Potentially preventable hospitalisations
Hospitalisations for conditions that can be effectively treated in a non-hospital setting are referred to as Potentially Preventable Hospitalisations (PPH). This is a key measure of the performance of the health system. In particular, it serves as a proxy measure of access to timely, effective and appropriate primary and community-based care (AIHW 2020c). An analysis of the conditions for which people are admitted to hospital reveals that, in many cases, the hospital admission could have been prevented through timely and effective care outside hospital (Li et al. 2009).
Measures of PPH include conditions for which hospitalisation is potentially avoidable through effective preventive measures and early diagnosis or disease management, usually delivered through primary health care (Page et al. 2007). The term ‘PPH’ does not mean that the patient did not require hospitalisation at the time of the admission, but that hospitalisation could potentially have been prevented with effective management in community health care settings (AIHW 2019).
PPH fall into three broad categories:
- Vaccine-preventable conditions—some examples are, influenza, tetanus, whooping cough, chicken pox, measles.
- Acute conditions—including cellulitis (skin infections), urinary tract infections, convulsions/epilepsy, dental conditions, ear nose and throat infections.
- Chronic conditions—including many forms of cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes complications, asthma, iron deficiency and hypertension.
PPH can be affected by the prevalence of diseases. Therefore, caution should be used when comparing across groups with different levels of disease, for example chronic conditions. Furthermore, number are affected by changes to ICD-10-AM/ACHI classifications of the reporting of ‘past history’ of hepatitis B were implemented from 1 July 2013 in the eighth edition of ICD-10-AM. This change in the coding standard resulted in increased reporting of the vaccine-preventable category of potentially preventable hospitalisations from 2013–14, which includes counts for additional diagnoses of Hepatitis B. Therefore, PPH data excluding chronic hepatitis B will also be presented where possible.
In the period from July 2017 to June 2019, there were 92,019 hospitalisations (excluding those for dialysis) for Indigenous Australians that were potentially preventable. This accounted for 15% of all hospitalisations among Indigenous Australians.
Figure HS 3 shows that Indigenous Australians have higher age-standardised rates of potentially preventable hospitalisations than non-Indigenous Australians, across all types of condition.
The crude rate of potentially preventable hospitalisations among Indigenous Australians has increased from 45 per 1,000 Indigenous Australians in 2013–14 to 56 per 1,000 in 2018–19 (Figure HS 4).
For more information, see the Indigenous Health Performance Framework Measure 3.07 Selected potentially preventable hospital admissions.