Potentially preventable hospitalisations

Introduction

A subset of hospitalisations are considered potentially preventable and are collectively known as potentially preventable hospitalisations (PPHs). Under the National Healthcare Agreement, PPHs are defined as hospitalisations from conditions that could have been prevented through the provision of appropriate individualised preventative health interventions and early disease management, usually delivered in a primary health care and community-based care settings.¹ They are used as measures of system performance in Australia and internationally.²

Potentially preventable hospitalisations are identified from diagnoses recorded in hospital admission data. There are three broad categories: chronic, acute, and vaccine preventable, consisting of 22 specific health conditions.

Potentially preventable hospitalisations by category

In 2022–23, Queensland residents had 184,006 potentially preventable hospitalisations (PPH) episodes of care in Queensland hospitals.³ These were 6.4% of all hospitalisations.

• The Queensland age-standardised rate (ASR also referred to as standardised rates) for total PPH was 31.4 per 1,000 persons.
• Of the three broad categories, acute conditions had the highest standardised rate (16.8 per 1,000 persons), followed by chronic conditions (12.5 per 1,000 persons) and vaccine preventable conditions (2.4 per 1,000 persons; Figure 1).
• Females had a 8.3% higher standardised rates of PPHs driven by acute PPHs.

Figure 1: Selected potentially preventable hospitalisations by category for Queensland residents, 2022–23

In 2022–23, considering age-standardised PPH rates across Australian juridications, Queensland ranked:

• 7th for total PPH
• 7th for acute PPH
• 6th for chronic PPH
• 7th for vaccine-preventable PPH.⁴

Age groups

PPHs vary by age. For example, older people were more likely to have chronic conditions that can lead to hospitalisations, while children were more likely to be hospitalised for acute conditions.

In 2022–23:

• Adults 85 years and older had the highest age-specific rate of PPH (194.4 per 1,000 persons) with the majority for chronic conditions such as chronic obstructive pulmonary disease (COPD)
• A few conditions, such as dental and asthma, had higher rates for children (Supplemental Figure S1 under Additional information)
• For vaccine preventable PPHs, children 0 to 4 years had rates higher than all but the three oldest age groups.

Figure 2: Selected potentially preventable hospitalisations in Queensland by category and age, 2022–23

Remoteness and socioeconomic differences

Because PPHs are considered a proxy measure of healthcare availability outside of hospital settings, regional variations may indicate inequitable primary healthcare access and variations in modifiable risk factors.^5,6 Addressing these disparities represents an opportunity to improve the health of many Queenslanders.

In 2022–23, the standardised rate of total PPHs was 2.0 times higher in remote and very remote areas (57.1 per 1,000 persons) compared to in major cities (29.1 per 1,000 persons). Furthermore, for each PPH category, the standardised rate of total PPHs in remote and very remote areas was almost, or more than, double that of major cities (Figure 3).

Similar disparities occurred by socioeconomic status in 2022–23. The standardised rate of total PPHs in the most socioeconomically disadvantaged areas was 84.8% higher than in the most advantaged areas (43.8 compared to 23.7 per 1,000 persons, respectively), with this discrepancy evident for each PPH category.³

Figure 3: Selected potentially preventable hospitalisations by remoteness and socioeconomic status for Queensland residents, 2022–23

Potentially preventable hospitalisations by specific condition

The leading PPH condition in 2022–23 was urinary tract infections, followed by dental conditions and cellulitis, which are acute PPHs.³

The conditions with the highest standardised rate differences by sex were:

• males—cellulitis, followed by dental conditions and diabetes complications
• females—urinary tract infections, dental conditions and iron deficiency anaemia (Figure 4).³

Figure 4: Selected potentially preventable hospitalisations by specific conditions for Queensland residents, 2022–23

Trends

Standardised rates for total PPH steadily increased from 2010–11, with subsequent declines largely driven by decreases for chronic conditions (Figure 5), such as angina, asthma, and COPD (Supplemental Figure S1). PPHs for acute conditions, however, have steadily increased over time.

Recent patterns for all PPHs show variability due to COVID-19. Vaccine preventable PPHs saw a decline from 2019–20 to 2020–21 potentially associated with reduced flu-related hospitalisations due to COVID-19 public safety measures. However, in 2022–23 rates of vaccine preventable PPHs have risen to be near their pre-COVID levels (Figure 5 and Supplemental Figure S1 under Additional information).

Figure 5: Trends in selected potentially preventable hospitalisations by sex for Queensland residents

Additional information

Data and statistics

The figure below provides more detailed information for PPHs.

Supplemental Figure S1: Trends in selected potentially preventable hospitalisations in Queensland

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Section technical notes

Data reported in this section were sourced from the Queensland Hospital Admitted Patient Data Collection (QHAPDC). Individual record in the QHAPDC are episode-based, meaning that multiple episodes from the same person will be counted each time.

The number of PPH are for Queensland residents in Queensland hospitals. This may differ from national reporting that includes Queensland residents admitted to hospitals in other Australian states and territories.

Separations for interstate residents, public psychiatric hospitals, and those flagged as unqualified newborns, organ donors or boarders are excluded.

For definition on selected potentially preventable hospitalisations, refer to coding standards in METEOR on the Australian Institute of Health website.

Age-standardised rates were calculated by standardising to 2001 Australian standard population.