Recognising potential for preventing hospitalisation

To identify the incidence and distribution of public hospital admissions in South Australia that could potentially be prevented with appropriate use of primary care services, analysis was completed of all public hospital separations from July 2006 to June 2008 in SA. This included those classified as potentially preventable using the Australian Institute of Health and Welfare criteria for selected potentially preventable hospitalisations (SPPH), by events and by individual, with statistical local area geocoding and allocation of relative socioeconomic disadvantage quintile. A total of 744 723 public hospital separations were recorded, of which 79 424 (10.7%) were classified as potentially preventable. Of these, 59% were for chronic conditions, and 29% were derived from the bottom socioeconomic status (SES) quintile. Individuals in the lowest SES quintile were 2.5 times more likely to be admitted for a potentially preventable condition than those from the top SES quintile. Older individuals, males, those in the most disadvantaged quintiles, non-metropolitan areas and Indigenous people were more likely to have more than one preventable admission. People living in more disadvantaged areas in SA appear to have poorer utilisation of effective primary care, resulting in preventable hospital admissions, than those in higher SES groups. The SA Health Care Plan, 2007–2016 is aimed at investing in improved access to primary care in those areas of most disadvantage. The inclusion of SPPHs in future routine reporting should identify if this has occurred. What is known about the topic? Ambulatory care sensitive conditions, or selected potentially preventable hospitalisation separations (SPPH), are an indicator of the availability and effectiveness of primary health care. SPPHs are increasingly reported by area level disadvantage. What does this paper add? This paper offers analysis by individuals. It shows around three-quarters of individuals had one potentially preventable public hospital separation. The rate among those living in the most disadvantaged areas was more than twice that of lowest disadvantage areas. What are the implications for practitioners? Realising the potential for preventing potentially avoidable hospitalisation may involve focus on particular target areas and subpopulations. Potentially preventable separations by area of disadvantage can assist with monitoring performance and evaluating policy and program initiatives. Analysis by numbers of individuals will enhance this further.