Australia’s health system is a complex mix of health professionals and service providers from a range of organisations—across all levels of government and the non-government sector. Collectively, they work to meet the health care needs of all Australians. Hospitals are an important part of this system, delivering a wide range of clinical services including treatment, care and rehabilitation1.
Understanding patients’ experiences and their interactions with parts of the health system such as hospitals is critical to ensuring that services are delivered appropriately and meet the needs of all Australians. High quality and well-coordinated health care is crucial to enhancing patients’ understanding, control and self-management of their illness2, 3, contributing to better health outcomes.
This publication presents findings from the third stage of the Coordination of Health Care Study (the Study) which links information on state and territory hospital admissions and emergency department presentations to the 2016 Survey of Health Care.
For New South Wales, Victoria, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory, hospital data provided to Australian Bureau of Statistics (ABS) for the Study was sourced from the Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database (NHMD). For Queensland and South Australia, data were sourced from the Queensland Hospital Admitted Patient Data Collection (QHAPDC) and South Australia Public Hospital Separations dataset respectively.
For New South Wales, Victoria, Queensland, Western Australia, Tasmania, the Northern Territory and the Australian Capital Territory, emergency department data provided to ABS for the Study was sourced from the AIHW National Non-admitted Patient Emergency Department Care Database (NNAPEDCD). For South Australia, data were sourced from the South Australia Public Hospital Emergency Department dataset.
The first stage of the Study, the 2016 Survey of Health Care, collected information on respondents' experiences with a range of health care professionals (for example, general practitioners and specialists) and the broader health care system (for example, diagnostic tests, hospital admissions and emergency department visits). The second stage, undertaken in 2018, explored patients’ experiences of coordinated care with health care providers in the context of their use of Medicare Benefits Schedule (MBS) services and Pharmaceutical Benefits Scheme (PBS) medicines.
The Coordination of Health Care Study is funded by the AIHW and is jointly conducted by ABS and the AIHW. This publication was jointly prepared and released by the ABS and the AIHW.
|The Study cohort|
Results in this publication are based on a sample of 25,502 Australians aged 45 years or over who had at least one GP visit between November 2014 and November 2015 and had participated in the 2016 Survey of Health Care. This sample has been weighted to represent the 8.8 million people in Australia aged 45 years and over who had at least one GP visit in this period (the Study cohort).
These 25,502 Study participants consented to linkage of information about the hospital and emergency department services they used between 1 January 2014 and 30 June 2018 to their 2016 Survey of Health Care records.
All linkage is approved by appropriate ethics committees and follows strict confidentiality procedures to ensure Study participants’ personal information is protected.
This publication focusses on participants’ use of hospital and emergency department services in 2015-16 to coincide with the Survey of Health Care reference period of 2016.
There are a number of factors that should be considered when interpreting information presented in this publication:
- data presented relate to hospitalisations and emergency department presentations in 2015-16 (see Glossary for more information). Services provided through outpatient clinics for which patients were not admitted to hospital are not included;
- the scope of hospital information available for linkage differed between states and territories. Data relate to public hospitalisations in all states and territories and private hospitalisations in New South Wales, Victoria, Queensland and Western Australia (see paragraphs 44 to 46 of the Explanatory Notes for more information);
- emergency department data relate to services provided at public hospitals that meet the criteria for inclusion in the NNAPEDCD (see paragraphs 54 to 57 of the Explanatory Notes for more information). Services provided at private hospital emergency departments are not included in the NNAPEDCD; and
- data on emergency department presentations in the Australian Capital Territory in 2015-16 were not available at the time of publication.
Due to these scope exclusions, geographic-level data in particular should be interpreted with caution. Comparisons between states and territories are not recommended (see the Data Quality section in the Explanatory Notes for more information). Additionally, variation in the use of health services across geographies may reflect the different demographic characteristics of these areas (for example, their age structures) as well as other factors such as the availability of particular health services or the way health services are provided.
Estimates in this publication are based on 25,502 people in the Study who provided consent for the release of their hospital and emergency department information to the ABS, from a sample of 35,495 people who participated in the 2016 Survey of Health Care. Potential bias in the consenting sample in addition to the participating sample may affect estimates. Furthermore, as the consenting sample were linked to state/territory administrative data sources, errors in this linkage (for example, non-linkage of records) may also affect estimates. As a result, while estimates in this publication are derived from a subset of information from state/territory hospital and emergency department collections, these estimates will not necessarily be consistent with data sourced directly from these collections.
Future work by the AIHW will combine all stages of the Coordination of Health Care Study. Analysis across the suite of integrated datasets (that is, Survey of Health Care, MBS, PBS, hospital and emergency department information) will build a more comprehensive picture of patient journeys and pathways of care. Themes such as potentially preventable hospitalisations, coordination of care in unplanned hospital readmissions and patient experiences of barriers to accessing care and unmet need may be explored.
1. Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW
2. Bywood P, Jackson-Bowers E & Muecke S 2011. Initiatives to integrate primary and acute health care, including ambulatory care services. PHCRIS (Primary Health Care Research & Information Service) policy issue review. Adelaide: PHCRIS
3. Jeon Y, Kraus S, Jowsey T & Glasgow N 2010. The experience of living with chronic heart failure: a narrative review of qualitative studies. BMC Health Services Research 10:77