INTRODUCTION
There is some evidence that Aboriginal and Torres Strait Islander people do not have the same level of access to many health services as other Australians and this can adversely impact on their health outcomes. The relatively poor health status and high mortality and morbidity rates among Indigenous Australians points to the need for more health services and a greater per capita investment of health resources for this population. Indigenous people face a number of barriers in accessing health care, including language and cultural barriers, distance to services, and the cost or services. Aboriginal and Torres Strait Islander people are under-represented in health-related occupations and in graduate courses in health. While Indigenous people were twice as likely as other Australians to be hospitalised, they were less likely to undergo a procedure once admitted to hospital.
Health services include primary health care services such as those provided by general medical practitioners (GPs), nurses and allied health professionals. They also include acute care provided in hospitals, and specialist services, such as those provided by obstetricians and eye specialists among others. These services are provided in a range of settings including community health centres, doctors' and specialists' rooms and hospitals. Aboriginal health services, which operate across Australia, are also important providers of comprehensive primary health services for Indigenous Australians, particularly in more remote areas. These services have funding provided by the Australian Government, the state and territory governments, or both.
This chapter presents analyses of various data collections in order to provide a comprehensive picture of Indigenous Australians' access to, and use of, health services. Health expenditure patterns show how health services are delivered and used. Some of the factors that impact on access to and use of health services are then examined, including cultural factors, such as language; availability of health professionals; the distances clients must travel to services and facilities; affordability of health services; and the participation of Indigenous people in the health and welfare workforce. The chapter also includes information on the use of health services, including Australian Government funded Aboriginal primary health care services, services provided by GPs, alcohol and other drug treatment services, mental health services and hospital services.
It is not always possible to accurately quantify the extent to which Aboriginal and Torres Strait Islander people access and use different health services. The administrative data on health services are collected by the various providers including Australian, state and territory governments, community organisations and private sector providers. There are, however, variations in the quality and coverage of these data, and in the accuracy with which Indigenous people are identified in various health service records.
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