Our hospitals are under enormous pressure, with vacant beds are hard to come by at the best of times. Which makes the latest data on potentially preventable hospitalisations (PPH) particularly infuriating.
The Australian Institute of Health and Welfare (AIHW) data shows there were a total of 11.6 million hospitalisations in Australia in 2021-22. Around one in 18 (660,000 or 5.7 per cent) were classified as PPH, which works out to a rate of 2600 PPH per 100,000 people.
The average length of stay for a PPH admission was 3.9 days, which gives a total of more than 2.5 million days of occupied hospital beds that could have been avoided.
Measuring rates of PPH helps demonstrate the effectiveness of community healthcare, as higher rates may suggest a lack of quality accessible healthcare in a particular region.
The report looked at hospitalisation rates for 22 conditions for which hospitalisation is considered potentially preventable.
Rates of PPH are higher among older people, with the figures showing people aged 65 years and over had about 303,000 hospitalisations in 2021-22 (6900 hospitalisations per 100,000 people) compared with those under 65 years (357,000 hospitalisations or 1700 hospitalisations per 100,000 people.
What were the conditions?
The conditions were placed into three broad categories:
- Acute conditions that come on suddenly and may not be preventable, but that wouldn’t result in hospitalisation if timely and adequate care was received in the community. Conditions in this category include dental conditions, ear, nose and throat infections, eclampsia and urinary tract infections.
- Vaccine-preventable conditions, in which hospitalisation could have been prevented by vaccination. This includes infectious disease like chicken pox, hepatitis B and rubella.
- Chronic conditions. These are persistent and long-lasting conditions that may be preventable through lifestyle change, and can also be managed in the community before symptoms worsen.
Acute conditions were found to be the most common cause of PPH, with approximately 317,000 hospitalisations or 1200 per 100,000 people; followed by chronic conditions at 305,000 or 990 per 100,000 and vaccine-preventable conditions at 43,300 cases or 155 per 100,000.
Interestingly, the rates of both acute and chronic PPH actually went down from the previous year, but the rate of vaccine-preventable PPH went up.
The mind immediately goes to COVID cases, but the AIHW says the increase is actually due to a greater prevalence of influenza and pneumonia, although it does admit COVID-era health measures may have contributed to the lower rate last year.
Overall, dental conditions were responsible for the most PPH, followed by urinary tract infections, anaemia from iron deficiency, congestive heart failure and cellulitis.
Why is this happening?
The answers to that question are complex, but staffing levels and access to healthcare in regional areas play a big role.
The data also broke down hospitalisations by geographic area. Leading the nation in PPH are western Queensland and the Northern Territory, both of which recorded about 1000 more PPH per 100,000 than any other area.
Of the top 10 most common areas for PPH, eight of them represent mostly rural areas.
Dr Nicole Higgins, president of the Royal Australian Society for General Practitioners (RAGCP), told newsGP the data is a demonstration of the value of GPs and their role in preventive medicine.
She says decreased government funding for frontline GPs is a huge driver of the high PPH rate.
“Government can’t ignore that it must increase its general practice funding as a percentage of the healthcare budget, which has now fallen to 5.7 per cent,” she said.
She says the lack of preventative care is placing an undue burden on our hospitals.
“We are seeing increased hospitalisations, ramping, hospital admissions, all of which cost significantly more to the taxpayer than a visit to the GP,” she says.
“We’re going to see more hospitalisations if the government does not fund general practice to increase its capacity and reduce barriers for patients, because prevention is always better than cure.”
Is accessing healthcare a challenge where you live? When was the last time you saw your GP? Let us know in the comments section below.
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I make my monthly GP appointments 6 months in advance. This assures me of being able to see my GP to check on my condition when required. My GP is immensely popular and is always fully booked daily. I live in semi-rural SA.