Healthy Communities: Australians' experiences with primary health care in 2010–11 - Technical Supplement - Medicare Local peer group design

Healthy Communities: Australians' experiences with primary health care in 2010–11

Medicare Local peer group design

What is a Medicare Local?

Medicare Locals are a new nationwide network of primary health care organisations established to improve responsiveness, coordinate primary health care delivery and tackle local health care needs and service gaps. They have been established by the Australian Government to drive improvements in primary health care and ensure that services are better tailored to meet the needs of local communities. For further information, see Glossary.

What is a Medicare Local peer group?

Australia is a diverse country settled by a diverse population. To enable the presentation and reporting of comparable information to stimulate and inform efforts to improve the health system, improve transparency, accountability and inform consumers, the Authority has grouped the 61 Medical Locals into seven clusters called peer groups. This enables a fairer comparison of individual Medicare Local with peers, and also gives a summary of variation across Australia’s diverse metropolitan, regional and rural populations by presenting aggregate results for each peer group.

The grouping of Medicare Locals into seven peer groups was undertaken by the Authority using statistical cluster analysis of 2006 Census based socioeconomic status for each Medicare Local (ABS, Information Paper: An Introduction to Socio-Economic Indexes for Areas (SEIFA), 2006 (ABS catalogue no. 2039.0)) and 2006 Census based Remoteness Area categories. The initial cluster analysis was conducted by the ABS at the request of the Authority, and further information was introduced, including discussions on early drafts with key stakeholders. The cluster analysis produced five groupings of Medicare Locals (see Figure 1). These initial groupings were considered a starting point. Using additional information on the average distance to the closest large capital city and major hospital (A1 public hospitals in AIHW’s Public Hospital Peer Group classification, 2010-11) and face validity testing using knowledge from stakeholders, the Authority further refined the five groups. In addition, some Medicare Locals within a group appeared as outliers in terms of socioeconomic status and remoteness. These were then reassigned to a more appropriate group. This resulted in an increase from five peer groupings (Figure 1) to a total of seven (Figure 2). Table 1 contains a list of the Medicare Locals and the group to which each was allocated in the initial cluster analysis alongside their final peer grouping.

ABS analysis of results of the 2011 Census to produce updated Socio-Economic Indexes for Areas and Remoteness Area Categories is under way and scheduled to be released by March 2013. The results will be examined by the Authority, along with other information and methods to review the current peer group design, categories, and future options for fair comparison and reporting of health and other information for Medicare Locals.

Figure 1: Initial Medicare Locals cluster analysis Socio-Economic Indexes for Areas - Index of Relative Socio-Economic Disadvantage4 variables with Remoteness and showing the original five peer group categories

Chart showing the initial Medicare Local cluster analysis Socio-Economic Indexes for Areas – Index of Relative Socio-Economic Disadvantage variables with Remoteness and showing the original five peer group categories (Metro A, Metro B, Metro C, Regional and Rural)

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Medicare Local IRSD4 Metro A Metro B Metro C Regional Rural
Eastern Sydney 1052.8 0.0
Inner West Sydney 1007.1 0.0
South Eastern Sydney 1047.1 0.0
South Western Sydney 952.2 0.1
Western Sydney 1002.7 0.0
Nepean - Blue Mountains 1017.3 0.1
Northern Sydney 1099.6 0.0
North Eastern Sydney 1101.8 0.0
Central Coast NSW 990.6 0.1
Illawarra - Shoalhaven 981.3 0.3
Hunter Urban 990.0 0.1
Hunter Rural 959.9 1.4
North Coast NSW 957.0 1.4
New England 957.4 2.9
Western NSW 967.0 2.3
Murrumbidgee 975.8 2.3
Southern NSW 1001.6 1.8
Far West NSW 897.0 6.5
Inner North West Melbourne 1011.1 0.0
Bayside 1067.0 0.0
South Western Melbourne 1011.7 0.0
Macedon Ranges and North Western Melbourne 973.7 0.1
Northern Melbourne 997.8 0.0
Inner East Melbourne 1073.0 0.0
Eastern Melbourne 1044.7 0.0
South Eastern Melbourne 977.2 0.0
Frankston - Mornington Peninsula 1012.4 0.0
Barwon 999.4 0.3
Grampians 973.9 1.3
Great South Coast 989.9 2.1
Lower Murray 955.8 3.1
Loddon - Mallee - Murray 978.3 1.3
Goulburn Valley 979.3 1.2
Hume 990.9 1.4
Gippsland 973.7 1.6
Metro North Brisbane 1039.0 0.0
Metro South Brisbane 1019.5 0.1
Gold Coast 1024.7 0.0
Sunshine Coast 1004.1 0.4
West Moreton - Oxley 985.4 0.2
Darling Downs - South West Queensland 976.9 2.0
Wide Bay 942.6 1.9
Central Queensland 988.9 2.4
Central and North West Queensland 951.5 9.0
Townsville - Mackay 997.4 3.6
Far North Queensland 953.9 4.4
Northern Adelaide 956.9 0.0
Central Adelaide and Hills 1007.2 0.0
Southern Adelaide - Fleurieu 1007.9 0.2
Country South SA 954.0 3.3
Country North SA 947.5 4.0
Perth Central and East Metro 1043.2 0.0
Perth North Metro 1041.6 0.0
Fremantle 1046.9 0.0
Bentley - Armadale 1014.1 0.0
Rockingham - Kwinana - Peel 997.0 0.2
South West WA 993.6 2.7
Goldfields - Midwest 971.3 5.7
Kimberley - Pilbara 936.6 10.4
Tasmania 963.3 2.5
Northern Territory 917.6 6.2
Australian Capital Territory 1071.8 0.0

4. Australian Bureau of Statistics 2008, Index of Relative Socio-Economic Disadvantage published in Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia - Data only, 2006. (ABS Catalogue No. 2033.0.55.001).

Figure 2: Medicare Local cluster analysis Socio-Economic Indexes for Areas - Index of Relative Socio-Economic Disadvantage5 with Remoteness following cluster refinement and stakeholder consultation resulting in seven peer groups

Chart showing the Medicare Local cluster analysis Socio-Economic Indexes for Areas – Index of Relative Socio-Economic Disadvantage with Remoteness following cluster refinement using additional information on the average distance to the closest large capital city, major hospital and stakeholder consultation resulting in seven peer groups (Metro 1, Metro 2, Metro 3, Regional 1, Regional 2, Rural 1 and Rural 2)

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Medicare Local IRSD5 Metro 1 Metro 2 Metro 3 Regional 1 Regional 2 Rural 1 Rural 2
Eastern Sydney 1052.8 3.7
Inner West Sydney 1007.1 3.8
South Eastern Sydney 1047.1 4.0
South Western Sydney 952.2 4.3
Western Sydney 1002.7 4.2
Nepean - Blue Mountains 1017.3 4.6
Northern Sydney 1099.6 4.1
North Eastern Sydney 1101.8 4.0
Central Coast NSW 990.6 4.5
Illawarra - Shoalhaven 981.3 4.7
Hunter Urban 990.0 4.9
Hunter Rural 959.9
North Coast NSW 957.0 5.0
New England 957.4 5.3
Western NSW 967.0 5.2
Murrumbidgee 975.8 5.1
Southern NSW 1001.6 4.9
Far West NSW 897.0 5.6
Inner North West Melbourne 1011.1 3.7
Bayside 1067.0 4.0
South Western Melbourne 1011.7 4.3
Macedon Ranges and North Western Melbourne 973.7 4.3
Northern Melbourne 997.8 4.1
Inner East Melbourne 1073.0 4.0
Eastern Melbourne 1044.7 4.3
South Eastern Melbourne 977.2 4.3
Frankston - Mornington Peninsula 1012.4 4.5
Barwon 999.4 4.6
Grampians 973.9 5.0
Great South Coast 989.9 5.1
Lower Murray 955.8 5.5
Loddon - Mallee - Murray 978.3 5.0
Goulburn Valley 979.3 4.9
Hume 990.9 5.2
Gippsland 973.7 5.0
Metro North Brisbane 1039.0 4.1
Metro South Brisbane 1019.5 4.1
Gold Coast 1024.7 4.0
Sunshine Coast 1004.1 4.8
West Moreton - Oxley 985.4 4.3
Darling Downs - South West Queensland 976.9 5.1
Wide Bay 942.6 5.2
Central Queensland 988.9 5.5
Central and North West Queensland 951.5 6.0
Townsville - Mackay 997.4 5.7
Far North Queensland 953.9 5.9
Northern Adelaide 956.9 4.1
Central Adelaide and Hills 1007.2 3.9
Southern Adelaide - Fleurieu 1007.9 4.3
Country South SA 954.0 5.3
Country North SA 947.5 5.3
Perth Central and East Metro 1043.2 4.1
Perth North Metro 1041.6 4.1
Fremantle 1046.9 4.1
Bentley - Armadale 1014.1 4.2
Rockingham - Kwinana - Peel 997.0 4.7
South West WA 993.6 5.2
Goldfields - Midwest 971.3 5.7
Kimberley - Pilbara 936.6 6.1
Tasmania 963.3 5.4
Northern Territory 917.6 6.1
Australian Capital Territory 1071.8 3.9

5. Australian Bureau of Statistics 2008, Index of Relative Socio-Economic Disadvantage published in Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia - Data only, 2006. (ABS Catalogue No. 2033.0.55.001).

Table 1: Medicare Locals6 by initial cluster and final peer group allocation

ML Code Medicare Local name Initial cluster Final peer group
101 Eastern Sydney 1 Metro 1
102 Inner West Sydney 1 Metro 1
103 South Eastern Sydney 1 Metro 2
104 South Western Sydney 2 Metro 3
105 Western Sydney 2 Metro 3
106 Nepean-Blue Mountains 3 Regional 1
107 Northern Sydney 1 Metro 1
108 Sydney North Shore and Beaches 1 Metro 1
109 Central Coast NSW 3 Regional 1
110 Illawarra-Shoalhaven 4 Regional 1
111 Hunter Urban6 3 Regional 1
112 Hunter Rural6 4 Regional 1
113 North Coast NSW 4 Regional 2
114 New England 4 Regional 2
115 Western NSW 4 Regional 2
116 Murrumbidgee 4 Regional 2
117 Southern NSW 4 Regional 2
118 Far West NSW 4 Rural 1
201 Inner North West Melbourne 1 Metro 1
202 Bayside 1 Metro 1
203 South Western Melbourne 3 Metro 2
204 Macedon Ranges and North Western Melbourne 2 Metro 3
205 Northern Melbourne 2 Metro 3
206 Inner East Melbourne 1 Metro 1
207 Eastern Melbourne 3 Metro 2
208 South Eastern Melbourne 2 Metro 3
209 Frankston-Mornington Peninsula 3 Regional 1
210 Barwon 3 Regional 1
211 Grampians 4 Regional 2
212 Great South Coast 4 Regional 2
213 Lower Murray 4 Rural 1
214 Loddon-Mallee-Murray 4 Regional 2
215 Goulburn Valley 4 Regional 2
216 Hume 4 Regional 2
217 Gippsland 4 Regional 2
301 Metro North Brisbane 3 Metro 2
302 Greater Metro South Brisbane 3 Metro 2
303 Gold Coast 3 Metro 2
304 Sunshine Coast 3 Regional 1
305 West Moreton-Oxley 3 Metro 3
306 Darling Downs-South West Queensland 4 Regional 2
307 Wide Bay 4 Regional 2
308 Central Queensland 4 Rural 1
309 Central and North West Queensland 5 Rural 2
310 Townsville-Mackay 4 Rural 1
311 Far North Queensland 4 Rural 2
401 Northern Adelaide 4 Metro 3
402 Central Adelaide and Hills 3 Metro 2
403 Southern Adelaide-Fleurieu-Kangaroo Island 3 Metro 2
404 Country South SA 4 Regional 2
405 Country North SA 4 Rural 1
501 Perth Central and East Metro 3 Metro 2
502 Perth North Metro 3 Metro 2
503 Fremantle 3 Metro 2
504 Bentley-Armadale 3 Metro 2
505 Perth South Coastal 3 Regional 1
506 South West WA 4 Regional 2
507 Goldfields-Midwest 4 Rural 2
508 Kimberley-Pilbara 5 Rural 2
601 Tasmania 4 Regional 2
701 Northern Territory 5 Rural 2
801 Australian Capital Territory 1 Metro 1

6. The catchments for Hunter Urban and Hunter Rural were combined by the Australian Government Department of Health and Ageing on 1st July 2012 to form a single Medicare Local named Hunter. For further information see www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/MediLocBound_ReviewExternal link, opens in a new window..