Hotspots of health inequality, and the best for busted knees

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Health Report 28 min 2 speakers 8 chapters transcribed 3 days ago

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What is the main topic discussed in this episode?

Norman Swan 0:00

Hello, I'm Norman Swann, and welcome to this week's health report. Today on the program, we offer succour to the sore knee. We offer reduced worries to women undergoing IVF. We take a hard look at Xanax and persistently large variations in preventable hospital admissions in Australia, particularly looking at Queensland and Victoria. This is a report just released from the Grattan Institute in Melbourne. Stephen Duckett's the Health Programme Director and he joins us from the studio in Melbourne. Welcome Stephen.

Stephen Duckett 0:28

Good afternoon, uh

Norman Swan 0:29

Norman. So this is about place. I mean this is just d just describe the study to us because th these are extraordinary variations where some parts of Australia, particularly in Queensland and Victoria, thirty eight places in Queensland Twenty five places in in Victoria have a fifty percent increased average um ho pro hospitalizations that are preventable and they've lasted for over a decade.

Stephen Duckett 0:53

Yeah, so we got uh all of the hospital data for Queensland and Victoria and we analyzed uh we decided there'd be a threshold of uh fifty percent worse than the state average. We used the list of uh so called ambulatory care sensitive conditions or potentially preventable hospitalizations. So these are ones

Norman Swan 1:11

that just ambulatory care is

Stephen Duckett 1:13

Called for they could be treated by your GP in the community. That's right. That's right. And so we we'd we used the list that had been agreed by governments and so we we we started by trying to identify those places which had high rates. What we found was that a an area with a high rate in one year has a fifty percent chance of being a l not a high rate the next year. Really? So we we were quite interested in in the extent of persistence that that we've got to actually see if something's uh going to have a high uh a place that's got a high rate for three years or more, it it it's likely to stay. Whereas if it's only one year it's not likely to stay high. So then we were even tougher and said, we're interested in those areas which have had high rates every year for a decade.

Stephen Duckett 1:58

And it surprised us we found these places that have th this is this is supposed to be potentially preventable hospitalizations where they're more than fifty percent above the state average every year for a decade. So what sort of places are we talking about? Are they surprises? Well, yes and no. Um th we found places in metropolitan areas and in rural areas, remote areas. So th some of the Aboriginal communities, Palm Island and so on, uh Aracoon have got high rates uh There's lower socio economic status areas in the suburbs like Caboolture in Brisbane or uh Broadmeadows in Melbourne also have high rates.

What are the key findings of the Grattan Institute report on preventable hospital admissions in Queensland and Victoria?

Stephen Duckett 2:35

Um but what was what was quite interesting about this, we we went in saying, Oh look, it all the low socioeconomic status areas are going to have high rates of potentially preventable hospitalizations. But that turned out not to be the case. So in Melbourne, So it wasn't just about poverty. It wasn't just about poverty. So in Melbourne, Broad Meadows has got a high rate of potentially preventable hospitalisations every year for a decade. Sunshine has never had a high rate of potentially preventable hospitalizations. So Yes. So it's it's quite mixed. There are individual and we also looked at differences in patterns. So in some of these places, a small number of of people who have high rates of readmission drive the problem.

Stephen Duckett 3:18

But in other in other places it's not readmissions at all, even though the many of these are chronic diseases. So it's it's a very localized issue and quite different in different parts of Australia.

Norman Swan 3:29

And what sort of conditions are we talking about here?

Stephen Duckett 3:32

So the standard sort of list of uh of chronic diseases, uh angina, diabetes, asthma, but also some acute conditions like dental dental care, admissions for dental care are also in our list.

Norman Swan 3:44

And extraordinary variations in dental care. Well

Stephen Duckett 3:49

It's it's quite extraordinary. So generally, in fact, if you look again at Melbourne, in Metropolitan Melbourne, none of the postcodes had high rates of admissions for dental care.