Health costs mount for Indigenous Australians in remote areas

Expenditure on potentially preventable hospital admissions more than double the amount for non-Indigenous Australians

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Helen Davidson The Guardian 23 August 2013

Health expenditure on potentially preventable hospital treatment of Indigenous Australians is more than double the expenditure on non-Indigenous Australians, a new report shows – but the cause is unclear.

The Australian Institute of Health and Welfare report, Expenditure on health for Aboriginal and Torres Strait Islander people 2010-11: an analysis by remoteness and disease, released on Friday, found that spending on health per person increased with remoteness – and did so particularly for Indigenous patients, because of hospital admissions that might have been prevented.

In 2010-11, for every dollar spent on non-Indigenous Australians living in remote or very remote areas on potentially preventable hospitalisations (PPH), $2.22 was spent on Indigenous Australians.

PPH expenditure for Indigenous people was $219m ($385 a person), and non-Indigenous expenditure was $3.4bn ($174 a person).

Whether the reason for the higher spending is more to do with remoteness or the lower standard of health among Indigenous Australians is largely unknown, said Dr Adrian Webster, a spokesman for the Australian Institute of Health and Welfare.

"That's the million-dollar question. It's really complicated and probably varies depending on which conditions you look at and which areas you're talking about – how remote you're talking about," he told Guardian Australia.

"We suffer a little from the fact our classification of remoteness is very broad when it comes to 'remote' and 'very remote'. It's actually very difficult within our data to estimate what proportion of cost differential is related to remoteness verses being Indigenous."

Previous studies have found that remote living has an extreme effect on health and health provisions across the whole Australian population. Changes to the classifications have been proposed.

The reasons for hospital admissions are also markedly different between the two groups when broken down by disease groups.

Spending on health per person increases with remoteness – and does so particularly for Indigenous patients, because of hospital admissions that might have been prevented, a report has found.

Image: Professor Harvey Coates tests the hearing of Jesse Williams 6 at Armadale-Kelmscott Hospital, WA

Genitourinary diseases – including kidney dialysis – accounted for the largest proportion (11%) of "hospital admitted expenditure" on Indigenous Australians, followed by mental and behavioural disorders (11%), maternal conditions (8%), unintentional injuries (8%) and cardiovascular disease (7%).

For non-Indigenous Australians the largest proportion in 2010-11 was cardiovascular diseases with 12%. The next highest proportion of expenditure was unintentional injuries (10%), musculoskeletal and connective tissue diseases (9%) and cancer (8%).

This difference is partly due to the lower life expectancy of Indigenous Australians, creating a younger population, according to Webster. "That is, I suppose, both a cause and an effect of the different disease profiles within those populations. A younger population you're going to expect to see less chronic conditions."