Aboriginal Health : Second Atlas of Healthcare Variation highlights higher Aboriginal hospitalisation rates for all 18 clinical conditions

 

“The report, compiled by the Australian Commission on Safety and Quality in Health Care, shows us that high hospitalisation rates often point to inadequate primary care in the community, leading to higher rates of potentially preventative hospitalization

The most disturbing example of this  has been the higher hospitalisation rates for all of the 18 clinical conditions surveyed experienced by Aboriginal and Torres Strait Islander Australians, people living in areas of relative socioeconomic disadvantage and those living in remote areas.

 Chairman of Consumers Health Forum, Tony Lawson who is a member of the Atlas Advisory Group.

 “Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Please note

  • Features of the second Atlas include: Analysis of data by Aboriginal and Torres Strait Islander status

DOWNLOAD Key-findings-and-recommendations

Mr Martin Bowles Secretary Dept of Health  launches the Second Australian Atlas of Healthcare Variation

A new report showing dramatic differences in treatment rates around Australia signals a pressing need for reforms to ensure equitable access to appropriate health care for all Australians, the Consumers Health Forum, says.

“A seven-fold difference in hospitalisation for heart failure and a 15-fold difference for a serious chronic respiratory disease depending on place of residence, are among many findings of substantial variations in treatment rates in Australia revealed in the Second Australian Atlas of Healthcare Variation,” the chairman of Consumers Health Forum, Tony Lawson, said.

“While there are a variety of factors contributing to these differences,  the variation in health and treatment outcomes is, as the report states, an ‘alarm bell’ that should make us stop and investigate whether appropriate care is being delivered.

“These findings show that recommended care for chronic diseases is not always provided.  Even with the significant funding provided through Medicare to better coordinate primary care for people with chronic and complex conditions, fragmented health services contribute to suboptimal management, as the report states.

“We support the report’s recommendation for a stronger primary health system that would provide a clinical ‘home base’ for coordination of patient care and in which patients and carers are activated to develop their knowledge and confidence to manage their health with the aid of a healthcare team.

“The Atlas provides further robust reasons for federal, state and territory governments to act on the demonstrated need for a more effective primary health system that will ensure better and more cost effective care for all Australians.

“The Atlas also examined  variations in women’s health care, and its findings included a seven-fold difference in rates of hysterectomy and  21-fold  difference in rates of endometrial ablation.  The report states that rates of hysterectomy and caesarean sections in Australia are higher than reported rates in other developed nations.  These results highlight the need for continuing support and information on women’s health issues,” Mr Lawson said.

The Second Australian Atlas of Healthcare Variation (second Atlas) paints a picture of marked variation in the use of 18 clinical areas (hospitalisations, surgical procedures and complications) across Australia.

This Atlas, the second to be released by the Commission, illuminates variation by mapping use of health care according to where people live.  As well, this Atlas identifies specific achievable actions for exploration and quality improvement.

The second Atlas includes interventions not covered in the first Atlas, such as hospitalisations for chronic diseases and caesarean section in younger women. It also builds on the findings from the first Atlas – for example, examining hysterectomy and endometrial ablation separately, and examining rates of cataract surgery using a different dataset.

Priority areas for investigation and action arising from the second Atlas include use of:

  • Hysterectomy and endometrial ablation
  • Chronic conditions (COPD, diabetes complications)
  • Knee replacement.

Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Healthcare Variation – what does it tell us

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the Atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

View the second Atlas

The second Atlas, released in June 2017, examined four clinical themes: chronic disease and infection – potentially preventable hospitalisations, cardiovascular, women’s health and maternity, and surgical interventions.

Key findings and recommendations for action are available here.

View the maps and download the data using the interactive platform.

What does the Atlas measure?

The second Atlas shows rates of use of healthcare interventions (hospitalisations, surgical procedures and complications,) in geographical areas across Australia.  The rate is then age and sex standardised to allow comparisons between populations with different age and sex structures. All rates are based on the patient’s place of residence, not the location of the hospital or health service.

The second Atlas uses data from national databases to explore variation across different healthcare settings. These included the National Hospital Morbidity Database and the AIHW National Perinatal Data Collection.

Who has developed the second Atlas?

The Commission worked with the Australian Institute of Health and Welfare (AIHW) on the second Atlas.

The Commission consulted widely with the Australian government, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the second Atlas.

Features of the second Atlas include:

  • Greater involvement of clinicians during all stages of development
  • Analysis of data by Aboriginal and Torres Strait Islander status
  • Analysis of data by patient funding status (public or private).

Table of Contents

Chapter 1 Chronic disease and infection: potentially preventable hospitalisations

1.1 Chronic obstructive pulmonary disease (COPD)
1.2 Heart failure
1.3 Cellulitis
1.4 Kidney and urinary tract infections
1.5 Diabetes complications

Chapter 2 Cardiovascular conditions

2.1 Acute myocardial infarction admissions
2.2 Atrial fibrillation

Chapter 3 Women’s health and maternity

3.1 Hysterectomy
3.2 Endometrial ablation
3.3 Cervical loop excision or cervical laser ablation
3.4 Caesarean section, ages 20 to 34 years
3.5 Third- and fourth-degree perineal tear

Chapter 4 Surgical interventions

4.1 Knee replacement
4.2 Lumbar spinal decompression
4.3 Lumbar spinal fusion
4.4 Laparoscopic cholecystectomy
4.5 Appendicectomy
4.6 Cataract surgery
Technical Supplement
About the Atlas
Glossary

Australian Atlas of Healthcare Variation data set specifications are available at http://meteor.aihw.gov.au/content/index.phtml/itemId/674758

 

NACCHO #ABS Aboriginal Health Report : Indigenous Australians consuming too much added sugar

 sugary-drink
 

In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice.

ABS Report abs-indigenous-consumption-of-added-sugars

Aboriginal and Torres Strait Islander people consume around 14 per cent of their total energy intake as free sugars, according to data from the Australian Bureau of Statistics (ABS).

The World Health Organization (WHO) recommends that free sugars contribute less than 10 per cent of total energy intake.

Director of Health, Louise Gates, said the new ABS report showed Aboriginal and Torres Strait Islander people are consuming an average of 18 teaspoons (or 75 grams) of free sugars per day (almost two cans of soft drink), four teaspoons more than non-Indigenous people (14 teaspoons or 60 grams).

OTHER KEY FINDINGS

    • Aboriginal and Torres Strait Islander people derived an average of 14% of their daily energy from free sugars, exceeding the WHO recommendation that children and adults should limit their intake of free sugars to less than 10% of dietary energy.
    • Free sugars made the greatest contribution to energy intakes among older children and young adults. For example, teenage boys aged 14-18 years derived 18 per cent of their dietary energy from free sugars as they consumed the equivalent of 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink. Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.
    • The majority (87%) of free sugars were consumed from energy dense, nutrient-poor ‘discretionary’ foods and beverages. Two thirds (67%) of all free sugars consumed by Aboriginal and Torres Strait Islander people came from beverages, led by soft drinks, sports and energy drinks (28%), followed by fruit and vegetable juices and drinks (12%), cordials (9.5%), and sugars added to beverages such as tea and coffee (9.4%), alcoholic beverages (4.9%) and milk beverages (3.4%).
    • Intakes were higher for Aboriginal and Torres Strait Islander people living in non-remote areas where the average consumption was 78 grams (18.5 teaspoons), around 3 teaspoons (12 grams) higher than people living in remote areas (65 grams or 15.5 teaspoons).
    • Aboriginal and Torres Strait Islander people consumed 15 grams (almost 4 teaspoons) more free sugars on average than non-Indigenous people. Beverages were the most common source of free sugars for both populations, however Aboriginal and Torres Strait Islander people derived a higher proportion of free sugars from beverages than non-Indigenous people (67% compared with 51%).

ENDNOTES

1 A level teaspoon of white sugar contains 4.2 grams of sugar.

sugary-drink-infographic

“Free sugars include the sugars added by consumers in preparing foods and beverages plus the added sugars in manufactured foods, as well as honey and the sugar naturally present in fruit juice,” said Ms Gates.

“The data shows that Aboriginal and Torres Strait Islander people living in urban areas derived more energy from free sugars than those living in remote areas (14 per cent compared with 13 per cent).”

Free sugars contributed 18 per cent to dietary energy intake for teenage boys aged 14-18 years, who consumed 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink.

Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.

“Beverages were the source of two thirds of free sugars, with soft drinks, sports and energy drinks providing 28 per cent, followed by fruit and vegetable juices with 12 per cent, cordials (9.5 per cent), sugars added to beverages such as tea and coffee (9.4 per cent), alcoholic beverages (4.9 per cent) and milk drinks (3.4 per cent),” said Ms Gates.

More details are available in Australian Aboriginal and Torres Strait Islander Health Survey: Consumption of Added Sugars (cat. no. 4727.0.55.009), available for free download from the ABS website, http://www.abs.gov.au.

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This year’s theme: Strengthening Our Future through Self Determination

As you are aware, the  2016 NACCHO Members’ Meeting and Annual General Meeting will be in Melbourne this year 6-8 December

1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today

 

NACCHO Aboriginal Health Alert : #AIHW and Minister Sussan Ley launch #AustraliasHealth2016 report

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 ” A new snapshot of Australia’s health has found we are living longer than ever before, but the rise of chronic disease still presents challenges in achieving equal health outcomes for Indigenous Australians and people living outside metropolitan areas.

Minister for Health Sussan Ley pictured above with Dr Mukesh Haikerwal

Download the Report Here

australias-health-2016

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-Indigenous.

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.”

AIHW Director and CEO Barry Sandison

                     AIHW website Australia’s Health 2016

aus-2016

The Minister today launched the Australian Institute of Health and Welfare’s (AIHW) publication Australia’s health 2016, which provides an update on the health of Australians and the performance of Australia’s health system.

“Australia’s health 2016 shows us that about 85 per cent of Australians rate their health as good, very good or excellent, which is a testament to the significant investment of the Turnbull Government into the health of our nation, with about one-quarter of total government revenue attributed to health spending,” Minister Ley said.

“Our Government’s priority is to ensure the high performance and sustainability of our health system over the long term. This is why the Turnbull Government is working closely with stakeholders to progress a range of health system reforms.”

Total Commonwealth investment in health will grow to more than $71 billion in 2015-16 and this will increase to $79 billion within four years. The Turnbull Government’s investment in Medicare is at $23 billion per year and this will increase by $4 billion over the next four years.

“The report indicates that health outcomes for Australians have improved over time with life expectancy at an all-time high of 80.3 years for males, while a baby girl could expect to live for 84.4 years. Survival rates for cancer are also improving,” Minister Ley said

Minister Ley said that despite plenty of good news on health in the report, managing chronic conditions and their impact on Australia’s health system remained one of our greatest health challenges.

“The report shows that half of Australians have a chronic disease – such as cardiovascular disease, arthritis, diabetes or a mental health disorder – and one-in four have two or more of these conditions,” Minister Ley said.

“This is why our initial investment of almost $120 million in the Health Care Homes initiative is so important. It will help to keep those with chronic conditions healthier and out of hospital. It will give GPs the flexibility and tools they need to design individual care plans for patients with chronic conditions and coordinate care services to support them.

“We recently announced the 10 geographic regions that will deliver Stage One of this important initiative from 1 July next year, and we hope the results will lead more broadly to a better, consumer-focused approach to health care.”

Australia’s health 2016 is available on the Australian Institute of Health and Welfare’s website.

85 out of 100 Australians say they’re healthy—but are we really? AIHW Press Release

Most Australians consider themselves to be in good health, according to the latest two-yearly report card from the Australian Institute of Health and Welfare (AIHW).

The report, Australia’s health 2016 is a key information resource, and was launched today byfederal Health Minister, the Hon. Sussan Ley.

AIHW Director and CEO Barry Sandison said the report provided new insights and new ways of understanding the health of Australians.

‘The report shows that Australia has much to be proud of in terms of health,’ he said.

‘We are living longer than ever before, death rates continue to fall, and most of us consider ourselves to be in good health.’

If Australia had a population of just 100 people, 56 would rate their health as ‘excellent’, or ‘very good’ and 29 as ‘good’.

‘However, 19 of us would have a disability, 20 a mental health disorder in the last 12 months, and 50 at least one chronic disease.’

Mr Sandison said the influence of lifestyle factors on a person’s health was a recurring theme of the report. ‘13 out of 100 of us smoke daily, 18 drink alcohol at risky levels, and 95 do not eat the recommended servings of fruit and vegetables.

‘And while 55 do enough physical activity, 63 of us are overweight or obese.’

Mr Sandison said that while lifestyle choices were a major contributor to the development of many chronic diseases, other factors such as our income, education and whether we had a job—known as ‘social determinants’—all affected our health, for better or worse.

‘As a general rule, every step up the socioeconomic ladder is accompanied by an increase in health.

‘Compared with people living in the highest socioeconomic areas, people living in the lowest socioeconomic areas generally live about 3 years less, are 1.6 times as likely to have more than one chronic health condition, and are 3 times as likely to smoke daily.’

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’ Mr Sandison said.

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.

For people living in rural and remote areas, where accessing services can be more difficult, lower life expectancy and higher rates of disease and injury—particularly road accidents— are of concern.

In Australia, health services are delivered by a mix of public and private providers that includes more than 1,300 hospitals and about 385,000 nurses, midwives and medical practitioners.

Of the $155 billion spent on health in 2013–14, $145 billion was recurrent expenditure. Hospitals accounted for 40% of recurrent expenditure ($59 billion), primary health care 38% ($55 billion), with the remaining 22% spent on other health goods and services.

For the first time, the report examines how spending by age for people admitted to hospital has changed over time.

Mr Sandison said the analysis showed that the largest increase in spending between 2004–05 and 2012–13 was for Australians aged 50 and over.

‘This was due to more being spent per person in the population as well as the increased number of people in these age groups.’

Mr Sandison also said that while Australia’s health 2016 provides an excellent overview of Australia’s health at a point in time, there is still scope to expand on the analysis.

New to this edition is information on the changing nature of services provided by publicand private hospitals over the last 10 years; information about how geography affects

Indigenous women’s access to maternal health services; and about the increasing role ofinstitutions such as hospitals and residential aged care in end-of-life care.

‘Good data is essential to inform debate and policy and service delivery decision-making— and improving its quality and availability is at the core of the AIHW’s work.

‘We’re committed to providing meaningful, comprehensive information about Australia’s health and wellbeing—to help create a healthier Australia.’

  • Preliminary material
    • Title and verso pages
    • Contents
    • Preface
    • Acknowledgments
    • Terminology
  • Body section
    • Chapter 1 An overview of Australia’s health
      • Introduction
      • What is health?
      • Australians: who we are
      • How healthy are Australians?
    • Chapter 2 Australia’s health system
      • Introduction
      • How does Australia’s health system work?
      • How much does Australia spend on health care?
      • Who is in the health workforce?
    • Chapter 3 Leading causes of ill health
      • Introduction
      • Burden of disease and injury in Australia
      • Premature mortality
      • Chronic disease and comorbidities
      • Cancer
      • Coronary heart disease
      • Stroke
      • Diabetes
      • Kidney disease
      • Arthritis and other musculoskeletal conditions
      • Chronic respiratory conditions
      • Mental health
      • Dementia
      • Injury
      • Oral health
      • Vision and hearing disorders
      • Incontinence
      • Vaccine preventable disease
    • Chapter 4 Determinants of health
      • Introduction
      • Social determinants of health
      • Social determinants of Indigenous health
      • Biomedical risk factors
      • Overweight and obesity
      • Illicit drug use
      • Alcohol risk and harm
      • Tobacco smoking
      • Health behaviours and biomedical risks of Indigenous Australians
    • Chapter 5 Health of population groups
      • Introduction
      • Health across socioeconomic groups
      • Trends and patterns in maternal and perinatal
      • health
      • How healthy are Australia’s children?
      • Health of young Australians
      • Mental health of Australia’s young people and adolescents
      • Health of the very old
      • How healthy are Indigenous Australians?
      • Main contributors to the Indigenous life expectancy gap
      • Health of Australians with disability
      • Health of prisoners in Australia
      • Rural and remote health
    • Chapter 6 Preventing and treating ill health
      • Introduction
      • Prevention and health promotion
      • Cancer screening
      • Primary health care
      • Medicines in the health system
      • Using data to improve the quality of Indigenous health care
      • Indigenous Australians’ access to health services
      • Spatial variation in Indigenous women’s access to maternal health services
      • Overview of hospitals
      • Changes in the provision of hospital care
      • Elective surgery
      • Emergency department care
      • Radiotherapy
      • Organ and tissue donation
      • Safety and quality in Australian hospitals
      • Specialised alcohol and other drug treatment services
      • Mental health services
      • Health care use by older Australians
      • End-of-life care
    • Chapter 7 Indicators of Australia’s health
      • Introduction
      • Indicators of Australia’s health
  • End matter
    • Methods and conventions
    • Symbols
    • Acronyms and abbreviations
    • Glossary
    • Index

 

 

NACCHO Aboriginal Health Data : Aboriginal and Torres Strait Islander Social Health Atlas released

atlas

The Public Health Information Development Unit (PHIDU) has published an Aboriginal and Torres Strait Islander Social Health Atlas.

This presents a range of demographic, socioeconomic, health outcomes and service use data for Aboriginal and Torres Strait Islander peoples at the Indigenous Area level.

The  2016 release of the atlas includes updated data for the following:

  • Estimate Resident Population (ERP) data for 2015
  • Projected ERP data for 2016
  • Immunisation data for 2015
  • Deaths data now includes data for 2013

And new hospitalisations data for:

  • Hospitalisations by principal diagnosis and age
  • Ambulatory-sensitive hospitalisations

Maps for the Aboriginal and Torres Strait Islander  Atlas can be found at the link below:

http://phidu.torrens.edu.au/current/maps/atsi-sha/atlas.html

For those who prefer the data in a spreadsheet format, the data can be found below:

http://phidu.torrens.edu.au/current/data/atsi-sha/phidu_atsi_data_ia_aust.xls

If you have any questions regarding the Social Health Atlas, our contact details can be found at the link below:

http://phidu.torrens.edu.au/contact-us

 

 

NACCHO Census2016 : Census mission to collect data on Indigenous populations in urban areas

Page 12 AD

 

” There could me a myriad of reasons why there is population growth – it could be naturally occurring or it could be people coming in from country areas, rural and remote, and/or other places within Australia.

We offer stuff to do with smoke cessation, alcohol and other drug use emotional and social well being, and general health checks.

It is an Aboriginal community controlled health organisation so it is being given direction by a group of Aboriginal and Torres Strait Islander people who are from the region.

The DANILA DILBA organisation’s chair, Braiden Abala, isn’t sure what’s behind the population shift. 

The clinic was commissioned by Danila Dilba, after Census data in 2011 revealed Aboriginal people had moved from Darwin’s city centre to the northern suburbs.

Above ad Page 12 NACCHO Aboriginal Health Newspaper

Full ABC TV Interview

MARK COLVIN: The Australian Bureau of Statistics is about to embark on a huge Census data collection mission in Indigenous communities across Northern Australia.

A key aim of the research is to capture more accurate statistics on the number of Aboriginal and Torres Strait Islander people living in urban areas.

Sally Brooks compiled this report.

MALE SPEAKER: I’d just like to introduce James Parfit to do a welcome to country for Larrakia.

JAMES PARFIT: I’d first like to say welcome everyone and thank you all for coming and a big congratulations of the opening of this great new facility that will make our people healthy and strong again.

SALLY BROOKS: A new Aboriginal health clinic opened in a suburb outside Darwin today.

DANILA DILBA: We offer stuff to do with smoke cessation, alcohol and other drug use emotional and social well being, and general health checks. It is an Aboriginal community controlled health organisation so it is being given direction by a group of Aboriginal and Torres Strait Islander people who are from the region.

SALLY BROOKS: The clinic was commissioned by Danila Dilba, after Census data in 2011 revealed Aboriginal people had moved from Darwin’s city centre to the northern suburbs.

The organisation’s chair, Braiden Abala, isn’t sure what’s behind the population shift.

BRAIDEN ABALA: There could me a myriad of reasons why there is population growth – it could be naturally occurring or it could be people coming in from country areas, rural and remote, and/or other places within Australia.

SALLY BROOKS: The trend is something Northern Australia Census director Tony Grubb thinks is being replicated in other jurisdictions.

TONY GRUBB: I think we are seeing that in a lot of our capital cities and even in our regional areas and we need to remember that 60 per cent of our Aboriginal and Torres Strait Islander peoples are actually in urban environments.

SALLY BROOKS: Tony Grubb is about to oversee a huge five to six week mission to collect data from Indigenous communities across Northern Australia.

TONY GRUBB: From Darwin we actually manage all the remote teams for the NT, the Kimberlys, Cape York, Torres Strait, and in that we actually use about 65 teams of about 200 staff and whilst we are actually out in communities we employ up to 1,500 more people to actually help with that undertaking.

Actually, we like to say, you know, it’s the largest peace time logistical operation that the country does.

SALLY BROOKS: Many of the remote employees will help to collect data by interviewing people in their own language.

TONY GRUBB: In our remote areas, quite distinct to how we do mainstream Australia in terms of asking people to actually jump online or fill in a form, we will actually employ local facilitators and local interviewers and actually interview the population and that allows us to get across to meet some of those challenges of cultural differences and language.

SALLY BROOKS: Like with the health clinic opened in Darwin today, Tony Grubb thinks this Census data will be critical to informing how Governments allocate resources for Indigenous people in future.

TONY GRUBB: So in addition to being one of the drivers for the allocation of funding across states and territories it’s also used by all levels of Government for organising and planning for services such as housing, education, and transport, and infrastructure.

So, yeah very important Aboriginal and Torres Strait Islander people.

MARK COLVIN: Northern Australia Census director Tony Grubb ending that report by Sally Brooks.