Potentially preventable hospitalisations in Australia by small geographic areas: 2017–18 to 2023–24

Hospital separations for the selected conditions presented in this report are considered to be ‘potentially preventable hospitalisations’ (PPH) as they are amenable in some circumstances to primary and community care interventions. These conditions reflect the National Healthcare Agreement: Performance Indicator 18-Selected potentially preventable hospitalisations, 2024 and are categorised as:

• acute (conditions that usually come on suddenly, and may not be preventable, but may not result in hospitalisation if timely and adequate care had been received in the community)
• vaccine-preventable (hospitalisations due to conditions that can be prevented by vaccination)
• chronic (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).

Primary and community health care – for example, care from a general practitioner or community health nurse – can effectively manage and treat many health conditions. Primary care provides an opportunity for early intervention, that can help to reduce the risk of a person developing a disease, their symptoms worsening, or complications developing.

If this care is not available or accessed, a person may need hospital care that could potentially have been avoided. A specific set of these hospital separations are known as PPH (see Box 1).

PPH can tell us about the effectiveness of health care in the community. Higher rates may suggest a lack of timely, accessible, and adequate primary care.

However, there are many 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, or a genuine need for hospital services. Some PPH may not be avoidable, such as for patients with complex illness, or patients having procedures as follow-up to primary care.

It is important not to assume that higher rates of PPH always indicate a less effective primary care system. PPH is a useful tool for identifying and investigating variation between different groups of people to better understand health inequalities. PPH can help guide research about how different groups access health services, including possible barriers and areas of unmet demand.

Data in this report are based on where people lived, not the location of the hospital they were admitted to. Data are presented for 2017–18 to 2023–24, across 4 geographic areas: Remoteness Areas (RA), Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD), Primary Health Networks (PHNs) and Statistical Area Level 3 (SA3). Detailed data for these areas can be found in the data tables.

The data in this report are based on the 2021 Australian Statistical Geography Standard and 2023 Primary Health Network boundaries and are not comparable to previous releases.

How common are potentially preventable hospitalisations?

In 2023–24, around 1 in 16 hospitalisations (6.2% or 778,000) were classified as PPH. These accounted for around 1 in 11 hospital bed days (9.0% or 3.1 million).

How have potentially preventable hospitalisations changed over time?

Between 2017–18 and 2021–22, rates of PPH decreased from 2,800 per 100,000 people to 2,300 per 100,000, before increasing to 2,600 per 100,000 in 2023–24 (Figure 1).

The decrease in rates of PPH between 2017–18 and 2021–22 was largely from a decrease in vaccine-preventable hospitalisations, particularly pneumonia and influenza (vaccine-preventable), and chronic conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD). The decreases for these conditions coincided with ongoing public health measures from the COVID-19 pandemic.

For more information about admitted patient hospitalisations, including the impact of COVID-19 on admitted patient activity, see Hospitals: Admitted patients. Additionally for more information on the indirect and direct effects of COVID-19 in Australia, see AIHW (2021).

How do potentially preventable hospitalisations vary across socioeconomic and remoteness areas?

This report is based on where people lived, not the location of hospital. People can attend a hospital outside their area. Hospitalisations, including PPHs, vary depending on the remoteness and socioeconomic disadvantage of where people live.

The rates of PPH increased with increasing disadvantage. People living in the highest socioeconomic areas (5 – highest) had an age-standardised rate of 2,000 potentially preventable hospitalisations per 1,000,000 people in 2023–24. The rate was 1.7 times higher for people living in the lowest socioeconomic areas (1 – lowest) (Figure 2). The difference between people living in the lowest and the highest socioeconomic areas was stable over time.

Rates of PPH were consistently higher for people living in Remote and Very remote areas than those living in other regions between 2017–18 and 2023–24 (Figure 3). People living in Remote and Very remote areas consistently had around twice the rate of PPH compared to people living in Major cities.

How do potentially preventable hospitalisations vary across Primary Health Networks?

Since 2017–18, people living in regional Primary Health Network (PHN) areas had higher rates of PPH than people living in metropolitan PHN areas (Figure 4).

There was considerable variation across the individual PHNs (Figure 5). In 2023–24, rates of PPH were highest in the Northern Territory (5,900 hospitalisations per 100,000 people) and lowest in Northern Sydney (1,800 hospitalisations per 100,000 people).

For detailed data at the PHN area level, refer to the data tab. For details about the geographical areas and groupings included in this report refer to the technical notes.

For more information about PHNs, including what they are, what they do and a map of their boundaries, see Primary Health Networks.

How do potentially preventable hospitalisations vary across Statistical Areas Level 3 (SA3)?

There was considerable variation across the individual SA3s (Figure 6). In 2023–24, rates of PPH were highest in Alice Springs (9,700 hospitalisations per 100,000 people) and lowest in Southern Highlands (1,500 hospitalisations per 100,000 people).

For detailed data at the Statistical Area Level 3 (SA3), refer to the data tab. For details about the geographical areas and groupings included in this report refer to the technical notes.