A new AIHW report reveals about one in 18 admissions could be avoided.
About one in 18 admissions to Australian hospitals in small geographic areas were for potentially preventable conditions, a new AIHW report has found.
And older Aussies aged 65 years and over had the highest rate of potentially preventable hospitalisations during the study period 2021-22.
Concerningly, the latest update to the institute’s Potentially preventable hospitalisations in Australia by small geographic areas, 2020–21 to 2021–22 also revealed age-standardised rates of vaccine-preventable hospitalisations increased between 2020-21 and 2021-22.
The National Rural Health Alliance described the findings as “troubling”, saying it highlighted that many illnesses among rural, regional and remote Australians could have been prevented or treated better with accessible primary care, thus avoiding the need for hospitalisation.
NRHA chief executive Susi Tegen said Australia’s rural populations, which comprised more than seven million people, often lacked access to such preventive healthcare and early interventions.
“We often see rural communities neglecting or putting off their health issues due to limited access to primary care, exacerbated by the tyranny of distance and cost of services. This leads to a cascade of problems, including overwhelming an already strained hospital and emergency system,” she said.
“This brings us to consider the need to increase strategic and fit-for-purpose investment in rural health care.”
The report explored 22 conditions for which hospitalisation was considered potentially preventable across three broad categories, including:
- acute (conditions that usually come on suddenly, and may not be preventable, but may not result in hospitalisation if timely and adequate care had been received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change, and can also be managed in the community to prevent worsening of symptoms or hospitalisation).
Overall, the most common condition for PPH in 2020–21 and 2021–22 was dental conditions, followed by urinary tract infections including pyelonephritis, iron deficiency anaemia, congestive heart failure and cellulitis.
“Primary and community health care – including care from a general practitioner or community health nurse – can effectively manage and treat these health conditions (for example, by administering vaccines or prescribing lifestyle changes),” wrote the report authors.
“Primary and community health care can be an opportunity for early intervention, that can help to reduce the risk of a person developing a disease, their symptoms worsening, or complications developing, to the point that they need a hospitalisation.”
The report was based on where people lived, not the location of the hospital that they were admitted to, and included two geographic areas: Statistical Area Level 3 (SA3) and Primary Health Network (PHN).
In 2021–22, there were 11.6 million hospitalisations in Australia (AIHW 2023). Of these, around one in 18 hospitalisations (5.7% or 660,000) was classified as a potentially preventable hospitalisation (PPH), a rate of 2600 hospitalisations per 100,000 people.
Of the 11.8 million hospitalisations in 2020–21 (AIHW 2023), the number and rate of PPH was steady (5.7%, or 670,000), a rate of 2600 hospitalisations per 100,000 people). The average length of stay for a PPH admission was 3.7 days in 2020–21 and 3.9 days in 2021–22.
The authors said measuring PPH provided valuable information about the effectiveness of health care in the community, as higher rates may suggest a lack of timely, accessible and adequate primary care.
However, there are many other reasons why an area or group of people may have higher rates of PPH. These may include:
- higher rates of disease
- lifestyle factors and other risks
- a genuine need for hospital services.
“Some PPH may not be avoidable, such as those for patients with complex illness, or patients having procedures as follow-up to primary care,” they wrote.
“This means that it is important not to assume that higher rates of PPH always indicate a less effective primary care system.
“Rather, PPH are a useful tool for identifying and investigating variation between different groups of people to better understand health inequalities. PPH can help guide research about how different groups use and respond to health services, including barriers they may face and areas of unmet demand.”
Ms Tegen said that given Australia’s annual health spending deficit of $6.55 billion in rural Australia, discovered through independent research last year, the NRHA strongly advocated for greater investment in rural health care for communities, which enable multidisciplinary and place-based solutions according to needs.
“The Alliance proposes the Primary care Rural Integrated Multidisciplinary Health Services (PRIM-HS) model, which is community-led and co-designed to meet the specific health needs of communities to promote the preventative aspect of health,” she said.
“The model aims to improve primary healthcare experiences, provide culturally safe, high-quality care which would become a major contributor to reduce the rates of potentially preventable hospitalisations in rural, regional and remote Australia, with federal and state /territory government partnership.
“Government funding to support this model would mean more rural primary care practices could continue to exist or be established in rural areas to provide essential care that many metropolitan communities take for granted.”