Healthy Communities: Avoidable deaths and life expectancies in 2009–2011 - Report - Introduction

Healthy Communities: Avoidable deaths and life expectancies in 2009–2011

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Introduction

About this report

The National Health Performance Authority (the Authority) bases its performance reports on the indicators agreed by the Council of Australian Governments (COAG). This report focuses on two indicators, potentially avoidable deaths and life expectancy at birth.

The report provides information on measures broken down by Medicare Local catchments. The national network of Medicare Local organisations was established between 2011 and 2012 to improve the responsiveness, coordination and integration of local health services. For the first time the report shows variation across local areas not seen when reporting at national or state and territory level.

In order to assist local areas to target improvements in prevention and health care and improve health for all Australians, the report also includes profiles for each Medicare Local catchment using 18 measures of health, prevention, use of health services and experiences.

Four of these 18 measures have not previously been reported at the local level, including additional COAG indicators on specialist attendances and use of allied health professionals and nurses.

Importantly, the information in this report is from the period January 2009 to December 2011 (potentially avoidable deaths and life expectancy at birth) and June 2011 to July 2012 (all other measures). These periods partially or entirely pre-date the establishment of Medicare Locals. Accordingly, the findings do not reflect on the performance of Medicare Locals as organisations.

Instead, the information in this report aims to help clinicians, health managers, administrators and the public to see how rates of potentially avoidable deaths and estimates of life expectancy differ across the country.

Measuring the effectiveness of health systems

The rate of potentially avoidable deaths in a local area is intended to measure the effectiveness of prevention activities and health care services, delivered by local health systems, across primary health care, hospitals and other health-related settings. By comparison, life expectancy information is reported as a broad health outcome measure to provide context for local areas.

Potentially avoidable deaths are those that occur prematurely (before the age of 75) that potentially could have been avoided through better prevention or health care.

Potentially avoidable deaths include two subcategories: deaths caused by conditions or actions that might have been prevented and secondly, deaths caused by conditions that might been avoided given better treatment. For the purposes of this report, this first sub-category is referred to as ‘potentially preventable deaths’ and the second category is referred to as ‘potentially treatable deaths’.

Potentially avoidable deaths include both preventable and treatable deaths.

  • Potentially preventable deaths are those that are responsive to preventive health activities such as screening, good nutrition and healthy habits such as exercise
  • Potentially treatable deaths are those that are responsive to medical services and therapeutic interventions such as surgery or medication.

These two categories are not mutually exclusive.

Figure 2: Amenable mortality* in 31 OECD countries, 2007 or last year available3

Image displaying amenable mortality in OECD countries in 2007 or the latest year available.

Graphic showing amenable mortality in OECD countries in 2007 or the latest year available.

Amenable mortality in 31 OECD countries in 2007 or the last year available is show in the table below. The international definition of amenable mortality is most similar to ‘potentially treatable deaths’ in this report. Show tabular data Hide tabular data
Country Amenable mortality age-standardised per 100,000
France 59
Iceland 61
Italy 65
Japan 66
Sweden 68
Netherlands 68
Australia§ 68
Austria 69
Norway 70
Spain 70
Canada§ 74
Luxembourg 75
Finland 79
Greece 79
Israel 81
Germany 81
Ireland 82
New Zealand 85
United Kingdom 86
Korea 86
Denmark 87
Slovenia 91
OECD 95
Chile 102
USA 103
Portugal# 108
Czech Republic 125
Mexico 137
Poland 138
Slovak Republic 188
Hungary 197
Estonia 199
*
The international definition of amenable mortality is most similar to ‘potentially treatable deaths’ in this report. More information can be found in this report’s Technical Supplement.
2006 data for France, Germany, Denmark, Korea, Italy, Mexico, Norway, Poland and Sweden.
2005 data for Spain, Hungary, Luxembourg, New Zealand, Slovak Republic and USA.
§
2004 data for Australia and Canada.
#
2003 data for Portugal.
Source:
WHO Mortality Database 2010, OECD calculations.

Some deaths could be avoided through both prevention and treatment (Figure 1). More information on the causes of potentially preventable and treatable deaths is provided in Table 1.

Australia rates highly in the prevention of potentially treatable deaths compared to similar countries2 (Figure 2) and has demonstrated high rates of improvement among comparable countries.3

The other focus of this report, life expectancy at birth, is considered a reliable measure of the health of a population. It is an estimate of the average number of years a newborn baby is expected to live. This measure assumes that the average death rate at the time of the reporting period for the Medicare Local catchment in which a person usually resides, continues throughout the person’s lifetime.

Figure 3: Life expectancy at birth for males and females, in Australia, 2002–2012

Image displaying life expectancy at birth for males and females in Australia between 2002 to 2012.

Year Life expectancy
Females Males
2002 82.6 77.4
2003 82.8 77.8
2004 83 78.1
2005 83.3 78.5
2006 83.5 78.7
2007 83.7 79
2008 83.7 79.2
2009 83.9 79.3
2010 84 79.5
2011 84.2 79.7
2012 84.3 79.9
Source:
Australian Bureau of Statistics. Deaths, Australia, 2012; ABS cat.no. 3302.0.

Australia has one of the highest life expectancies at birth in the world and is ranked seventh after Switzerland, Japan, Italy, Spain, Iceland and France.1

Over the last decade, from 2002 to 2012, the life expectancy of females in Australia has increased by 1.7 years, from 82.6 to 84.3 years, and by 2.5 years for males, from 77.4 to 79.9 years (Figure 3).

About the data

Information on potentially avoidable deaths and life expectancy at birth is from the Australian Bureau of Statistics. For both of these indicators deaths are attributed to the Medicare Local catchment in which a person usually resided, irrespective of where the person died.

Information for the health profiles for each Medicare Local catchment was calculated using:

  • Australian Bureau of Statistics Life Tables 2009–2011
  • Australian Bureau of Statistics Causes of Death 2009–2011
  • Australian Bureau of Statistics Patient Experience Survey 2011–12
  • Australian Bureau of Statistics Australian Health Survey 2011–2013
  • Medicare Benefits Schedule data 2011–12
  • Australian Childhood Immunisation Register 2011–12
  • Admitted Patient Care National Minimum Data Set for 2011–12.

Fair comparisons

To enable fairer comparisons, the Authority has allocated each Medicare Local catchment to one of seven peer groups, based on socioeconomic status, remoteness and distance to hospitals: three in metropolitan areas, two in regional areas, and two in rural areas.

Rates for potentially avoidable deaths have also been age-standardised to enable fair comparison of rates between populations with different age structures by removing the influence of age.

For further information see this report’s Technical Supplement.

More detailed information on differences in rates of potentially avoidable deaths across local areas, particularly those which are potentially preventable, between males and females is found on Potentially avoidable deaths: differences between males and females section on Key findings page and Table 3 on Key findings page.

More detailed information on differences in life expectancy at birth across local areas, particularly between males and females, is found on Life expectancy at birth section on Key findings page and Table 4 on Key findings page.

Local health profiles for all 61 Medicare Local catchments are found on Medicare Local health profiles page.

Table 1: Average number of potentially treatable and preventable deaths per year by cause and sex in Australia, 2009–11

Deaths by cause Males Females Persons
No. % No. % No. %
TREATABLE DEATHS
Ischaemic heart disease (I20–I25)* 2,086 30.0 630 10.7 2,715 21.1
Colorectal cancer (C18–C21) 1,193 17.1 778 13.2 1,971 15.3
Breast cancer (C50) NA NA 1,749 29.6 1,749 13.6
Cerebrovascular diseases (I60–I69)* 522 7.5 391 6.6 913 7.1
Melanoma of skin 573 8.2 264 4.5 837 6.5
Selected invasive bacterial and protozoal infections (A38–A41, A46, A48.1,B50–B54, G00, G03, J02.0, J13–J15, J18, L03) 396 5.7 291 4.9 687 5.3
Diabetes (E10–E14)* 389 5.6 233 3.9 622 4.8
Birth defects (H31.1, P00, P04, Q00–Q99) 319 4.6 266 4.5 585 4.5
Nephritis and nephrosis (I12, I13, N00-N07, N17–N19) 269 3.9 215 3.6 485 3.8
Bladder cancer (C67) 245 3.5 79 1.3 324 2.5
Complications of perinatal period (P03, P05–P95) 185 2.7 123 2.1 308 2.4
Epilepsy (G40, G41) 131 1.9 83 1.4 214 1.7
Uterus cancer (C54–C55) NA NA 193 3.3 193 1.5
Diseases of appendix, hernia, gallbladder, biliary tract and pancreas(K35–K38, K40–K46, K80–K83, K85, K86) 111 1.6 77 1.3 188 1.5
Lymphoid leukaemia – acute/chronic (C91.0, C91.1) 118 1.7 59 1.0 178 1.4
Cervix cancer (C53) NA NA 166 2.8 166 1.3
Non-melanocytic skin cancer (C44) 120 1.7 32 0.5 152 1.2
Hypertensive heart disease (I11) 75 1.1 40 0.7 115 0.9
Rheumatic and other valvular heart disease (I01–I09) 41 0.6 71 1.2 112 0.9
Peptic ulcer disease (K25–K28) 50 0.7 27 0.5 77 0.6
Other treatable 135 1.9 133 2.3 268 2.1
Total potentially treatable deaths 6,958 100 5,900 100 12,858 100
PRVENTABLE DEATHS
Lung cancer (C33–C34) 2,673 19.0 1,729 27.1 4,403 21.5
Ischaemic heart disease (I20–I25)* 2,086 14.8 630 9.9 2,715 13.3
Suicide and self-inflicted injuries (X60–X84, Y87.0) 1,937 13.8 630 9.9 2,567 12.6
Chronic Obstructive Pulmonary Disease (J40–J44) 907 6.5 685 10.7 1,593 7.8
Road traffic injuries (V01–V04, V06, V09–V80, V87, V89, V99) 944 6.7 327 5.1 1,270 6.2
Alcohol-related diseases (F10, I42.6, K29.2, K70) 696 5.0 248 3.9 944 4.6
Accidental poisonings (X40–X49) 665 4.7 274 4.3 939 4.6
Cerebrovascular diseases (I60–I69)* 522 3.7 391 6.1 913 4.5
Liver cancer (C22) 593 4.2 206 3.2 798 3.9
Oesophagus cancer (C15) 548 3.9 136 2.1 684 3.3
Diabetes (E10–E14)* 389 2.8 233 3.6 622 3.0
Stomach cancer (C16) 385 2.7 173 2.7 558 2.7
Lip, oral cavity and pharynx cancer (C00–C14) 367 2.6 100 1.6 467 2.3
Aortic aneurysm (I71) 242 1.7 95 1.5 336 1.6
Falls (W00–W19) 232 1.7 84 1.3 316 1.5
Chronic liver disease (excl. alcohol-related disease; K73, K74) 169 1.2 70 1.1 238 1.2
Violence (X85–Y09, Y87.1) 151 1.1 73 1.1 224 1.1
Drownings (W65–W74) 137 1.0 37 0.6 174 0.9
Pulmonary embolism (I26) 71 0.5 67 1.0 138 0.7
Phlebitis and thrombophlebitis of other deep vessels of lower extremities (I80.2) 58 0.4 58 0.9 116 0.6
Other preventable 286 2.0 139 2.2 425 2.1
Total potentially preventable deaths 14,053 100 6,384 100 20,438 100
TOTAL POTENTIALLY AVOIDABLE DEATHS 21,011 NA 12,284 NA 33,295 NA
NA
Not applicable.
*
Deaths from ischaemic heart disease, cerebrovascular diseases and diabetes are distributed equally between preventable and treatable cases of death.
Notes:
Treatable deaths include all deaths which occurred between the ages of 0 and 74 years, except for deaths due to asthma which includes only those deaths which occurred between the ages of 0 and 44 years. Preventable deaths include all deaths which occurred between the ages of 0 and 74 years, except for deaths due to childhood vaccine-preventable diseases which include only those deaths which occurred between the ages of 0 and 14 years, and Chronic Obstructive Pulmonary Disease which includes only those deaths which occurred between the ages of 45 to 74 years. Totals may not equal the sum of rows, due to separate rounding of data values.
Source:
Australian Bureau of Statistics Causes of Death 2009–2011.

For more information see this report’s Technical Supplement.

1. Organisation for Economic Co-operation Development [Internet] OECD Health Data; 2011 [cited 2013 Nov 21]. Available from: http://www.compareyourcountry.org/health

2. Gay, JG et al. Mortality Amendable to Health Care in 31 OECD Countries. 2011

3. Nolte E, McKee CM. Variations in amenable mortality – Trends in 16 high-income nations. Health Policy. 2011;103:47-52

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