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Preventable hospitalisations reveal access gaps between states, PHNs


Amanda Lyons


15/11/2019 2:40:30 PM

The data supports findings that areas of lower socioeconomic advantage and higher levels of remoteness need better access to quality primary care.

Hospital bed
The report hospitalisations shows significant variation across the country, often delineated by remoteness and socioeconomic advantage.

Potentially preventable hospitalisations (PPHs) are defined as admissions that could have been avoided by better healthcare provision within the community.
 
Such a definition means their rates are often used as a proxy measure of the effectiveness of primary care in a particular area.
 
According to a report released this week, there were nearly 748,000 PPHs across the country in 2017–18, representing about 7% of all hospitalisations. Additionally, PPHs accounted for nearly 10% of the total hospital bed days.
 
National rates of PPHs have been steadily rising over the past five years, from an age-adjusted rate of 2522 per 100,000 people in 2013–14 to 2793 per 100,000 in 2017–18.
 
However, a closer look at the data reveals that PPH rates were not spread evenly throughout the nation, with significant variations across states, territories and Primary Health Networks (PHNs) in line with differences in socioeconomic classification and levels of remoteness.
 
The Australian Capital Territory displays the lowest numbers overall, with a total PPH rate of 2145 per 100,000 people.
 
At the other end of the list is the Northern Territory, with a total PPH rate of 5807 per 100,000 people. This is more than 2000 ahead of the jurisdiction with the next highest rate, Queensland, which had an overall PPH rate of 3409 per 100,000 people.
 
The NT also had exceptionally high rates in every sub-category detailed in the report, including PPHs attributable to vaccine-preventable conditions, which reached a staggering 1032 per 100,000 people. To put this into context, the next highest jurisdiction was Queensland with a rate of 366.
 
The NT was also the only jurisdiction, apart from Western Australia, with higher rates of PPHs for vaccine-preventable conditions other than pneumonia and influenza, at 692 per 100,000 versus 355.
And the difference between NT and the next jurisdiction was once again vast, with WA’s figures for other vaccine-preventable conditions standing at 111 per 100,000 people, compared to 72 for PPH resulting from pneumonia and influenza.
 
Rates of PPH among PHNs also revealed significant differences.

The five PHNs with the highest numbers of total PPHs per 100,000 people were: 

  • NT – 5777
  • Western Queensland – 5383 
  • Murumbidgee (NSW) – 3513 
  • Northern Queensland – 3488 
  • Darling Downs and West Moreton (Qld) – 3457
Almost all of these PHNs cover areas that are considered as being in a low quintile of socioeconomic advantage, and many are classified as remote.
 
By contrast, three out of the five PHNs with the lowest numbers of total PPHs per 100,000 people are classified by a high quintile of socioeconomic advantage, while Gippsland ranks in the middle and Tasmania is mixed, with high proportions of the state classified in the lower quintiles.
 
These PHNs include:
 
  • Northern Sydney (NSW) – 2032
  • Central and Eastern Sydney (NSW) – 2082
  • Gippsland (Vic) – 2193
  • ACT – 2285
  • Tasmania – 2312
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