Spending on potentially preventable hospitalisations by Indigenous status

Health equity requires health resources to be distributed to reflect differing levels of need among populations, to ensure that everyone has equal opportunities to be healthy. Inequalities in health outcomes can be due to inadequate access to health-care, social and economic disadvantage, or exposure to unhealthy living conditions. Systemic barriers to accessing culturally safe and timely primary care contribute to disproportionately higher rates of both disease burden and health-care expenditure among Aboriginal and Torres Strait Islander (First Nations) people compared to the non-Indigenous population. Measuring potentially preventable hospitalisations (PPH) can indicate where there are potential inequities in primary care as well as reflect different patterns of disease burden.

Key findings:

In 2023–24:

  • there were 58,385 PPH admissions among First Nations people, and $797 million in expenditure on PPH.
  • age-standardised rate of PPH was higher among First Nations people (68 per 1,000) than non-Indigenous Australians (25 per 1,000), contributing to higher per person expenditure ($774 and $268 respectively).
  • average LOS was shorter for First Nations people (3.7 days) than non-Indigenous Australians (4.0).
  • the percent of total PPH spending due to acute conditions was similar for First Nations people and non-Indigenous Australians (34.3% and 37.9%), though chronic conditions were lower (40.1% and 45.6%) and vaccine preventable conditions higher (23.0% and 13.5%) for First Nations Australians compared to non-Indigenous Australians.
  • for First Nations people, diabetes complications, vaccine preventable conditions, and COPD were the PPH conditions with highest spending. For non-Indigenous Australians, these were diabetes complications, congestive cardiac failure, pneumonia and influenza, (vaccine-preventable) and COPD (Figure 8).
  • the proportion of PPH expenditure was higher for First Nations females (53.2%) than non-Indigenous females (46.3%).
  • PPH expenditure occurs at younger ages for First Nations people. PPH spending on those aged 65 and over was 18.0% of total PPH spending for First Nations people, and 54.5% for non-Indigenous Australians.

From 2016–17 to 2023–24:

  • PPH admissions in First Nations people increased by almost 35%, while overall spending increased in real terms by 69.2%.
  • per person expenditure on PPH increased by 24.4% from $622 to $774 for First Nations people.
  • per person spending on vaccine-preventable pneumonia and influenza conditions doubled, while that of diabetes complications and hypertensions increased by around 60% for First Nations people (Figure 9).

Figure 8: Summary of measures by PPH category and conditions, and Indigenous status, 2014–15 to 2023–24

The line graph shows annual spending, hospitalisation numbers, crude rates, age-standardised rates and cost per bed day for potentially preventable hospitalisations. Data is grouped by category, condition and Indigenous status. Among hospitalisations for First Nations peoples, spending was highest for diabetes complications, vaccine-preventable conditions and chronic obstructive pulmonary disease (COPD). Among hospitalisations for non-Indigenous Australians, spending was highest for diabetes complications, congestive cardiac failure, pneumonia and influenza (vaccine-preventable), and COPD.

The line graph shows annual spending, hospitalisation numbers, crude rates, age-standardised rates and cost per bed day for potentially preventable hospitalisations. Data is grouped by category, condition and Indigenous status. Among hospitalisations for First Nations peoples, spending was highest for diabetes complications, vaccine-preventable conditions and chronic obstructive pulmonary disease (COPD). Among hospitalisations for non-Indigenous Australians, spending was highest for diabetes complications, congestive cardiac failure, pneumonia and influenza (vaccine-preventable), and COPD.

Figure 9: Summary of measures, PPH category and conditions, Indigenous status, age groups and sex, 2014-15 to 2023–24

The data visualisation shows two population pyramids for potentially preventable hospitalisations from 2016–17 to 2023–24. One pyramid represents First Nations people, and the other represents non-Indigenous Australians. Each pyramid displays measures by category, condition, Indigenous status, age and sex. Hospitalisation expenditure was higher for First Nations females than for non-Indigenous females. For First Nations peoples, most spending was for those aged under 65. Spending on people aged 65 and over made up almost 20 per cent of total expenditure for First Nations peoples, compared with more than 50 per cent for non-Indigenous Australians.

The data visualisation shows two population pyramids for potentially preventable hospitalisations from 2016–17 to 2023–24. One pyramid represents First Nations people, and the other represents non-Indigenous Australians. Each pyramid displays measures by category, condition, Indigenous status, age and sex. Hospitalisation expenditure was higher for First Nations females than for non-Indigenous females. For First Nations peoples, most spending was for those aged under 65. Spending on people aged 65 and over made up almost 20 per cent of total expenditure for First Nations peoples, compared with more than 50 per cent for non-Indigenous Australians.
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