a service was rendered but not claimed within the reference period, then that service will not be included in those data.

The denominator data used in the calculation of rates are ABS estimates and projections (Series B) based on the 2011 Census.

Types of health assessments:

MBS item 715 health assessmentAll Aboriginal and Torres Strait Islander people, regardless of age, are eligible for an annual Indigenous-specific health check through the MBS. This health check, listed as item 715 on the MBS, was designed especially for Indigenous people. It was established because Indigenous Australians have considerably higher morbidity and mortality levels than non-Indigenous Australians, with earlier onset and more severe disease progression for many chronic diseases. The aim of the health checks is to provide Indigenous Australians with primary health care matched to their needs by supporting early detection, diagnosis and intervention for common and treatable conditions.

General MBS health assessmentThere are four time-based health assessment items, consisting of brief, standard, long and prolonged consultations (MBS items 701, 703, 705 and 707, respectively). All Australians (including both non-Indigenous and Indigenous Australians) are eligible to receive such assessments if they meet specific criteria—see Department of Health 2015 for details.

Indigenous identification:

The identification of Indigenous Australians in MBS data is not complete. Since 2002, individuals who choose to identify as being of Aboriginal and/or Torres Strait Islander origin have been able to have this information recorded on the Medicare database through the Voluntary Indigenous Identifier (VII). Indigenous identification is through either a Medicare VII form or a tick-box on a Medicare enrolment form. Both methods indicate that identifying as Indigenous is optional. As at March 2016, an estimated 65% of the Indigenous population had identified as being of Aboriginal and/or Torres Strait Islander origin through the VII process (AIHW 2016).

Use of the VII in calculations for this measure

MBS item 715 is an Indigenous-specific health assessment—thus, in the calculations for this type of health assessment, it is assumed that all people who receive an MBS 715 are Indigenous.

For the other types of MBS health assessments (which relate to services that can be claimed irrespective of Indigenous status), Indigenous status is determined using the VII.

As not all Indigenous Australians have recorded their Indigenous status with Medicare, the MBS data based on the VII were scaled up by the Australian Government Department of Health to reflect the size of the total Indigenous population.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN].N

Data source attributes

Data sources:Help on this term
Data SourceMedicare (MBS) data
Frequency
Monthly
Data custodian
Department of Health

Data SourceABS Indigenous estimates and projections (2011 Census-based)
Frequency
Periodic
Data custodian
Australian Bureau of Statistics

Accountability attributes

Reporting requirements:Help on this term

Annual reporting by the Australian Institute of Health and Welfare (AIHW 2015, 2016).

Organisation responsible for providing data:Help on this term

Australian Government Department of Health

Release date:Help on this term24/11/2016

Source and reference attributes

Submitting organisation:Help on this term

Australian Institute of Health and Welfare

Origin:Help on this term

AIHW 2016. Better Cardiac Care measures for Aboriginal and Torres Strait Islander people: second national report 2016. Cat. no. IHW 169. Canberra: AIHW.

Reference documents:Help on this term

AIHW (Australian Institute of Health and Welfare) 2015. Better Cardiac Care measures for Aboriginal and Torres Strait Islander people: first national report 2015. Cat. no. IHW 156. Canberra: AIHW.

AIHW 2016. Better Cardiac Care measures for Aboriginal and Torres Strait Islander people: second national report 2016. Cat. no. IHW 169. Canberra: AIHW.

Better Cardiac Care Forum 2014. National recommendations for Better Cardiac Care for Aboriginal and Torres Strait Islander people: post-forum report. Unpublished paper prepared for Australian Health Ministers’ Advisory Council meeting, Canberra, June.

Department of Health 2015. Medicare Benefits Schedule—Note A25. Canberra: Department of Health. Viewed 6 September 2016, http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&qt=
NoteID&q=A25
.

NACCHO & RACGP (National Aboriginal Community Controlled Health Organisation & Royal Australian College of General Practitioners) 2012. National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. South Melbourne: RACGP.

Relational attributes

Related metadata references:Help on this term

See also Indigenous Better Cardiac Care measure: 1.3-Primary care practitioner follow-up, 2016 Health, Standard 17/08/2017

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