Use of hospitals and homelessness services by refugees and humanitarian entrants

In 2020–21, around 1 in 14 hospitalisations (7.2%) in humanitarian entrants were for conditions classified as potentially preventable. This was compared with 1 in 21 hospitalisations (4.8%) in other permanent migrants.

Compared with published data the rate of potentially preventable hospitalisations (PPH) in humanitarian entrants in 2020–21 was lower than the overall rate in the general Australian population (AIHW 2022).

When examining the proportion of PPH with at least one diagnosis in the cause category, in 2020–21, in comparison with other permanent migrants, humanitarian entrants had a higher proportion of PPH that were classified as vaccine preventable, a lower proportion of PPH classified as chronic, and a similar proportion of PPH classified as acute (Table 4).

The numbers of PPH for vaccine-preventable conditions were lower in the 2020–21 financial year amongst both humanitarian entrants and other permanent migrants compared to earlier years. This is due to drops in the rates of pneumonia and influenza-related hospitalisations during this period which may have been influenced by the coinciding public health measures instigated in response to the COVID-19 pandemic (AIHW 2024).

Source: Refugee health linked data set

Notes:

1. Denominator is the total number of potentially preventable hospitalisations.
2. This does not include hospitalisations which occurred in WA or NT or for people living in WA or NT.
3. Hospitalisations are grouped into the categories presented in this table as per the description of the indicator National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2021 (METEOR identifier: 725793). Not all hospitalisations with the described diagnosis are considered potentially preventable, only those which meet the criteria outlined in the indicator description. 
4. Other chronic conditions includes bronchiectasis, hypertension, nutritional deficiencies and rheumatic heart disease. 
5. Othe acute conditions includes pneumonia (not vaccine-preventable), perforated/bleeding ulcer, cellulitis, pelvic inflammatory disease, eclampsia and gangrene.
6.  The total number of hospitalisations in each category may not equal the total within a group or the total overall as one potentially preventable hospitalisations can encompass more than one potentially preventable condition.
7. COVID-19 is not included in the definition of potentially preventable hospitalisation.
8. This analysis includes all ages unless otherwise prescribed in the indicator description.

The most common cause of PPH in humanitarian entrants in 2020–21 was other vaccine-preventable conditions, followed by iron deficiency/anaemia and urinary tract infections. These were also the top three causes of PPH in other permanent migrants, with iron deficiency anaemia being the most common. This differs from the general Australian population where dental conditions are the most common cause of PPH, followed by urinary tract infections (AIHW 2022).

Other vaccine-preventable conditions include chicken pox (varicella), diphtheria, haemophilus meningitis, hepatitis B, German measles (rubella), measles, mumps, polio, rotavirus, tetanus and whooping cough (pertussis) but does not include COVID-19.

The COVID-19 pandemic impacted health service access, use and delivery, especially in New South Wales, Victoria and the Australian Capital Territory which had extensive lockdowns restricting services throughout this period (AIHW 2024). This may have impacted access to primary health care and admitted patient care activity, and by extension impacted PPHs. For more detail on the impact of COVID-19 on health care service utilisation see Australia's Heath 2024: COVID-19.