Palliative care services in Australia

Indigenous status

Australia’s Aboriginal and Torres Strait Islander people hold a unique place in the country's society and culture. Accurate, consistent statistics are essential to understanding their wellbeing and developing policies that promote positive social and economic outcomes. Information about Aboriginal and Torres Strait Islander people is collected through self-identification questions, using the ABS Standard Indigenous Question (SIQ), which is widely used by government agencies and organisations (ABS 2014).

The statistical variable "Indigenous status" is recognised as one of the core indicators for measuring cultural and linguistic diversity, endorsed by the Ministerial Council of Immigration and Multicultural Affairs and supported by the Council of Australian Governments. All jurisdictions are required to use the standard ABS Indigenous question in key data collections, as outlined in the National Indigenous Reform Agreement (ABS 2014).

Indigenous status is a measure of whether a person identifies as being of Aboriginal or Torres Strait Islander origin (AIHW 2024). The Indigenous status variable in this report is based on the ABS standard and is used to classify individuals' Indigenous status. It has a hierarchical structure with four detailed categories grouped into two broad categories: Indigenous Australians (Aboriginal, Torres Strait Islander, or both) and Non-Indigenous Australians. Additionally, there is a supplementary category for responses that are 'Not stated/inadequately described,' which is primarily used when data cannot be clearly mapped or when a response is unclear or unavailable (AIHW 2024). For more detailed guidance, refer to the Indigenous status page in ABS website.

The AIHW recommends ‘First Nations' as the preferred term to refer to Aboriginal and Torres Strait Islander people.

Australian Statistical Geographical Standard for Remoteness Areas

The Australian Statistical Geographical Standard for Remoteness Areas (ASGS) was developed by the Australian Bureau of Statistics (ABS) to collect and disseminate geographically classified statistics (ABS 2011; ABS 2016; ABS 2021).

The ASGS’s remoteness structure categorises geographical areas in Australia into five remoteness areas:

• Major cities
• Inner regional
• Outer regional
• Remote
• Very remote.

The Australian Statistical Geography Standard page in ABS website includes detailed information on ASGS, including the key changes made between each edition.

Data on remoteness of geographical location in the National Hospital Morbidity Database (NHMD) are collected based on patients’ usual residential address and in the National Public Hospital Establishments Database (NPHED), this is determined by hospital street address. This release provides hospital data on remoteness using 2022–23 NHMD (ASGS 2021 edition). Further information on the quality of the usual residence of the patient data in the NHMD can be found in National Hospital Morbidity Database (NHMD) Technical appendices/notes 2022–23.

Index of Relative Socio-economic Disadvantage

The Index of Relative Socio-economic Disadvantage (IRSD) is one of four Socio-Economic Indexes for Areas (SEIFA) developed by the ABS (ABS 2018). The IRSD represents the socioeconomic position of Australian communities by measuring aspects of disadvantage, such as low income, low educational attainment, high unemployment, and jobs in relatively unskilled occupations. Areas are then ranked according to their level of disadvantage.

When the IRSD is used in this report, people living in the 20% of areas with the greatest overall level of disadvantage are described as living in the ‘lowest socioeconomic areas’. The 20% of people at the other end of the scale – those living in areas with the least overall level of disadvantage – are described as living in the ‘highest socioeconomic areas’.

It is important to note that the IRSD reflects the overall or average socioeconomic position of the population of an area; it does not show how individuals living in the same area might differ from each other in their socioeconomic position.

Primary Health Network areas

Primary Health Networks (PHNs) are administrative regions established to deliver primary care services and coordinate with local hospitals to enhance the overall efficiency of healthcare delivery (ABS 2022).

PHN can refer to both the organisation that services a defined geographic region, and the geographic region itself. In this report, PHN refers to the geographic region.

Australia has 31 PHN regions which are independent organisations working to streamline health services which closely align with the state and territory local hospital networks (Department of Health and Aged Care 2021). Statistical information in this report is presented using the boundaries of these 31 Primary Health Networks as released by the Department of Health and Aged Care.

Maps of the geographical areas covered by the various Primary Health Networks can be obtained from the Primary Health Networks page in Department of Health and Ageing website.

International Statistical Classification of Diseases and Related Health Problems

The International Statistical Classification of Diseases and Related Health Problems (ICD), which was developed by the World Health Organization (WHO), is the international standard for coding morbidity and mortality statistics. It was designed to promote international comparability in collecting, processing, classifying and presenting these statistics. The ICD is periodically reviewed to reflect changes in clinical and research settings (WHO 2022).

The version currently used in Australia to code causes of death, ICD-10 (WHO 1992), was endorsed in May 1990 and officially came into use in WHO member states from 1994. The 11th revision of the ICD was released in June 2018. Member States will begin reporting health data using ICD-11 in 2022. Read ICD page in WHO website for further information.

ICD-10-AM

Diagnosis, procedure and external cause in hospital data for 2022–23 were reported to the NHMD by all states and territories using the 12th edition of the Australian Modification of ICD-10 (referred to as ICD-10-AM), which was based on ICD-10 (NCCH 2013). ICD-10 was modified for the Australian setting by the National Centre for Classification in Health to make it more relevant to Australian clinical practice. Compatibility with ICD-10 at the higher levels (that is, up to 4-character codes) of the classification has been maintained. ICD-10-AM has been used to classify diagnoses in admitted patient hospital records in all Australian states and territories since 1999–2000 (AIHW 2000).

The ICD-10-AM disease classification is hierarchical; a small number of summary disease chapters are divided into a large number of more specific disease groupings (represented by 3-character codes). Most of the 3-character disease groupings can be divided into an even larger number of very specific disease categories represented by 4- character and 5-character codes (see Table 1 in Technical notes: Disease-related information).