In 2004-05, $1.17 was spent on Aboriginal and Torres Strait Islander health for every $1.00 spent on the health of non-Indigenous Australians. The relatively high levels of morbidity and mortality among Indigenous Australians, however, suggest that current expenditures for Aboriginal and Torres Strait Islander people may not be sufficient to address their health needs.
The access of Aboriginal and Torres Strait Islander people to health services may be hindered by a number of barriers, sometimes resulting in them not accessing care when needed. In the 2004-05 NATSIHS, for example, 21% of Indigenous Australians reported they had needed to go to a dentist in the last 12 months, but had not gone, and 15% had needed to go to a doctor, but had not gone. Reasons reported for not accessing care include lack of availability of services, transport and distance to services, cost, and language and cultural barriers. A higher proportion of Indigenous people in non-remote areas reported cost as a reason for not seeking health care, while for those in remote areas, transport/distance and the service not being available in the area were more commonly reported.
Indigenous participation in the delivery of services is considered an important factor for improving access to services. In 2006 Indigenous Australians were under-represented in almost all health-related occupations and comprised 1% of the health workforce. Indigenous students were also under-represented among those completing graduate courses in health. Aboriginal and Torres Strait Islander people, however, were better represented in selected welfare and community service occupations, comprising 3.6% of people employed in this sector.
After adjusting for differences in the age structures of the Indigenous and non-Indigenous populations, Indigenous Australians were more likely to have taken at least one health-related action in 2004-05, such as visiting a doctor or being admitted to hospital, than non-Indigenous Australians. The differences were most marked in relation to visits to casualty and other health professionals where the rates for Indigenous Australians were twice the rates for non-Indigenous Australians. On the other hand, the rate of Indigenous Australians who visited a dentist was 0.6 times the rate for non-Indigenous Australians.
In 2005-06, Indigenous males and females were more than twice as likely as other males and females to have been hospitalised, with the greatest differences in hospitalisation rates for people aged 25 years and over. Most of the difference in hospitalisation rates was due to high rates of care involving dialysis, and potentially preventable hospitalisations. Indigenous Australians were hospitalised for care involving dialysis at 14 times the rate of other Australians and for potentially preventable hospitalisations at five times the rate of other Australians.
While Indigenous Australians were more likely to be hospitalised than other Australians, they were less likely to undergo a procedure once admitted to hospital. It is not clear why Indigenous patients are less likely to undergo a procedure, but some possible factors include communication difficulties, institutionalised racism, the presence of co-morbidities, and presentation late in the course of illness.