Wind turbine syndrome, heart rate changes, hospital complications and chronic condition self-management

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What is wind turbine syndrome and why is it controversial?

Dr. Norman Swan 0:00

Hello and welcome to this week's health report with me, Norman Swan. Today, wind turbine syndrome. It got some politicians going and generated a lot of fervor on both sides. It's a

Simon Chapman 0:10

disease which appears to only speak English. There are very few examples of it manifesting or being expressed in countries where English is not the first language.

Dr. Norman Swan 0:22

Communicated diseases later. Plus, how much help do you really need to look after yourself when you have a chronic illness? And according to a Grattan Institute report released yesterday, there's a lot of variation in the chances of experiencing a complication in hospital. The report claims that if all hospitals were to perform at the level of the best 10%, a quarter of a million people each year would leave hospital without complications they'd have otherwise had. The report also argues that there's too much secrecy and that hospital performance on complications should be more widely available. One of the authors is Stephen Duckett and he's in our Melbourne studio. Welcome back to the health report, Stephen.

Dr. Norman Swan 0:57

Thanks, Norman. You quote nine hundred complications each year in Australian hospitals. How many are serious?

Stephen Duckett 1:04

Well, the they vary as you know, uh, Norman, from from things that are resolved pretty quickly, uh uh nausea and vomiting is an example of that, to things which uh are quite m much more serious, falling out of bed, breaking your hip, medication errors. So the full spectrum is there. We estimate that there's about uh one in every four overnight patients has something go wrong, and that would be that full spectrum of things that can resolve quickly. to things that are much more serious and some of them uh associated with death.

How many hospital complications occur in Australia and what do they cost?

Dr. Norman Swan 1:33

And the the impact, economic impact you suggest, is an extra on average five days in hospital?

Stephen Duckett 1:39

Well we looked at uh sometimes it's hard to to measure the impact on length of stay because the longer you stay in hospital the the more you risk. So we just looked at procedural complications, those where the the actual complication takes place during the uh the surgery, and uh that adds in fact five days to the average person who has one of those. They ha stay an extra five days in hospital.

Dr. Norman Swan 1:59

What's the extent of variation?

Stephen Duckett 2:02

Well there's huge variation. Uh in in looking at uh on average, if you're uh just a uh any any stay in hospital, either same day or or overnight, uh there's uh eleven percent of patients have a complication. Uh in some hospitals that's down around the two percent mark. In h some hospitals it's around the seventeen percent mark. So there's quite a significant variation across the country.

Dr. Norman Swan 2:24

Now you're saying that you there's th that people don't know what the complication rate is between hospitals. Yeah, h how do you know those data and other people don't?

Stephen Duckett 2:32

So we've got a data set which is three years of data which consists of all patients discharged from all hospitals, public and private, uh across the country in those three years. Unfort well fortunately I think the the names of the hospitals are suppressed so we can't tell which hospital is which. Uh but the the data is there and we can analyse it to see these differences in rates. And what that's what we're that's one of the c critical recommendations we're making that But first of all, this information should be available to the hospitals so that the hospitals can analyse their own data, they can compare themselves with other hospitals, they can see where they're going badly or where they're going well and they can actually start improving.

Stephen Duckett 3:11

And y we're also saying that we should publish that information so the public can see that as well.

Dr. Norman Swan 3:16

Now you chaired an inquiry in Victoria into hope complication uh into safety and quality in Victorian hospitals, which led to a new commission being developed, new part of the bureaucracy to look at this. Are you saying that you didn't achieve in getting transparency in Victoria? 'Cause I think the Victorian government would say there's pretty good transparency now.

Stephen Duckett 3:34

So uh our report was issued uh in November of uh twenty sixteen and they're implementing the government's committed to implement all the recommendations and they've set up a new agency called the Victorian Agency for Health Improvement, which is committed to publishing this information.