Introduction
Primary and community health care is usually a person’s first encounter with the health system, and includes a range of activities and services, from health promotion and prevention, to management and treatment of acute and chronic conditions. Currently, few data sources measure the impact of this sector on the health of Australians (AIHW 2019).
What are potentially preventable hospitalisations (PPH)?
Potentially preventable hospitalisations (PPH) are used as a measure of access to timely, effective and appropriate primary and community health care.
PPH are specific hospital admissions that could potentially have been avoided through preventative health interventions (such as vaccination), or appropriate individualised disease management (such as treatment of infections or management of chronic conditions) in the community.
Classifying a hospitalisation as “potentially preventable” does not mean that the hospitalisation itself was unnecessary, it means that optimal management at an earlier stage might have prevented the patient’s condition worsening to the point where they needed hospitalisation.
PPH are grouped into three broad categories: Vaccine-preventable, Acute and Chronic conditions.
How might hospitalisations be prevented?
Primary health care interventions that can help people avoid hospitalisation for some conditions include:
- reducing and managing risk factors for disease
- vaccination
- oral health checks
- sexual health checks
- antenatal care
- diagnosis and prescribing to manage infections
- lifestyle interventions to reduce the development of chronic conditions
- management of chronic conditions to slow progression and risk of complications, including support for self-management
This care is usually delivered by general practitioners, medical specialists, dentists, nurses and allied health professionals and may be accessed through a variety of community settings, including Aboriginal and Community Controlled Health Services.
What factors affect PPH other than primary care?
PPH are a useful tool for identifying and investigating variation in health outcomes between different populations.
It is important not to assume that higher rates of PPH always indicate a less effective primary care system. There are other reasons why an area or group of people may have higher rates of PPH—including higher rates of disease, lifestyle factors and other risks, as well as a genuine need for hospital services.
Some PPH may not be avoidable, such as those for chronically ill or elderly patients who have received optimum primary care, or procedures such as tonsillectomies that are an appropriate follow-up to primary care.
Changes in hospital coding standards, admission policies and clinical practices can artificially affect PPH rates—conditions known to be impacted include hepatitis B, iron deficiency anaemia, angina and some conditions requiring rehabilitation care.
These factors need to be considered when looking at PPH data.
More information on these factors is in the PDF report, Disparities in potentially preventable hospitalisations across Australia, 2012–13 to 2017–18. The PDF report explores disparities in PPH between populations and provides information to help users interpret PPH data.
A summary of findings is available in the fact sheet.
References
AIHW (Australian Institute of Health and Welfare) 2019. Developing a National Primary Health Care Data Asset: consultation report. Cat. no. PHC 1. Canberra: AIHW.