Healthy Communities: Potentially preventable hospitalisations in 2013–14 - Report - Summary

Healthy Communities: Potentially preventable hospitalisations in 2013–14

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Summary

Key findings

Nationally, in 2013–14 there were 600,267 hospitalisations for the 22 conditions that are considered potentially preventable. This represented 6% of the 9.7 million hospital admissions in that year. Hospitalisations from both public and private hospitals are included.

Potentially preventable hospitalisations also accounted for nearly 2.4 million bed days, equivalent to 8% of all hospital bed days.

Variation across Australia

The report shows that in 2013–14, the age-standardised rate of potentially preventable hospitalisations was almost three times higher in some PHN areas compared to others, ranging from 1,702 hospitalisations per 100,000 people in Northern Sydney PHN to 4,891 per 100,000 in Northern Territory PHN (Table 1 and Chronic conditions, Acute and vaccine-preventable conditions, Chronic obstructive pulmonary disease, Diabetes complications, Heart failure, Cellulitis and Kidney and urinary tract infections sections).

Across more than 300 local areas (SA3s), age-standardised rates of potentially preventable hospitalisations were nine times higher in some areas compared to others, ranging from 1,406 per 100,000 people in Pennant Hills-Epping (NSW) to 12,705 hospitalisations per 100,000 in Barkly (NT).

The report finds that people who are older have more potentially preventable hospitalisations. It also shows that people in regional and remote areas and those of lower socioeconomic status often have higher rates of potentially preventable hospitalisations (Figure 3 and Appendix 1). This may be due to poorer health among people living in these areas and, potentially, poorer access to health care services provided in the community.

However, the report shows large variations in age-standardised rates of potentially preventable hospitalisations even when comparing among areas that are similar in terms of remoteness and socioeconomic status, and accounting for differences in the age profile of residents.

For example, across similar local areas in major cities with lower socioeconomic status, age-standardised rates were two times higher in some areas compared to others, ranging from 1,800 per 100,000 people in Hurstville (NSW) to 4,062 per 100,000 in Mount Druitt (NSW).

Considerable variation was also seen among similar areas of higher and medium socioeconomic status in major cities, and in similar inner and outer regional and remote areas (Figure 3 and Chronic conditions section). This variation may be due to differences in primary health and hospital care provided in some areas compared to others.

Variation in potentially preventable hospitalisations may be due to differences in hospital admission policies and practices. For example, nationally 33% (194,914) of people admitted for a potentially preventable hospitalisation were discharged on the same day. However, the proportion of same-day admissions was almost two times higher in some PHN areas compared to others, ranging from 23% in Hunter New England & Central Coast PHN (NSW) to 41% in Perth North PHN (Table 1).

Variation by condition

For the first time, information is presented at the local level on five of the 22 conditions for which hospitalisation is considered potentially preventable. In 2013–14, these five conditions contributed to almost half (47%) of all potentially preventable hospitalisations and almost two-thirds (62%) of bed days for these admissions nationally. These conditions are:

  • Chronic obstructive pulmonary disease (COPD)
  • Diabetes complications
  • Heart failure
  • Cellulitis
  • Kidney and urinary tract infections (UTIs).

The contribution of each of these conditions to total potentially preventable hospitalisations and bed days varies across PHN areas (Table 2).

The report also shows that there is substantial variation across PHN areas in age–standardised rates of potentially preventable hospitalisations for each of the five conditions (Figure 1)

This information is included because it may provide opportunities for PHNs to target efforts where the greatest improvements could be realised, in both reducing the number of potentially preventable hospitalisations and the number of days patients spend in hospital.

Remoteness and lower socioeconomic status are also factors that may influence rates of potentially preventable hospitalisations for each of the five conditions. For further detail see Figure 5, Figure 6, Figure 7, Figure 8 and Figure 9.

A detailed picture of the rates, numbers and breakdowns of potentially preventable hospitalisations is provided for each of the 31 PHN areas in the Primary Health Network profiles section.

Figure 1: Variation in age-standardised potentially preventable hospitalisations across Primary Health Network areas, by condition, 2013–14

Variation in age-standardised potentially preventable hospitalisations across Primary Health Network areas

The following link expands the table data. Show tabular data Hide tabular data
Condition Lowest rates National rate Highest rates
COPD Northern Sydney PHN
112 per 100,000
239 per 100,000 Northern Territory PHN
600 per 100,000
Diabetes complications Northern Sydney PHN
83 per 100,000
166 per 100,000 Western Queensland PHN
365 per 100,000
Heart failure Northern Sydney PHN
118 per 100,000
195 per 100,000 Western Queensland PHN
360 per 100,000
Cellulitis Perth North PHN
149 per 100,000
237 per 100,000 Western Queensland PHN
696 per 100,000
Kidney and UTIs Tasmania PHN
191 per 100,000
279 per 100,000 Murrumbidgee PHN
462 per 100,000

Sources: National Health Performance Authority analysis of Admitted Patient Care National Minimum Data Set 2013–14, data supplied March 2015; and Australian Bureau of Statistics Estimated Resident Population 30 June 2013.

Box 1: How can the information in this report be used?

Local-level variation in potentially preventable hospitalisations and bed days could be the result of a broad range of factors that may include:

  • Different needs for health services among local populations such as a higher prevalence of chronic conditions in lower socioeconomic areas and more remote areas
  • Issues with access to timely and appropriate primary health care and other non-hospital care, such as supply of health providers and cost barriers to care
  • Differences in the effectiveness of primary health care to prevent people from getting sick or managing their health conditions to keep them out of hospital
  • Differences in hospital admission policies and practices and variation across hospitals in the length of time people stay for a condition
  • Differences in the availability of hospital beds.

Understanding the relative impact of such factors requires local investigation. With experience and local knowledge, health care professionals can identify factors relevant to their region.

To support this work, information is provided in this report and on the MyHealthyCommunities website by Primary Health Network area and other smaller geographic areas. Supplementary data are also available for download.

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