Can preventing hospital admissions help reduce health costs?

Data from the Australian Institute of Health and Welfare (AIHW) shows:

  • hospitalisation for preventable illness rising
  • greater incidence of preventable hospitalisation in the public system
  • significant incidence of preventable hospitalisation among older Australians
  • hospitalisation for vaccine preventable conditions such as influenza is increasing rapidly.

What’s so interesting about Potentially Preventable Hospitalisations (PPH)?

PPH are hospital admissions that potentially could have been prevented by timely and adequate health care in the community. Twenty-two conditions are considered potentially preventable across three broad categories: chronic, acute and vaccine-preventable conditions.

  • Chronic conditions include asthma, congestive cardiac failure, diabetes, COPD, angina, iron deficiency anaemia, hypertension, nutritional deficiencies and rheumatic heart disease.
  • Acute conditions include dehydration/gastroenteritis, pyelonephritis, perforated/bleeding ulcers, cellulitis, pelvic inflammatory disease, ear nose and throat infections, dental conditions, appendicitis with generalised peritonitis, convulsions and epilepsy, and gangrene.
  • Vaccine-preventable conditions include influenza, certain types of bacterial pneumonia, tetanus, diphtheria, whooping cough, measles, mumps, rubella, certain types of bacterial meningitis, hepatitis B and polio.

PPH is one of the indicators used in the National Health Performance Framework (NHPF) to help health professionals understand the accessibility and effectiveness of the health system.

How are we doing?

According to the AIHW data, there was a total of 748,000 PPH across Australia in 2017-18, accounting for a total of 2,972,878 bed days that were potentially preventable. By comparison there were 715,000 PPH in 2016-17, accounting for 2.8 million bed days.

With hospital admissions numbering 11.3 million in 2017-18, preventable hospitalisations made up around 6.6 per cent of hospital admissions, a rise from 6.5 per cent in 2016-17.

The proportion of PPH in public hospitals was much higher than in private – with public hospitals experiencing 8.6 per cent of admissions as PPH compared to only 3.7 per cent for private.

While all PPH admissions aren’t entirely preventable, it might indicate that some people are not getting the right treatment in the primary care system, leading them to enter acute hospital care, costing the public purse more than if they were treated earlier.

This has important ramifications for the efficiency of the hospital system, so it’s important that all governments work together to ensure that people get the care they need before things escalate.

Preventing hospitalisation in older people

Of those that were hospitalised for potentially preventable illnesses, 345,835 or 46.2 per cent were people aged 65 and over. This is despite only making up roughly 15 per cent of the total population.

There is ongoing debate about whether hospital admissions are truly preventable in the older population, which is understandable given that older people have more chronic health conditions and are susceptibile to illness, which can precipitate hospital admission.

Regardless, the high incidence of older Australians admitted to hospital for potentially preventable illnesses suggests more could be done to assist older people in the primary health care system.

One example is the need for greater access to GPs in aged care to avoid hospital admissions for preventable illness as a result of neglect.

The rising tide of vaccine preventable hospitalisation

The largest increase in PPH is in the category of vaccine preventable conditions.

Between 2016–17 and 2017–18, Vaccine preventable hospitalisations rose by 46.5 per cent. According to the Admitted patient care 2017–18 report, this reflects large increases in admissions for Pneumonia and vaccine-preventable influenza in most states and territories.

Data for people aged 65 and over, shows there were 40,649 PPH which were vaccine preventable.

It also shows that the rate of PPH per 100,000 of the population aged 65 and over was more than four times that of the population under 65 for vaccine preventable PPH.

Not surprisingly, a significant proportion of vaccine preventable hospitalisations were related to pneumonia and influenza.

Reducing barriers to health care

National Seniors is continuing to fight for your health rights.

With your support, we will continue to campaign for a reduction in out-of-pocket health care costs as we know that this is a barrier to accessing timely primary health care and preventing unnecessary hospitalisation.

Read more about the campaign.

We are also fighting for basic dental for pensioners through our Fix Pension Poverty campaign, which is one of the conditions leading to PPH.

Learn more here.

If you would like to find out more about our current campaigns and how you can help, visit the advocacy page on our website.

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