New Atlas plots variation in healthcare across Australia

On 26 November the Australian Commission on Safety and Quality in Health Care (ACSQHC) launched the first Australian Atlas of Healthcare Variation (see here). The Atlas highlights the variation in healthcare provision across Australia, and importantly highlights the potential overuse of procedures, medication and interventions.

Key highlights of the Atlas are as follows:

  1. Antimicrobial dispensing – significant variation across the country, with the highest rate of total antimicrobial dispensing (Campbelltown, NSW) being almost 12 times more than the area with the lowest rate (Tiwi Islands/ West Arnhem). WA stands out as being more successful than other parts of the country in keeping rates of antimicrobial dispensing relatively low. Internationally, Australia has a very high rate of antimicrobial dispensing (more than twice the rates of the Netherlands for instance)
  2. Diagnostic interventions – wide variation of particular interventions across the country (an example being colonoscopies where the highest rate was 30 times that of the lowest).
  3. Surgical interventions – wide variation across the country (for example women living in regional areas of Australia were over five times more likely to undergo a hysterectomy or endometrial ablation than those living in metropolitan areas)
  4. Interventions for mental health and psychotropic medicines – the greatest variation was seen in in dispensing of prescriptions for psychotropic medicines for those aged 17 years and under (for example the number of prescriptions for attention deficit hyperactivity disorder (ADHD) medicines in the area with the highest rate was 75 times more than in the area with the lowest rate)
  5. Opioid medicines – a wide variety of rates of prescriptions for opioids across the country (the number of prescriptions dispensed was more than 10 times higher in the area with the highest rate compared to the area with the lowest rate)
  6. Interventions for chronic diseases – reflective of the generally poorer health status of indigenous Australians, hospital admission rates for asthma, COPD, heart failure and diabetes-related amputations were markedly higher in remote areas of Australia.

What variations in healthcare provision have you seen or experienced? We would love to know.

Mental health of young people

On 7 August 2015, the Minister for Health, the Hon Sussan Ley MP, released The Mental Health of Children and Adolescents, a report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The report, described as the largest ever national survey of youth mental health of its kind in Australian history, follows on from the first national survey of the mental health of children and adolescent which was undertaken 17 years ago.

Some key highlights of the report are set out below:

  • One in seven children and young people experienced a mental disorder in the previous 12 months – the equivalent of 560,000 young Australians
  • Attention deficit hyperactivity disorder (ADHD) was the most common mental disorder in children and adolescents
  • Just over one third (35%) of 4-17 year-olds with a mental disorder had seen a general practitioner in the past 12 months
  • Schools provided services to 40.2% of the children and adolescents with mental disorders who attended them, and 5.6% had seen a school nurse
  • Around one in 10 12-17 year-olds (10.9%) reported having ever self-harmed
  • Females aged 16-17 years had the highest rates of self-harm, with 16.8% having harmed themselves in the previous 12 months
  • About one in thirteen (7.5%) 12-17 year olds had seriously considered attempting suicide in the previous 12 months.

While some of the information contained in the report is concerning, there are a number of positives, such as the large increase in the number of young people seeking help.

What is your experience of dealing with young people with mental health issues? Do you think there are adequate processes in place to identify mental disorders and provide the care and support needed?