WORKING GROUP DRAFT – IN CONFIDENCE

In Australia, the health sector consists of four main services.

Primary and community health

Primary and community health services aim to promote health, prevent illness and support people to manage their health issues in the community. These include general practice, pharmaceutical services, dentistry, allied health services, community health services, maternal and child health and alcohol and other drug treatment.

• Total government real recurrent expenditure on primary and community health services was $50.3 billion in 2022-23.
• There were 29,215 full-time equivalent (FTE) general practitioners (GPs), equating to 109.7 per 100,000 people nationally in 2023.
• Around 226 million services were subsidised under Section 85 and Section 100 of the Pharmaceutical Benefits Scheme (PBS) in 2023-24.

Ambulance services

Ambulance service organisations are the primary agencies involved in providing emergency medical care, pre-hospital and out-of-hospital care, and transport services.

• Total government real recurrent expenditure on ambulance services was $5.9 billion in 2023-24.
• Total ambulance service organisation revenue was $5.6 billion in 2023-24.
• There were 25,345 registered paramedics in Australia in 2023-24.
• There were 5.8 million ambulance responses to 4.4 million incidents in 2023-24.

Public hospitals

Public hospitals aim to alleviate or manage illness and the effects of injury by providing acute, non and sub-acute care along with emergency and outpatient care.

• Total government real recurrent expenditure on public hospitals (excluding depreciation) was $96.1 billion in 2022-23.
• There were 700 public hospitals in Australia in 2022-23, comprising 65,051 public hospital beds (equivalent to 2.5 beds per 1,000 people).
• Approximately 7.1 million separations from public (non-psychiatric) hospitals in 2022-23.

Services for mental health

Services for mental health aim to promote mental health and wellbeing, and where possible prevent the development of mental health problems; and when mental health problems and illness do occur, reduce their impact.

• Total government real recurrent expenditure allocated to mental health services was $12.6 billion in 2022-23.
• A further $5.3 billion was provided to support people with a significant and enduring primary psychosocial disability through the National Disability Insurance Scheme (NDIS) in 2022-23.
• 12.6 million Medicare-subsidised services for mental health were provided in Australia in 2023-24. This includes Medicare-subsidised mental health services provided by primary and community health providers, state and territory government specialised mental health services and non-government services providing community-based support.

Detailed information on the equity, effectiveness and efficiency of service provision and the achievement of outcomes for the primary and community health, ambulance services, public hospitals, and mental health services is contained in the service-specific sections.

Flows in the sector

Health services in Australia are delivered by a variety of government and non‑government providers in a range of service settings that do not have a clearly defined path (figure E.1).

Intersection of ambulance services and public hospital emergency departments

The intersection of ambulance services and public hospital emergency departments (EDs) is a vital component of the healthcare system, facilitating patients receiving timely and effective emergency care. Efficient ambulance-to-ED transfers ensures timely treatment, prevents complications, and maintains emergency service capacity (Dawson et al. 2022).

Delays in transfers may disrupt patient care and limit ambulance and ED response capabilities, increasing strain on the health system (Mengyu et al. 2019). Delays may result from hospital overcrowding, partly a consequence of increasing presentations to EDs (AIHW 2025a; Crawford et al. 2014). Long-stay patients awaiting discharge can further reduce hospital capacity and delay admissions from the ED (IFEM 2020). Limited aged care and disability support services, along with staff and resource shortages may compound the issue (Kruk 2023; Queensland Health 2024).

Governments are working to minimise patient transfer delays to provide immediate medical care for lower acuity patients and divert unnecessary presentations from EDs (DHAC 2023; Savira et al. 2025). For example:

• Medicare Urgent Care Clinics aim to ease the pressure on hospitals and give patients more options to see a health care professionals when they have an urgent, but not life threatening, need for care.
• 'Hospital in the Home’ programs provide hospital-level care at home also aim to increase availability of hospital beds by reducing demand (Montalto et al. 2020).
• Virtual Emergency Department care provides urgent medical care remotely, particularly for conditions that are not life-threatening. These services allow patients to connect with emergency-trained health professionals via telehealth, potentially avoiding the need to visit a physical ED.

These measures diversify the care settings available to patients and provide an alternative to public hospital-based care, thus increasing hospital capacity and reducing patient transfer delays.

This overview provides selected population health insights across four themes:

• Babies born of low birthweight
• Selected potentially preventable diseases
• Life expectancy
• Mortality rates.

Babies born of low birthweight

In 2022, 5.1% of babies born in Australia were of low birthweight (table EA.1). Nationally, the proportion of babies born of low birthweight to Aboriginal and Torres Strait Islander mothers was more than twice that for babies born to non-Indigenous mothers (figure E.2).

Further information on the historical and ongoing context for Aboriginal and Torres Strait Islander people is available on the Closing the Gap Information Repository website – Target 2

Selected potentially preventable diseases

Selected potentially preventable diseases are diseases that could potentially have been prevented through the provision of health interventions and early disease management. Diseases covered in this report include selected cancers, heart attacks and type 2 diabetes.

• Nationally in 2021, the age standardised rate of new cases of selected cancers was highest for female breast cancer (123.3 per 100,000 females), followed by melanoma, bowel cancer and lung cancer (49.1, 47.7 and 40.9 per 100,000 people, respectively) and lowest for cervical cancer (7.1 per 100,000 females) (table EA.11).
• Nationally in 2022, the age standardised rate of heart attacks (acute coronary events) was 266.9 cases per 100,000 people aged 25 years or over (table EA.14). The national rate has decreased each year over the 10 years included in this report. The rate for females is less than half the rate for males.
• Nationally in 2022, an estimated 4.5% of adults had type 2 diabetes (table EA.16).

Life expectancy

Historically, life expectancy has risen steadily over time but has decreased in recent years. In 2021–23, life expectancy at birth was 81.1 years for males and 85.1 years for females – slightly lower than 2020–22 (table EA.20). The life expectancy of Aboriginal and Torres Strait Islander people is considerably lower than that of other people, with a life expectancy at birth of 71.9 years for Aboriginal and Torres Strait Islander males and 75.6 years for Aboriginal and Torres Strait Islander females born between 2020–22 (table EA.21).

Further information on the historical and ongoing context for Aboriginal and Torres Strait Islander people is available on the Closing the Gap Information Repository website – Target 1

Mortality rates

The national age standardised mortality rate was 512.9 deaths per 100,000 people in 2023 – a decrease from 2022 (figure E.3). In line with life expectancy data, mortality rates are higher for Aboriginal and Torres Strait Islander people compared to non-Indigenous people (table EA.23).

Child mortality

Mortality data is separately reported for children as follows:

• Registered perinatal deaths, comprising fetal deaths (stillbirths) and neonatal deaths (death of an infant within 28 days of birth)
• Registered infant deaths (children aged less than 1 year)
• Registered infant and child deaths (children aged 0–4 years).

Registered perinatal, infant and child deaths data are sourced from the Australian Bureau of Statistics (ABS) Causes of Death collection, which is based on information from births, deaths, and marriage registrars. Further information on hospital recorded perinatal deaths is available from the Australian Institute of Health and Welfare (AIHW) National Perinatal Mortality Data Collection (2024).

Nationally, in 2023:

• there were 8.2 registered perinatal deaths per 1,000 births (table EA.32), of which around 72.2% were fetal deaths and the remainder neonatal deaths (table EA.30–31)
• the average infant mortality rate was 3.2 registered deaths per 1,000 live births (table EA.26). Over the past 10 years, the average infant mortality rate has ranged from 3.1 (2016 and 2018) to 3.4 (2014) registered deaths per 1,000 live births.

The Australian infant and child combined mortality rate (3-year average) has decreased over time from 82.5 deaths per 100,000 population in 2012–14 to 74.5 deaths per 100,000 population in 2021–23 (table EA.28).

Causes and prevention

The most common causes of death among all Australians in 2023 were neoplasms (cancer) and circulatory diseases (including heart disease, heart attack and stroke) (table EA.24). Data by Indigenous status is available in table EA.25.

There is potential to prevent some deaths through individualised care and/or to treat health conditions through existing primary or hospital care.

• Nationally, there were 97.2 potentially avoidable deaths per 100,000 people in 2023 – a decrease on 2022 (101.8 per 100,000 people) (table EA.17).
• The rate of potentially avoidable deaths in 2019–23 for Aboriginal and Torres Strait Islander people was 301.0 per 100,000 people – the highest rate over the reported time series (since 2017–21) and more than three times the rate for other Australians (94.5) (table EA.18).

Data on key risk factors affecting population health outcomes (including overweight or obesity, smoking and risky alcohol consumption) are available in tables EA.3–10. In summary, nationally in 2022:

• 33.7% of adults were overweight, while 31.1% were obese – a decrease and increase, respectively, since 2017-18. Additionally, 19.5% of children aged 5–17 years were overweight, while 8.3% were obese – an increase since 2017-18 (table EA.3).
• 10.7% of Australians reported that they were current daily smokers, the lowest proportion recorded in the time series (since 2007-08) (table EA.6).
• 12.9% of Australians exceeded the alcohol lifetime risk guidelines (as defined by the 2009 National Health and Medical Research Council [NHMRC] guidelines) – the lowest proportion recorded in the time series (since 2007-08) (table EA.8).

Data on key risk factors affecting Aboriginal and Torres Strait Islander people is available in tables EA.30-33. Nationally in 2022-23:

• 74.5% of Aboriginal and Torres Strait Islander people over the age of 18 reported being overweight or obese (table EA.30)
• 32.5% of Aboriginal and Torres Strait Islander people reported that they smoke daily, the lowest proportion recorded in the time series (since 2004-05) (table EA.31)
• rates of long-term risky alcohol consumption have reduced to 17%, the second lowest proportion in the time series behind 2014-15 (15.8%) (table EA.32)

Further information on the historical and ongoing context for Aboriginal and Torres Strait Islander people is available on the Closing the Gap Information Repository website – Target 1

Health workforce

The health care workforce is essential to the health system’s function, providing care, supporting public health efforts, and ensuring operational continuity. Nationally in 2023:

• there were 118,937 FTE medical practitioners. There were 762 medical practitioners who identified as Aboriginal and Torres Strait Islander, an increase of 19% compared to 2022 (table EA.34).
• there were 358,705 FTE nurses and midwives, the seventh consecutive increase over a seven-year period (table EA.35)

Data for allied health professionals, dentists and allied dental workers is available in tables EA.36-38.

A summary of the primary and community health, ambulance services, hospitals and mental health services performance indicator results are presented. Detailed information is in the service-specific sections.