Summary
On this page
- Why measure potentially preventable hospitalisations?
- What this report examines
- How common are potentially preventable hospitalisations?
- The most common potentially preventable conditions
- Potentially preventable hospitalisations by age
- Potentially preventable hospitalisations by category
- Vaccine-preventable hospitalisations
Hospital separations for the selected conditions presented in this report are considered to be ‘potentially preventable hospitalisations’ as they are amenable in some circumstances to primary and community care interventions. These conditions reflect the National Healthcare Agreement: Performance Indicator 18-Selected potentially preventable hospitalisations, 2022 and are categorised as being:
- acute (conditions that usually come on suddenly, and may not be preventable, but may not result in hospitalisation if timely and adequate care had been received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change, and can also be managed in the community to prevent worsening of symptoms or hospitalisation).
Primary and community health care – including care from a general practitioner or community health nurse – can effectively manage and treat these health conditions (for example, by administering vaccines or prescribing lifestyle changes). Primary and community health care can be an opportunity for early intervention, that can help to reduce the risk of a person developing a disease, their symptoms worsening, or complications developing, to the point that they need a hospitalisation.
Why measure potentially preventable hospitalisations?
Potentially preventable hospitalisations (PPH) can tell us about the effectiveness of health care in the community, as higher rates may suggest a lack of timely, accessible, and adequate primary care.
However, there are many other reasons why an area or group of people may have higher rates of PPH. These may include:
- higher rates of disease
- lifestyle factors and other risks
- a genuine need for hospital services.
Some PPH may not be avoidable, such as those for patients with complex illness, or patients having procedures as follow-up to primary care.
This means that it is important not to assume that higher rates of PPH always indicate a less effective primary care system. Rather, PPH are a useful tool for identifying and investigating variation between different groups of people to better understand health inequalities. PPH can help guide research about how different groups use and respond to health services, including barriers they may face and areas of unmet demand.
What this report examines
This report explores 22 conditions for which hospitalisation is considered potentially preventable across 3 broad categories:
- acute (conditions that usually come on suddenly, and may not be preventable, but may not result in hospitalisation if timely and adequate care was received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change, and can also be managed in the community to prevent worsening of symptoms or hospitalisation).
For more information on the conditions included in this report, see What are potentially preventable hospitalisations?
Data in this report are based on where people lived, not the location of the hospital that they were admitted to, and are presented for 2020–21 and 2021–22, across 2 geographic areas: Statistical Area Level 3 (SA3) and Primary Health Network (PHN).
How common are potentially preventable hospitalisations?
In 2021–22, there were 11.6 million hospitalisations in Australia (AIHW 2023). Of these, around 1 in 18 hospitalisations (5.7% or 660,000) were classified as PPH, a rate of 2,600 hospitalisations per 100,000 people. Of the 11.8 million hospitalisations in 2020–21 (AIHW 2023), the number and rate of PPH was steady (5.7%, or 670,000), a rate of 2,600 hospitalisations per 100,000 people. The average length of stay for a PPH admission was 3.7 days in 2020–21 and 3.9 days in 2021–22.
The most common potentially preventable conditions
Overall, the most common condition for PPH in 2020–21 and 2021–22 was dental conditions, followed by urinary tract infections, and iron deficiency anaemia. The 5 most common PPH conditions (based on highest rates per 100,000 people) are presented in Figure 1 below.
Figure 1: Five most common potentially preventable hospitalisations conditions, rate per 100,000 people, 2020–21 and 2021–22
Dental conditions was the most common potentially preventable hospitalisations conditions, followed by urinary tract infections and iron deficiency anaemia.
| Condition | 2020-21 | 2021-22 |
|---|---|---|
| Dental conditions | 323 | 306 |
| Urinary tract infections, including pyelonephritis | 313 | 292 |
| Iron Deficiency anaemia | 265 | 250 |
| Congestive Heart Failure | 252 | 237 |
| Cellulitis | 250 | 232 |
About the measure
Potentially preventable hospitalisations (PPH) in this report are defined in accordance with the National Healthcare Agreement specifications PI 18-Selected potentially preventable hospitalisations, 2022.
The PI 18 definition includes 22 conditions, for which hospitalisation is considered potentially preventable across 3 broad categories:
- acute (conditions that come on suddenly and lasts for a limited time, but may not result in hospitalisation if timely and adequate care had been received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change and can be managed effectively through timely care to prevent deterioration and hospitalisation).
It is important to note that PPH does not mean that a patient admitted for that condition did not need to be hospitalised at the time of admission. Rather, the hospitalisation could have potentially been prevented through the provision of appropriate individualised preventative health interventions and early disease management usually delivered in primary and community-based care settings.
Source:
AIHW analysis of the National Hospital Morbidity Database (NHMD) 2020–21 and 2021–22.
Higher rates of potentially preventable hospitalisations among older Australians
Rates of PPH in 2021–22 were higher in older Australians, aged 65 years and over (about 303,000 hospitalisations or 6,900 hospitalisations per 100,000 people) compared with Australians aged under 65 years (about 357,000 hospitalisations or 1,700 hospitalisations per 100,000 people) (Figure 2). Rates of PPH were also higher in older Australians in 2020–21.
Figure 2: Rates of total potentially preventable hospitalisations by age group, 2020–21 and 2021–22
In 2020–21 and 2021–22, people aged 65 years and over had higher rates of potentially preventable hospitalisations than those aged under 65 years.
| Period | Under 65 years | 65 years and over |
|---|---|---|
| 2020-21 | 1686 | 7304 |
| 2021-22 | 1670 | 6923 |
About the measure
Potentially preventable hospitalisations (PPH) in this report are defined in accordance with the National Healthcare Agreement specifications PI 18-Selected potentially preventable hospitalisations, 2022.
The PI 18 definition includes 22 conditions, for which hospitalisation is considered potentially preventable across 3 broad categories:
- acute (conditions that come on suddenly and lasts for a limited time, but may not result in hospitalisation if timely and adequate care had been received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change and can be managed effectively through timely care to prevent deterioration and hospitalisation).
It is important to note that PPH does not mean that a patient admitted for that condition did not need to be hospitalised at the time of admission. Rather, the hospitalisation could have potentially been prevented through the provision of appropriate individualised preventative health interventions and early disease management usually delivered in primary and community-based care settings.
Source:
AIHW analysis of the National Hospital Morbidity Database (NHMD) 2020–21 and 2021–22.
Most potentially preventable hospitalisations in 2021–22 were for acute conditions
The number and age-standardised rate of acute PPH in 2021–22 (317,000 or 1,200 per 100,000 people, after adjusting for age) was higher than both chronic PPH (305,000 or 990 per 100,000 people) and vaccine-preventable PPH (43,300 or 155 per 100,000 people) (Figure 3).
Figure 3: Age-standardised rates of potentially preventable hospitalisations by category, 2020–21 and 2021–22
The number and age-standardised rate of acute potentially preventable hospitalisations was higher than both the chronic and vaccine-preventable categories.
| Potentially Preventable Hospitalisation category | 2020-21 | 2021-22 |
|---|---|---|
| Acute | 1212 | 1168 |
| Vaccine-Preventable | 100 | 154 |
| Chronic | 1057 | 989 |
About the measure
Potentially preventable hospitalisations (PPH) in this report are defined in accordance with the National Healthcare Agreement specifications PI 18-Selected potentially preventable hospitalisations, 2022.
The PI 18 definition includes 22 conditions, for which hospitalisation is considered potentially preventable across 3 broad categories:
- acute (conditions that come on suddenly and lasts for a limited time, but may not result in hospitalisation if timely and adequate care had been received in the community)
- vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
- chronic (conditions that are persistent and long-lasting but may be preventable through lifestyle change and can be managed effectively through timely care to prevent deterioration and hospitalisation).
It is important to note that PPH does not mean that a patient admitted for that condition did not need to be hospitalised at the time of admission. Rather, the hospitalisation could have potentially been prevented through the provision of appropriate individualised preventative health interventions and early disease management usually delivered in primary and community-based care settings.
Source:
AIHW analysis of the National Hospital Morbidity Database (NHMD) 2020–21 and 2021–22.
Age-standardised rates of vaccine-preventable hospitalisations increased between 2020–21 and 2021–22
Between the period 2020–21 and 2021–22, age-standardised rates of chronic and acute conditions declined slightly, while the age-standardised rates for vaccine-preventable conditions increased. This change was driven by an increase in pneumonia and influenza (vaccine-preventable) hospitalisations (15 per 100,000 people, after adjusting for age, in 2020–21 compared with 74 per 100,000 people in 2021–22).
Notably, the 2020–21 period coincided with continuing public health measures from the COVID-19 pandemic, which may have contributed to a reduction in the prevalence of pneumonia and influenza in the community, and a subsequent reduction in vaccine-preventable hospitalisations during this period (AIHW 2022).
For more information about admitted patient hospitalisations, including the impact of COVID-19 on admitted patient activity, see MyHospitals: Admitted patients.
References
AIHW (Australian Institute of Health and Welfare) (2022) Australia’s health 2022: data insights, AIHW, Australian Government, accessed 09 April 2024.
AIHW (2023) Hospital activity, AIHW, Australian Government, accessed 09 April 2024.