HealthStats NSW
HealthStats NSW
HealthStats NSW

Potentially preventable hospitalisations by category

Vaccine-preventable conditions, 2017-18
272.3Vaccine-preventable conditions, 2016-17
172.9Vaccine-preventable conditions, 2015-16
146.4Vaccine-preventable conditions, 2014-15
132.6Vaccine-preventable conditions, 2013-14
95.6Vaccine-preventable conditions, 2012-13
58.8Vaccine-preventable conditions, 2011-12
49Vaccine-preventable conditions, 2010-11
42.7Vaccine-preventable conditions, 2009-10
52.1Vaccine-preventable conditions, 2008-09
45.9Vaccine-preventable conditions, 2007-08
49.3Vaccine-preventable conditions, 2006-07
34.2Vaccine-preventable conditions, 2005-06
38.7Vaccine-preventable conditions, 2004-05
40.8Vaccine-preventable conditions, 2003-04
50.2Vaccine-preventable conditions, 2002-03
53.1Vaccine-preventable conditions, 2001-02
56.7Chronic conditions, 2017-18
891.6Chronic conditions, 2016-17
894.1Chronic conditions, 2015-16
867.9Chronic conditions, 2014-15
868.3Chronic conditions, 2013-14
875.6Chronic conditions, 2012-13
852Chronic conditions, 2011-12
850.4Chronic conditions, 2010-11
831.3Chronic conditions, 2009-10
1016Chronic conditions, 2008-09
1024.1Chronic conditions, 2007-08
1043.9Chronic conditions, 2006-07
1052.1Chronic conditions, 2005-06
1023.2Chronic conditions, 2004-05
1022.9Chronic conditions, 2003-04
1023.2Chronic conditions, 2002-03
1031.8Chronic conditions, 2001-02
1080.1Acute conditions, 2017-18
1051Acute conditions, 2016-17
1035.1Acute conditions, 2015-16
998.5Acute conditions, 2014-15
982.9Acute conditions, 2013-14
968.3Acute conditions, 2012-13
936.4Acute conditions, 2011-12
933.7Acute conditions, 2010-11
930.9Acute conditions, 2009-10
886.3Acute conditions, 2008-09
888.3Acute conditions, 2007-08
921Acute conditions, 2006-07
888.6Acute conditions, 2005-06
876.7Acute conditions, 2004-05
823.3Acute conditions, 2003-04
807Acute conditions, 2002-03
793.1Acute conditions, 2001-02
797Total, 2017-18
2180.5Total, 2016-17
2080.6Total, 2015-16
1996.2Total, 2014-15
1969.5Total, 2013-14
1929.4Total, 2012-13
1840.3Total, 2011-12
1827.3Total, 2010-11
1800.5Total, 2009-10
1947.7Total, 2008-09
1952.9Total, 2007-08
2008.4Total, 2006-07
1969.7Total, 2005-06
1932.9Total, 2004-05
1881.2Total, 2003-04
1873.3Total, 2002-03
1869.4Total, 2001-02
1923.8
  • + Source

    NSW Combined Admitted Patient Epidemiology Data and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.

  • + Notes

    Potentially Preventable Hospitalisations (PPH) are based on National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations.

    Conditions are mutually exclusive. Rotaviral Enteritis is included for records after 1 July 2007 onwards.

    Only NSW residents are included. Rehabilitation episodes are excluded. Figures are based on where a person resides, rather than where they are treated. Hospital separations were classified using ICD-10-AM. Rates were age-adjusted using the Australian population as at 30 June 2001.

    Patients treated solely within the emergency department are excluded from this indicator report due to a policy change (PD2017_015). Please note that a minority of patients being managed in short stay areas of emergency departments are still included. Further information is found in a paper in the HealthStatsPLUS Methods tab on this website.

    Hospital episodes with source of referral being a transfer from another hospital or a type change admission were excluded in order to reduce multiple counting of hospitalisation episodes related to the same event. Hospital episodes with bed/unit type being hospital in the home were also excluded. Hospital episodes with a length of stay greater than 120 days were excluded to minimise the effect of outliers on estimated average and total bed days for conditions (episodes with length of stays greater than 120 days account for less than 0.01% of all potentially preventable hospitalisations).

    Numbers for recent years include an estimate of the small number of hospitalisations of NSW residents in interstate public hospitals, data for which were unavailable at the time of production. Further details can be found in the Methods tab in the following HealthStats NSW indicator: http://www.healthstats.nsw.gov.au/Indicator/bod_hos_cat

    LL/UL 95%CI = lower and upper limits of the 95% confidence interval for the point estimate.

  • + Commentary

    Potentially Preventable Hospitalisations (PPH) are those conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management, usually delivered in an ambulatory setting, such as primary health care. 

    The term does not mean that a patient admitted for that condition did not need to be hospitalised at the time of admission. Rather, the hospitalisation may have been prevented by timely and appropriate provision of primary or community-based health care. Reducing hospitalisations might involve vaccination, early diagnosis and treatment, and/or good ongoing management of risk factors and conditions in community settings (see AIHW and Associated Information tab for detailed definition).

    After July 2010, numbers and rates fell, affected by a significant change in coding standards for diabetes, a substantial contributor to total potentially preventable hospitalisations.

    The increase in hospitalisations for vaccine-preventable conditions in 2013-14 and 2014-15 was largely driven by a change in Australian Coding Standards (ACS) for viral hepatitis in July 2013 which resulted in a substantial increase in the number of hospitalisations for different types of viral hepatitis, particularly Hepatitis B in this instance. For more information see Australian Consortium for Classification Development. The increase in hospitalisations for vaccine-preventable conditions was associated with this change and also due to an increase in hospitalisations for influenza and pneumonia.

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  • + Methods
  • + Codes
    • Codes: Potentially preventable hospitalisations

      The International Statistical Classification of Diseases and Related Health Problems

      National Centre for Classification in Health, Australia; AM - Australian Modification
      CategoryICD-10-AMComments
      Vaccine preventable conditions    
      Pneumonia and influenza (vaccine-preventable) J10, J11, J13, J14

      In any diagnosis. Exclude people under 2 months. Rehabilitation records are excluded.

      Other vaccine-preventable conditions A08.0, A35, A36, A37, A80, B01, B05, B06, B16.1, B16.9, B18.0, B18.1, B26, G00.0

      In any diagnosis. Rotaviral Enteritis (A08.0) included for records with separation date 1 July 2007 onwards. Rehabilitation records are excluded.

      Chronic    
      Asthma J45, J46

      As principal diagnosis. Exclude children aged less than 4 years. Rehabilitation records are excluded.

      Congestive cardiac failure I50, I11.0, J81

      As principal diagnosis. Exclude cases with the following cardiac procedure codes: Blocks 600-606, 608-650, 653-657, 660-664, 666, 669-682, 684-691, 693, 705-707, 717 and codes 33172-00[715], 33827-01[733], 34800-00[726], 35412-00[11], 38721-01[733], 90217-02[734], 90215-02[732]. Rehabilitation records are excluded.

      Diabetes complications E10, E11, E13, E14 As principal diagnosis. Rehabilitation records are excluded.
      COPD J20, J41, J42, J43, J44

      J41-J44 as principal diagnosis. J20 as principal diagnosis with additional diagnoses of J41, J42, J43, J44. Rehabilitation records are excluded.

      Bronchiectasis J47, J20

      As principal diagnosis. J20 only with additional diagnosis of J47. Rehabilitation records are excluded.

      Angina I20, I24.0, I24.8, I24.9

      As principal diagnosis. Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category above. Rehabilitation records are excluded.

      Iron deficiency anaemia D50.1, D50.8, D50.9 As principal diagnosis. Rehabilitation records are excluded.
      Hypertension I10, I11.9

      As principal diagnosis.Exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category above. Rehabilitation records are excluded.

      Nutritional deficiencies E40, E41, E42, E43, E55.0, E64.3 As principal diagnosis. Rehabilitation records are excluded.
      Rheumatic heart diseases I00, I01, I02, I05, I06, I07, I08, I09 As principal diagnosis. Rehabilitation records are excluded.
      Acute    
      Pneumonia (not vaccine-preventable) J15.3, J15.4, J15.7, J16.0

      In any diagnosis. Exclude people under 2 months. Rehabilitation records are excluded.

      Urinary tract infections, including pyelonephritis N10, N11, N12, N13.6, N15.1, N15.9, N28.9, N39.0, N39.9 As principal diagnosis. Rehabilitation records are excluded.
      Perforated/bleeding ulcer K25.0, K25.1, K25.2, K25.4, K25.5, K25.6, K26.0, K26.1, K26.2, K26.4, K26.5, K26.6, K27.0, K27.1, K27.2, K27.4, K27.5, K27.6, K28.0, K28.1, K28.2, K28.4, K28.5, K28.6 As principal diagnosis. Rehabilitation records are excluded.
      Cellulitis L02, L03, L04, L08, L88, L98.0, L98.3

      As principal diagnosis. Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure. Rehabilitation records are excluded.

      Pelvic inflammatory disease N70, N73, N74 As principal diagnosis. Rehabilitation records are excluded.
      Ear, nose and throat infections H66, J02, J03, J06, J31.2 As principal diagnosis. Rehabilitation records are excluded.
      Dental conditions K02, K03, K04, K05, K06, K08, K09.8, K09.9, K12, K13, K14.0 As principal diagnosis. Rehabilitation records are excluded.
      Convulsions and epilepsy G40, G41, R56 As principal diagnosis. Rehabilitation records are excluded.
      Eclampsia O15 As principal diagnosis. Rehabilitation records are excluded.
      Gangrene R02, I70.24, E09.52 R02 in any diagnosis. I70.2 and E09.52 as principal diagnosis. Rehabilitation records are excluded.

      Based on National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2017. In HealthStats NSW, ‘In any diagnosis’ uses 51 diagnosis fields.

  • + Related Indicators
  • + Associated Information
    • Key points: Potentially preventable hospitalisations

      • The rate of potentially preventable hospitalisations was 2,141.6 per 100,000 population in 2018-19.

      • Rates of potentially preventable hospitalisations remained stable between 2001-02 and 2009-10, but decreased by about 7% between 2009-10 and 2010-11. This was due to a significant change in coding standards for diabetes, which is a substantial contributor to chronic and total preventable hospitalisations, in July 2010. The change caused a 60% decrease in the number of hospitalisations where diabetes with complications was coded as a principal diagnosis in 2010-11. The trend has been slowly increasing since 2010-11, associated mainly with acute conditions and an increase in hospitalisations for vaccine-preventable conditions in 2013-14 and 2014-15, largely driven by a change in Australian Coding Standards for viral hepatitis in July 2013 and an increase in hospitalisations for influenza and pneumonia in 2014-15 and 2017-18.

      • The age-adjusted rate of admission for potentially preventable hospitalisations for Aboriginal people in 2018-19 was 4,949 per 100,000 population compared with 2,032 per 100,000 population for non-Aboriginal people (2.4 times higher for Aboriginal people). There are a number of reasons why the rate for Aboriginal people has increased in recent years, including a 10% improvement in the reporting of Aboriginal people in NSW hospital data since 2009-10 and the implementation of programs to improve access to health services by Aboriginal people in response to a higher health need.

      • Cellulitis, chronic obstructive pulmonary disease (COPD), urinary tract infections (including pyelonephritis), dental conditions, ear, nose and throat infections and congestive heart failure account for over half of all potentially preventable hospitalisations in NSW.

      • Diabetes with complications was ranked first among individual conditions collectively comprising total potentially preventable hospitalisations in 2009-10. After the change in coding standards in July 2010 diabetes has remained around the ninth ranking since this time.  

      • The rate of potentially preventable hospitalisations increases with geographic remoteness and with increasing disadvantage, a pattern that is consistent over time. These gradients may reflect differences in access to primary health care, differences in the prevalence of disease in population subgroups, as well as urban and rural differences in hospital admission practices. Rates are also consistently higher among Aboriginal people in NSW compared with non-Aboriginal people.

    • Introduction: Potentially preventable hospitalisations

      Potentially preventable hospitalisations

      Potentially preventable hospitalisations (PPH) are included as a national performance indicator in the National Healthcare Agreement. The Australian Commission on Safety and Quality in Health Care is leading a national Potentially Preventable Hospitalisations Working Party to review the evidence for inclusion of each of the PPH conditions. This Working Party includes jurisdictional and clinical representatives and the Secretariat is provided by the Australian Institute of Health and Welfare. 

      Potentially preventable hospitalisation reporting on HealthStats NSW uses the National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2017 definition.

    • Interventions: Potentially preventable hospitalisations

      Potentially preventable hospitalisations for chronic conditions

      The most common chronic conditions defined as potentially preventable hospitalisations or ambulatory care sensitive hospitalisations are included in the NSW Severe Chronic Disease Management Program.

      In response to the Garling Report 2008, the NSW Ministry of Health started implementing the NSW Chronic Disease Management Program. Currently, this program is being overseen by the NSW Agency for Clinical Innovation. It aims to improve the quality of life of older people with chronic and complex conditions, their carers and families and to prevent unplanned and avoidable hospital admissions. It achieves this by coordinating a statewide chronic disease management approach.

      The NSW Chronic Disease Management Program is described at: http://www.health.nsw.gov.au/cdm/pages/default.aspx.

      Potentially preventable hospitalisations for vaccine preventable conditions

      The NSW Immunisation Program provides the community of NSW with protection against vaccine preventable diseases through initiatives targeting infants, children, adolescents, healthcare workers and older people. For more information see: http://www.health.nsw.gov.au/immunisation/pages/default.aspx

    • For more information: Potentially preventable hospitalisations

      Useful websites include:

      Australian Institute for Health and Welfare (AIHW) at http://myhealthycommunities.gov.au/our-reports/

      Australian Bureau of Statistics at http://www.abs.gov.au

      Australian Institute of Health and Welfare at http://www.aihw.gov.au

      healthdirect at http://www.healthdirect.gov.au

Last Updated At: Tuesday, 10 March 2020