In 2014-2015 almost half (47 per cent) of the potentially preventable hospitalisations (PPH) in Australia were due to chronic obstructive pulmonary disease (COPD), heart failure, cellulitis, kidney and urinary tract infections (UTI), and diabetes complications. When comparing Queensland to the other states and territories, Queensland has the second highest rates for all five PPHs. While some variation in care is expected, do you think this is reasonable?
Understanding the underlying reasons for marked differences is critical to improving the quality, value and appropriateness of care.
The Second Australian Atlas of Healthcare Variation reports substantial variation in healthcare delivered between local areas. In Queensland, variation was greatest for diabetes complications (approximately 12-fold difference), COPD and cellulitis (approximately 10-fold difference for both). Rates of hospitalisation for heart failure and UTIs varied four-fold and three-fold respectively.
Variation in healthcare is well documented and while some variation is expected and can be a good thing, the Australian Commission on Safety and Quality in Health Care suggests some of it may be unwarranted. Where is variation occurring in Queensland and why is it happening? What is the relationship between variation, quality and healthcare outcomes? If clinical decisions are a key driver of healthcare variation, how should we respond to improve the quality of care we provide? These were the questions examined at the November 30 and December 1 Clinical Senate meeting.