NSW Admitted Patient Data Collection and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
COPD= chronic obstructive pulmonary disease.
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.
Numbers for the last year 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_catLL/UL 95%CI = lower and upper limits of the 95% confidence interval for the point estimate. Data for some LHDs may not be included individually due to low numbers. All LHDs include Albury Local Government Area and those LHDs where numbers are low and records where the LHD was missing or not stated.
Local Health Districts (LHDs) are health administrative areas constituted under Section 17 of the NSW Health Services Act, 1997 which became effective from January 2011 and were initially called Local Health Networks.
There are 15 geographically-based LHDs (8 covering the Sydney metropolitan region and 7 rural and regional NSW) and two specialist networks focussing on Children's and Paediatric Services and Forensic Mental Health. A third network operates across the public health services provided by three Sydney facilities operated by St Vincent's Health: these include St Vincent's Hospital and the Sacred Heart Hospice at Darlinghurst and St Joseph’s at Auburn.
LHDs replaced the former Area Health Services and have their own budgets, management and accountabilities. Geographically-based LHDs are overseen by Governing Boards. Please refer to the NSW Health website for a list of Local Health Districts and the membership of Boards.
Local Health Districts are:
Metropolitan NSW: Central Coast, Illawarra Shoalhaven, Nepean Blue Mountains, Northern Sydney, South Eastern Sydney, South Western Sydney, Sydney, Western Sydney.
Rural & regional NSW: Far West, Hunter New England, Mid North Coast, Murrumbidgee, Northern NSW, Southern NSW, Western NSW
The term ‘small area’ refers to a small geographical area or a small population. Data analysed for small areas may result in estimates that display considerable variability from year to year, particularly for rare conditions or events. Smoothing is a general term for statistical methods used to reduce the random variability of data. Examples include rounding, moving averages, extending the period of time in which cases are counted or increasing the size of the areas. In addition, Bayesian statistical smoothing can be used to adjust raw estimates in small areas by taking into account information from adjacent areas (local or spatial variability) and from the whole state (global or non-spatial variability).
In this report, extending the period of time, in which cases in the Local Health Districts are counted, was the most frequently used smoothing technique. Results for some Local Health Districts were completely suppressed in some indicators due to very low numbers and privacy concerns. Please refer to Notes under the graphs or Methods tabs for confirmation of suppression and the smoothing technique used.
NSW Health. Home page. Last updated 1 July 2011. Available at http://www.health.nsw.gov.au/services/pages/default.aspx
Lung cancer is classified with cancers, not with respiratory diseases, in the International Statistical Classification of Diseases and Related Health Problems (ICD-9-CM, ICD-10-AM), which is the main coding system used for health data in NSW.
Consequently, whenever total figures in respiratory disease category (ICD-10-AM: J codes) are stated in this report, lung cancer (ICD-10-AM: C33-C34) is not included. Nevertheless, lung cancer may be shown in graphs and tables among other respiratory diseases, because it is appropriate, from a clinical and health services planning perspective, to include lung cancer together with other respiratory diseases when considering the burden of respiratory disease.
Other cancers of respiratory and intrathoracic organs (ICD-10-AM: C30-C39) are not included in indicators showing respiratory diseases. Infectious and parasitic diseases with respiratory manifestation (for example, tuberculosis, whooping cough and other diseases which can be found in ICD-10-AM: A00-B99) are not included either.
|Description||ICD-10 & ICD-10-AM||Comments|
|Respiratory diseases: Total||J00-J99||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Influenza and pneumonia||J09-J18||All records are included except those involving rehabilitation, NSW residents only, all ages.|
All other acute upper (J00-J06) and lower (J20-J22) respiratory infections
|J00-J06 or J20-J22||All records are included except those involving rehabilitation, NSW residents only, all ages.
|Asthma||J45, J46||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Chronic obstructive pulmonary disease||J40-J44||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Pneumonitis due to food and vomit||J69.0||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Other respiratory diseases principally affecting the interstitium.||J80-J84||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Bronchiectasis||J47||All records are included except those involving rehabilitation, NSW residents only, all ages.|
|Remaining respiratory diseases||J30-J39, J60-J70, J85-J86, J90-J99||All records are included except those involving rehabilitation, NSW residents only, all ages..|
|Cancer: lung. This type is not included in the Total of respiratory diseases.||C33-C34||All records are included except those involving rehabilitation, NSW residents only, all ages.|
Where numbers do not allow reporting of specific diseases, remaining respiratory diseases* also include Other acute respiratory infections, Pneumonitis due to food and vomit, Bronchiectasis and Pneumoconioses
• In 2016 in NSW, 11.3% of adults aged 16 years and over (9.2% of men and 13.3% of women) had asthma currently, as estimated from the 2016 NSW Adult Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). In 2015-2016, 13.8% of boys and 10.4% of girls aged 2-15 years were reported to currently have asthma, with 19.3% of boys and 14.4% of girls reported as ever having asthma, as estimated from the NSW Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). Asthma was responsible for 147 deaths in 2015 and 13,401 hospitalisations in 2016-17.
• Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, was responsible for 2,389 deaths in 2015 in NSW (91% or 2,180 in those aged 65 years and over) and more than 24,005 hospitalisations in 2016-17.
• Asbestosis is a chronic lung disease that is associated with occupational exposure to asbestos. Total hospitalisations due to asbestos in NSW have remained stable in recent years.
Respiratory diseases include acute diseases such as influenza and pneumonia, and chronic respiratory diseases (specifically asthma, chronic obstructive pulmonary disease, asbestosis, and respiratory tuberculosis), where preventive measures and better management of conditions can reduce the burden of disease and reduce associated healthcare costs.
Chronic respiratory diseases were responsible for 8.3% of the total burden of disease and injury in Australia in 2011, with chronic obstructive pulmonary disease and asthma accounting for 43% and 29% of this burden, respectively (AIHW 2016).
Influenza and pneumonia are acute respiratory diseases that can be very severe and, in persons at high risk, can lead to death. Influenza and pneumonia cause around 1.8% of all deaths and around 0.9% of hospital separations and are an important cause of hospitalisations in the very young, and of death and hospitalisations among older age groups.
Asthma is a significant public health problem in Australia and it is estimated that Australian prevalence rates are among the highest in the world. Fortunately, recent studies in children show no further increase in prevalence. In Australia in 2011, asthma was estimated to account for 2.4% of the disease burden (AIHW 2016).
Chronic bronchitis and emphysema are the two main conditions comprising chronic obstructive pulmonary disease (COPD). In Australia in 2011, COPD was estimated to account for 3.6% of the disease burden (AIHW 2016).
Tuberculosis (TB) is caused by the bacterial organism Mycobacterium tuberculosis. Despite the increasing burden from respiratory tuberculosis globally, it is not a major public health problem in NSW. In fact the mortality and morbidity from all types of tuberculosis in NSW is one of the lowest in the world.
Lung cancer is usually excluded from analyses of respiratory diseases as it is classified with cancers in the International Classification of Diseases (the coding system used for health data in NSW). It has been included with respiratory diseases here to provide a more appropriate measure of the burden of respiratory disease from a clinical and health services planning perspective.
Cigarette smoking is the main risk factor for both COPD and lung cancer and the current incidence rates of these conditions reflect smoking rates 20 years and more in the past. Lung cancer is one of the leading causes of death in Australia.
Australian Institute of Health and Welfare 2016. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. BOD 4. Canberra: AIHW. Available at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129555176
Written asthma management plans are recommended as part of the national guidelines for the management of asthma: Australian Asthma Handbook (NACA 2015). They enable people with asthma to recognise a deterioration in their condition and initiate appropriate treatment, thereby reducing the severity of acute episodes.
The Australian Asthma Handbook promotes preventive care activities, proper inhaler technique and adherence and stepped medical management where the use of medicines can be increased or decreased depending on circumstances and the therapy combinations.
The NSW Tuberculosis Program is successful as the incidence of tuberculosis in NSW has remained stable over the last decade despite large-scale migration from high-prevalence countries and the treatment success rates have been high, with the absence of treatment failures and low rates of relapse of cases initially treated in Australia.
The main challenges to the NSW Tuberculosis Program are similar to those that face tuberculosis control globally. They include control of multi-drug resistant and extreme drug-resistant tuberculosis and identification and management of tuberculosis-HIV coinfection (O'Connor et al. 2009).
Influenza and pneumococcal disease are covered by the National Immunisation Programs in NSW.
Influenza has been a notifiable disease by all laboratories under the Public Health Act in NSW since 2001. Surveillance is enhanced in winter months when the NSW Ministry of Health collects and reports weekly on influenza-like illness presentations to Emergency Departments, through the Public Health Rapid, Emergency, Disease and Syndromic Surveillance System (PHREDSS), and laboratory-confirmed diagnoses of influenza virus infections.
Emergency Departments in NSW are prepared for influenza epidemics with peak visit plans and similar measures in winter months.
National Asthma Council Australia. Australian Asthma Handbook. NACA, 2015. Available at: https://www.nationalasthma.org.au/health-professionals/australian-asthma-handbook
O'Connor B, Fritsche L, Christensen A, McAnulty J. EpiReview: Tuberculosis in New South Wales, 2003-2007. NSW Public Health Bulletin, 2009. Available at: www.publish.csiro.au/index.cfm?act=view_file&file_id=NB09001.pdf
Australian Centre for Airways disease Monitoring (ACAM) at http://www.asthmamonitoring.org
National Asthma Council Australia at http://www.nationalasthma.org.au
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