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

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

Introduction

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.

Potentially avoidable deaths comprise two subcategories: preventable deaths, for which the conditions or actions responsible for the deaths might have been prevented (an example being lung cancer), and deaths that might have been avoided by better access to or provision of medical care, even if the medical condition could not itself have been prevented (an example being breast cancer). 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’. These two categories are not mutually exclusive. Some deaths could be avoided by both prevention and treatment.

By comparison, life expectancy at birth is reported as a broad health outcome measure to provide context for local areas.

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 outcomes, prevention, use of health services and experiences.

Measures presented

The report presents national information on the following measures for the first time at a local level, using data for the three calendar years from 2009 to the end of 2011:

  • Rates of potentially avoidable deaths per 100,000 people on average per year for all Australians, and for males and females
  • Rates of potentially preventable and potentially treatable deaths per 100,000 people on average per year
  • Life expectancy at birth in years for all Australians, and for males and females.

The report also presents information for the 61 Medicare Local catchments on a range of other measures using data for the financial period 2011–12. The 18 measures presented in the profiles, and the data sources for these measures are listed below:

  • Potentially avoidable deaths, ABS Causes of Death, 2009–2011
  • Life expectancy at birth, ABS Life Tables, 2009–2011
  • Adults who are overweight or obese, ABS Australian Health Survey, 2011–2013
  • Adults who are obese, ABS Australian Health Survey, 2011–2013
  • Adults who smoke daily, ABS Australian Health Survey, 2011–2013
  • Immunisation rates for 1 year old children, Australian Childhood Immunisation Register, 2011–12
  • Immunisation rates for 5 year old children, Australian Childhood Immunisation Register, 2011–12
  • GP attendances, MBS 2011–12
  • Specialist attendances, MBS 2011–12
  • People who saw an allied health professional or nurse, ABS National Health Survey, 2011–12
  • Adults who visit hospital EDs, ABS Patient Experience Survey 2011–12
  • Adults admitted to hospital, ABS Patient Experience Survey 2011–12
  • Potentially avoidable hospitalisations, Admitted Patient Care National Minimum Data Set 2011–12
  • Waiting times for GP appointments, ABS Patient Experience Survey 2011–12
  • Waiting times for medical specialists, ABS Patient Experience Survey 2011–12
  • Cost barriers to GP care, ABS Patient Experience Survey 2011–12
  • Cost barriers to prescribed medication, ABS Patient Experience Survey 2011–12
  • Cost barriers to seeing a medical specialist, ABS Patient Experience Survey 2011–12.

Four of these measures have not previously been reported nationally at the local level, including indicators in relation to potentially avoidable deaths, life expectancy at birth, specialist attendances and use of allied health professionals and nurses. These measures are further described in this technical supplement. For further information on measures in the report that the Authority has reported previously, refer to the Appendix for the relevant technical supplement.

Geography levels

All of the measures are presented by Medicare Local catchment and seven clusters of Medicare Local catchments called peer groups. This enables fairer comparisons of individual Medicare Local catchments, and also provides a summary of the variation across Australia’s diverse metropolitan, regional and rural populations by presenting aggregate results for each peer group.

The Authority identified seven peer groups of Medicare Local catchments on the basis of:

  • Proximity of each Medicare Local to major metropolitan areas (using the ABS Australian Standard Geographic Classification, 2006 Remoteness Structure)
  • Proximity to major hospitals (A1 public hospitals in the Australian Institute of Health and Welfare Public Hospital Peer Group classification, 2010–11)
  • Socioeconomic status.

More information on Medicare Local peer groups can be found in Healthy Communities: Australians’ experiences with primary health care in 2010–11, Technical Supplement.

The Authority also released with this report updated local-level information for 2012–13 on www.myhealthycommunities.gov.au for specialist attendances, GP attendances, after-hours GP attendances and bulk-billed GP attendances.

All of these updated measures, as well as additional tabular information for some of the measures are available by ABS Statistical Areas Level 3 (SA3) to enhance understanding of variation across local areas, and are available on www.myhealthycommunities.gov.au

There are 351 SA3s, comprising 333 areas that cover the whole of Australia without gaps or overlaps, and 18 special classifications (two per state and territory). These special classifications are not required when population is estimated on the basis of place of usual residence, and therefore the Authority reports on 333 SA3s when reporting at this level of geography.

Interpretation of statistics

Measures are presented in the report for each Medicare Local catchment in a health profile graphic and have been grouped into health outcomes, prevention, use of health services and experiences with health services categories. This allows for Medicare Local results to be compared against the results of their peers across 18 measures and four categories, providing a unique health profile for each Medicare Local catchment.

Image showing the health profile graphic of Medicare Local catchments grouped into health outcomes, prevention, use of health services and experiences with health services categories.

Within each of these categories a different ‘slice’ of the chart gives results for a specific measure. Individual Medicare Local results for each measure are represented by a white dot, placed relative to the average result of other similar Medicare Local catchments, represented by a dark grey circle. The closer each dot is to the centre of the chart (green), the more desirable the result. The further away a dot is from the middle of the chart, the less desirable the result (orange).

The dots in the blue section at the bottom of the chart are results for measures of health service use, which have not been interpreted as more or less desirable but as higher and lower use.

The health profile graphics featured in this report compare a range of measures for Medicare Local catchments against the results of their peers. In order to make these comparisons, the results for each measure were converted to standardised scores and then plotted. The standardised score is derived as follows:

Image showing the standardised score formulaThe standardised score is the Medicare Local result minus its peer group result, divided by its peer group standard deviation.

This standardised score can be interpreted as the distance that the result for each measure for a Medicare Local catchment is from its peers. Results indicating more desirable health outcomes or higher use of services are plotted toward the inside of the graphic. Results indicating less desirable health outcomes or lower use of services are plotted toward the outside of the graphic.

Each health profile also provides summary statistics for the Medicare Local catchment in the grey box at the bottom of the page alongside a legend to help interpret the chart.

Medicare Local catchment profile

There are six statistics reported in the catchment profile. Their data sources are listed below:

  • Total population: ABS Estimated Resident Population (ERP) June 2012 (preliminary)
  • Indigenous population: Aboriginal and Torres Strait Islander Estimated Resident Population 30 June 2011, expressed as a percentage of ABS ERP June 2011 (final).
  • Age proportions: Percentages within the following age groups (0–17, 18–64 and 65+) were calculated using single year of age, ABS ERP June 2012.
    When the sum of age proportions did not equal 100%, individually rounded values were rescaled
  • Total land area: Department of Health (km squared).
    Map projection: GDA 1994 Australian Albers Equal Area. The mapping software used to verify areas was ArcGIS Desktop
  • Population split: Data was calculated using ABS ERP, June 2012. Male data was rounded to one decimal place, and then female computed as 100 – male rounded
  • Socioeconomic status: 2011 Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD), at the SA1 level.
    Counts of SA1 by Medicare Local were summarised according to IRSAD percentile as follows:
    Low:
    Percentile 1 to 33
    Medium:
    Percentile 34 to 67
    High:
    Percentile 68 to 100
    Note that SA1 areas that are split across Medicare Local boundaries were counted in each Medicare Local.

To summarise the diversity in a larger region, the ABS recommends a distributional analysis of SA1 results in the region. The percentage of SA1 areas in each category (Low, Medium, and High) was calculated. Note: this is not weighted by population – each SA1 area is weighted equally

When the sum of Low, Medium and High did not equal 100%, individually rounded values were adjusted to sum to 100%. This was done by choosing the adjustment with the least percentage error.

Age Standardisation

The measures of potentially avoidable deaths (including preventable and treatable deaths), potentially avoidable hospitalisations and the measures using MBS statistics on health service use have been age-standardised to allow comparisons to be made between local areas that take account of differences in the age-structure of local populations.

Suppression of estimates

The Authority applies suppression protocols that are customised to each data source used in the report, to ensure confidentiality when reporting at local levels of geography. The suppression rules for new measures are described in this technical supplement

Additional information on the complete list of the measures included in this report, and released on www.myhealthycommunities.gov.au are provided in the Appendix.