Chronic musculoskeletal conditions

National populations

The population data used are estimated resident populations (ERPs) derived from the ABS Census of Population and Housing.

For more information: National, state and territory population (ABS 2023a).

International Classifications of Disease and Related Health Problems

For causes of death

Australia uses the International Statistical Classification of Diseases and Related Health Problems (ICD) to code causes of death (WHO 2019). In this report, deaths were coded using the 10th Revision (ICD-10) (Table 1).

Source: WHO 2019.

For hospital diagnosis and related data

For hospital diagnoses and procedures, a classification modified for Australia is used. Data were coded using the ICD-10-AM classification (International Statistical Classification of Diseases and Related Health Conditions, 7^th to 11^th Revision, Australian Modification) (ACCD 2019a), incorporating the Australian Classification of Health Interventions (ACHI) (ACCD 2019b) (Tables 2 to 4).

Methods

Age-standardised rates

Age-standardisation is a method of removing the influence of age when comparing populations with different age structures–ither different populations at one time or the same population at different times.

Rates are directly age-standardised in this report where possible, to enhance comparison across groups where the age structure of the population may affect interpretation.

The Australian ERP as at 30 June 2001 has been used as the standard population.

Age-standardised rates are not shown where the numerator is less than 20.

Rates that have been age-standardised are identified as such throughout the report.

Remoteness

Comparisons of regions in this report use the ABS Australian Statistical Geography Standard (ASGS) 2016 Remoteness Structure, which groups Australian regions into 6 remoteness areas.

The 6 remoteness areas are Major cities, Inner regional, Outer regional, Remote, Very remote and Migratory. These areas are defined using the Accessibility/Remoteness Index for Australia (ARIA), which is a measure of the remoteness of a location from the services that large towns or cities provide.

In some instances, data for remoteness areas have been combined because of small sample sizes.

For more information on the ASGS, see the ABS website (ABS 2023b).

Socioeconomic areas

Socioeconomic classifications in this report are based on the ABS Index of Relative Socio-economic Disadvantage (IRSD). Geographic areas are assigned a score based on social and economic characteristics of that area, such as income, educational attainment, public sector housing, unemployment and jobs in low-skill occupations. The IRSD relates to the average disadvantage of all people living in a geographical area. It cannot be presumed to apply to all individuals living in the area.

For the analyses in this report, the population is divided into 5 socioeconomic groups, with roughly equal populations (each around 20% of the total), based on the level of disadvantage of the statistical local area of their usual residence. The first group includes the 20% of areas with the highest levels of relative disadvantage (referred to as Group 1, most disadvantaged), while the last group includes the 20% of areas with the lowest levels of relative disadvantage (referred to as Group 5, least disadvantaged).

The IRSD values used in this report are based on the 2016 Census.

For more information on the IRSD, see the ABS website (ABS 2023c).

Deriving Remoteness and Socioeconomic area statistics for 2021

The National Mortality Database includes information on people’s area of usual residence prior to death. For 2022, this was at Statistical Areas Level 2 (SA2) based on the 2021 ASGS.

This location information from the National Mortality Database, along with IRSD values based on the ABS 2021 Census of Population and Housing, and estimated resident populations, have been used to derive statistics for 2021 ASGS Remoteness areas and 2021 IRSD SEIFA population-based quintiles.

For more information on SA2, see the ABS website (ABS 2023b).

Data sources

Australian Burden of Disease Database

The Australian Burden of Disease Database contains aggregate burden of disease metrics from the Australian Burden of Disease Study (ABDS) undertaken by the AIHW. This includes measures of fatal burden (years of life lost, YLL), non-fatal burden (years lived with disability, YLD) and total burden (disability-adjusted life years, DALY) 

The 2023 study builds on the AIHW's previous burden of disease studies and disease monitoring work and provides Australian-specific estimates for over 200 diseases and injuries in 2023, including comparisons with previous studies. 

The 2018 ABDS also provides estimates of how much of the burden can be attributed to 40 different risk factors. Results were published in November 2021. 

For more information, see Burden of disease.

Disease Expenditure Database

The AIHW Disease Expenditure Database provides a broad picture of the use of health system resources classified by disease groups and conditions.

It contains estimates of expenditure by the Australian Burden of Disease Study diseases and injuries, age group, and sex for admitted patient, emergency department and outpatient hospital services, out-of-hospital medical services, and prescription pharmaceuticals.

It does not allocate all expenditure on health goods and services by disease – for example, neither administration expenditure nor capital expenditure can be meaningfully attributed to any particular condition due to their nature.

For more information, see Health & Welfare expenditure.

Medicare Benefits Schedule

Statistics were extracted by the AIHW from the Medicare Benefits Schedule (MBS) claim records data in the Australian Government Department of Health Enterprise Data Warehouse or from online MBS published reports.

The MBS provides a subsidy for services listed in the MBS, for all Australian residents and certain categories of visitors to Australia. The major elements of Medicare are contained in the Health Insurance Act 1973. See details of the services covered by the MBS. 

MBS items for pathology tests are subject to episode coning. Episode coning is an MBS funding arrangement that applies to general practitioners ordering more than 3 items in an episode for a non-hospitalised patient on the same day. Under the coning rule, Medicare benefits are only payable for the 3 most expensive items. The remaining items are coned out. As a result of the application of this rule, MBS data for some items will not reflect the number of tests performed for non-hospitalised patients.

Pathology services requested for hospitalised patients, or ordered by specialists, are not subject to these coning arrangements. Episode coning was introduced to prevent over servicing by doctors.

For more information, see Medicare Benefits Schedule (MBS) data collection.

National Aboriginal and Torres Strait Islander Health Survey

The National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) is conducted by the ABS to obtain national information on the health of First Nations people, their use of health services and health-related aspects of their lifestyle. The most recent NATSIHS was conducted in 2018–19.

The NATSIHS collects information from First Nations people of all ages in non-remote and remote areas of Australia, including discrete First Nations communities.

For more information, see the National Aboriginal and Torres Strait Islander Health Survey, 2018–19 (ABS 2019).

National Health Survey

The National Health Survey (NHS) is conducted by the ABS to obtain national information on the health status of Australians, their use of health services and facilities, prevalence of long-term health conditions and health risk factors. The most recent NHS was conducted in 2022. 

The NHS collects self-reported data on whether a respondent had one or more long-term health conditions; that is, conditions that lasted, or were expected to last, 6 months or more.

When interpreting data from the NHS, some limitations need to be considered:

• Data that are self-reported and as such rely on respondents knowing and providing accurate information.
• The survey does not include information from people living in nursing homes or otherwise institutionalised.
• Residents of Very remote areas and discrete First Nations communities were excluded from the survey. This is unlikely to affect national estimates, but will impact prevalence estimates by remoteness.

For more information, see the National Health Survey (ABS 2023d). 

National Hospital Morbidity Database

The National Hospital Morbidity Database (NHMD) is a compilation of episode-level records from admitted patient morbidity data collection systems in Australian hospitals.

Reporting to the NHMD occurs at the end of a person’s admitted episode of care (separation or hospitalisation) and is based on the clinical documentation for that hospitalisation.

The NHMD is based on the Admitted Patient Care National Minimum Data Set (APC NMDS). It records information on admitted patient care (hospitalisations) in essentially all hospitals in Australia, and includes demographic, administrative and length-of-stay data, as well as data on the diagnoses of the patients, the procedures they underwent in hospital and external causes of injury and poisoning.

The hospital separations data do not include episodes of non-admitted patient care given in outpatient clinics or emergency departments. Patients in these settings may be admitted subsequently, with the care provided to them as admitted patients being included in the NHMD.

The following care types were excluded when undertaking the analysis: 7.3 (newborn – unqualified days only), 9 (organ procurement – posthumous) and 10 (hospital boarder).

Further information about the NHMD, see the National Hospitals Data Collection. 

AIHW National Mortality Database

The AIHW National Mortality Database (NMD) comprises information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. The cause of death data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice) and include cause of death coded by the ABS. The data are maintained by the AIHW in the NMD.

In this report, deaths registered in 2018 and earlier are based on the final version of cause of death data; deaths registered in 2019 are based on the revised version; and deaths registered in 2020 and 2021 are based on the preliminary version. Revised and preliminary versions are subject to further revision by the ABS.

The data quality statements underpinning the AIHW National Mortality Database can be found in the following Australian Bureau of Statistics (ABS) publications:

• ABS quality declaration summary for Deaths, Australia (ABS 2023e).
• ABS quality declaration summary for Causes of death, Australia (ABS 2023f).

For more information, see the National Mortality Database (NMD).

National Non-admitted Patient Emergency Department Care Database

The AIHW National Non-admitted Patient Emergency Department Care Database (NNAPEDCD) is a compilation of episode-level records (including waiting times for care) for non-admitted patients registered for care in emergency departments in selected public hospitals. The database only captures information for physical presentations to emergency departments and does not include advice provided via telehealth or videoconferencing.

Patients being treated in emergency departments may be subsequently admitted, including admission in the emergency department, another hospital ward or to hospital-in-the-home. For this reason, there is an overlap in the scope of the NNAPEDCD NMDS and the Admitted Patient Care National Minimum Data Set (APC NMDS).

For more information, see the National Hospitals Data Collection.

Pharmaceutical Benefits Scheme

Statistics were extracted by the AIHW from the Pharmaceutical Benefits Scheme (PBS) records data in the Australian Government Department of Health and Aged Care Enterprise Data Warehouse or from published reports.

The Australian Government subsidises the cost of a wide range of medicines through the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS). Claims for reimbursement for the supply of PBS- or RPBS-subsidised medicines are submitted by pharmacies through Services Australia for processing and are provided to the Australian Government Department of Health and Aged Care. 

Subsidies for prescription medicines are available to all Australian residents who hold a current Medicare card, and overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement. In general, patients pay a contribution to the cost of the medicine (co-payment), and the Australian Government covers the remaining cost. This remaining cost is referred to as the benefit paid.

PBS data are from records of prescriptions dispensed under the PBS and RPBS, where either:

• the Australian Government paid a subsidy
• the prescription was dispensed at a price less than the relevant patient co-payment (under co-payment prescriptions) and did not attract a subsidy.

PBS data cover all PBS prescriptions dispensed by approved suppliers, including community pharmacies, public and private hospital pharmacies and dispensing doctors.

For more information, see Pharmaceutical Benefits Scheme (PBS) data collection.