Introduction
What are potentially preventable hospitalisations?
Potentially preventable hospitalisations (PPH) are hospital admissions for specific conditions that could potentially be avoided through timely and effective primary care, early disease management, or public health interventions. The rate of PPH is a proxy measure of the effectiveness of health care in the community, as higher rates may suggest a lack of timely, accessible, and adequate primary care. PPH can highlight gaps in health-care access and quality, particularly in under-served populations and regions.
The term 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 preventative health interventions and early disease management in primary care and community-based care settings (including by general practitioners, medical specialists, dentists, nurses and allied health professionals). Some PPH may not be avoidable, such as those for patients with complex illness, or patients having procedures as follow-up to primary care.
What conditions are considered?
In Australia, potentially preventable hospitalisations (PPH) are defined under the National Healthcare Agreement 2024, covering 22 conditions across three categories: acute, vaccine-preventable and chronic.
Acute conditions are 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. Acute conditions include cellulitis, convulsions and epilepsy, dental conditions, ear, nose and throat infections, eclampsia, gangrene, pelvic inflammatory disease, perforated/bleeding ulcer, pneumonia (not vaccine-preventable), urinary tract infections (including kidney infections).
Vaccine-preventable conditions are hospitalisations due to conditions that can be prevented by vaccination. Vaccine preventable conditions include pneumonia and influenza (vaccine-preventable), and other vaccine preventable conditions. 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).
Chronic conditions are 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. Chronic conditions include angina, asthma, bronchiectasis, chronic obstructive pulmonary disease, congestive cardiac failure, diabetes complications, hypertension, iron deficiency anaemia, nutritional deficiencies and rheumatic heart diseases.
How are spending estimates derived?
Potentially preventable hospitalisation (PPH) estimates in this report are estimated from the Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database (NHMD) for financial years 2014–15 to 2023–24 and includes all public and private hospitalisations across Australia. PPH separations are identified using the National Healthcare Agreement 2024 definitions. Costs associated with each hospital separation are derived from the AIHW Disease Expenditure database. In this database, costs are estimated for each hospital separation in the NHMD based on the estimated National Weighted Activity Units (NWAU) for each separation, the national efficient price, and scaled to total hospital spending from the AIHW Health expenditure Australia database. Further details on methods are available in the technical notes.