NSW Admitted Patient Data Collection and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
The 'Remaining respiratory diseases' category include respiratory diseases, such as asbestosis, silicosis, pleural diseases, abscesses, pulmonary oedema and others.
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 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
A recent policy change (PD2017_015) resulted in patients treated solely within the emergency department being excluded from this indicator report. 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.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.
LL/UL 95%CI = lower and upper limits of the 95% confidence interval for the point estimate.
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.
Episodes that are entirely within an emergency department are excluded.
Episodes that are entirely within an emergency department are excluded.
|Influenza and pneumonia||J09-J18|
All other acute upper (J00-J06) and lower (J20-J22) respiratory infections
|J00-J06 or J20-J22|
|Chronic obstructive pulmonary disease||J40-J44|
|Lung dust disease||J60-J67|
|Remaining respiratory diseases||J07, J08, J19, J23-J39, J47-J59, J68-J99|
|Cancer: lung. This type is not included in the Total of respiratory diseases.||C33-C34|
Where small numbers do not allow reporting of hospitalisations for lung dust disease, these are included in remaining respiratory diseases
• In 2018 in NSW, 10.5% of adults aged 16 years and over (9.0% of men and 12.9% of women) had asthma currently, as estimated from the 2018 NSW Adult Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). In 2016-2017, 14.5% of boys and 11.1% of girls aged 2-15 years were reported to currently have asthma, with 21.7% of boys and 17.2% 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 165 deaths in 2017 and 10,880 hospitalisations in 2017-18.
• Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, was responsible for 2,564 deaths in 2017 in NSW (91% or 2,332 in those aged 65 years and over) and more than 22,720 hospitalisations in 2017-18.
• Asbestosis is a chronic lung dust disease that is associated with occupational exposure to asbestos. Total hospitalisations due to asbestos in NSW have steadily decreased 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 7.5% of the total burden of disease and injury in Australia in 2015, with chronic obstructive pulmonary disease and asthma accounting for 51.4% and 33.8% of this burden, respectively (AIHW 2019).
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 2.5% 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 2015, asthma was estimated to account for 2.5% of the disease burden (AIHW 2019).
Chronic bronchitis and emphysema are the two main conditions comprising chronic obstructive pulmonary disease (COPD). In Australia in 2015, COPD was estimated to account for 3.9% of the disease burden (AIHW 2019).
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 2019. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015. Australian Burden of Disease Study series no. 19. BOD 22. Canberra: AIHW. Available at: https://www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015/contents/table-of-contents
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.
Australia is fortunate in having one of the lowest rates of TB in the world. This has been primarily achieved as a result of a continued commitment to provide specialised health services dedicated to the prevention and control of TB in each of the states and territories. The National TB Advisory Committee’s Strategic Plan for the Control of Tuberculosis, 2011-2015 sets out the goals and objectives of TB control in Australia.
Despite Australia’s success in reducing TB, there is no room for complacency. Global connectivity through air travel and migration means that TB will remain a public health concern in Australia until worldwide control of TB is achieved. The NSW TB Program is the provider of specialised services for the prevention and control of TB in NSW and plays a vital role in maintaining Australia’s success in reducing the burden of TB.
Influenza and pneumonia
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
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