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.

23 June 2014

APNA continues to deliver important and valuable professional development education and networking opportunities nationally.

Last week in Adelaide, I had the pleasure of co-facilitating the 4th in a series of APNA Continuing Education Workshops for Nurses in General Practice. I am very proud as a South Aussie to have co facilitated this with the APNA team and with an amazing attendance of more than 70 nurses.  For further workshops nationally see APNA NiGP Workshops 2014.

One of the many highlights was a keynote presentation on Lifestyle and Weight Management from Dr Rick Kausman, author of If not dieting, then what? Dr Rick Kausman, a medical doctor based in Melbourne, is recognised as the Australian pioneer of the person-centred approach to wellbeing and healthy weight management. He has many years of experience in the field of weight management and offering training to health professionals throughout Australia and overseas.

Rick’s presentation for me, brought a breath of fresh insight into how we work with our communities around healthy eating. Rick’s presentation was at times confronting when we realise the damage we as health professionals can do to people who struggle with healthy weight management, when we have such opportunity to instead encourage our clients to be the healthiest they can be, and as a result of that, achieve and maintain a healthy, comfortable weight for them without being deprived of food or losing quality of life. To enjoy food without feeling guilty, see If not dieting.

Another highlight was keynote Dr Rob Grenfell, a GP and Public Health Physician and the National Director, Cardiovascular Health at the Heart Foundation. See Heart Foundation Professionals Information. Rob leads the Cardiovascular Health Team which includes the full spectrum of heart health activities from prevention to clinical care.

Rob entertained us with his many anecdotes, all of which demonstrated the importance of the team approach to heart health in general practice and the rising evidence of nurses as leaders in cardiovascular disease management in primary care. Rob also spoke of the imperative and responsibility we have to adopt evidence based practice for prevention of cardiovascular disease.
By the end of both of these presentations many of us wanted to work with these very enlightened and entertaining doctors who truly understood the value of working collaboratively in teams, with nurses leading health improvement for their identified communities.

Networking was paramount and much conversation was had with the delightful Peter Larter refreshing us with innovative ways to support our work using MBS and the PNIP.  Peter is a Health Economist and a long term supporter of nurses working in General Practice and primary health care and shed new light on creative use of business cases to further enable nurse led delivery of care and coordination.

We also had many wonderful presentations from many local nurse leaders around CKD, compression therapy, diabetes, immunisation, travel health, COPD and Asthma.

The two days finished up with a wonderful Q&A session led by Samantha Moses “The progress of nursing in Australian general practice”. Sam is a Registered Nurse, Nurse Consultant for APNA and Primary Healthcare Consultant with over 20 years’ experience in primary health care.  Sam was the founder and inaugural president of the Australian Practice Nurses Association and remains committed to advancing the role of the primary care nurse in Australia.  APNA is thrilled and delighted to be able to share Sam’s passion, skill, knowledge and experience with its members and thanks Sam for her ongoing commitment to APNA and PHC nurses.

I recommend if you haven’t attended one of the APNA Continuing Education Workshops please consider registering, and please watch APNA’s enews and website for more exciting face to face and online opportunities throughout 2014-15. www.apna.asn.au 

Your thoughts are very welcome at president@apna.asn.au.