People are often admitted to hospital for reasons that could have been attended to with effective, timely preventative care in primary healthcare and other community health settings. The performance indicator set under Australia’s National Healthcare Agreement defines 22 categories of health conditions for which hospitalisation is potentially preventable, a range of acute, chronic and vaccinepreventable conditions.
In December 2017, the Health Performance Council published a bitesize teaser report of some high level analysis of South Australian public hospital admissions data to reveal some areas of the state, mainly in regional and remote country areas, which had particularly and persistently high levels of these potentially preventable hospital admissions. As we reported at the time, SA Health had been leading a collaborative effort to produce a more detailed and robust study on the topic. Two years on, as we continue to await that detailed SA Health report, we have produced this second edition of our bitesize high level analysis with more recent data and improved analytical methods.
There were 36,500 inpatient admissions for potentially preventable hospitalisations recorded in South Australia’s public hospitals in the 2018–19 financial year, some one in every 11 of all inpatient admissions. Effective, timely interventions in primary care settings or through public health interventions may have prevented many of these hospital admissions from having been necessary or reduced their incidence. Early interventions that could have removed the need for some of these admissions include take-up of vaccinations, early treatment of infections with GP-prescribed medications, and GP-led long-term management plans for chronic diseases.
But these potentially preventable hospital admissions are not evenly spread through the state. Comparing the number of these hospital admissions against the population in each community region of the state reveals some areas to be particular ‘hotspots’ for these admissions, having rates of admission much higher than elsewhere in the state. Consistent with methods used for other analyses of data from Victoria, Queensland and Western Australia, we have chosen to flag as ‘hotspots’ of potentially preventable hospital admission those areas with admission rates at least 50% higher than the state-wide average. We have adjusted for the effects of different population demographics (age and sex) by calculating direct-standardised rates. These relatively high rates of potentially preventable admission to hospital are potential indicators of areas being candidates for primary care or public health programs to secure that people receive earlier community based interventions and reduce hospital admission rates.