Notes on the data: Hospital admissions

Same-day admissions for dialysis for kidney disease, 2020/21

Policy context: Between July 2015 and June 2017, the leading cause of hospitalisation for Indigenous Australians was care involving dialysis (461,806 hospitalisations), which accounted for 46% of all hospitalisations for Indigenous Australians. The rate of care involving dialysis for Indigenous Australians was 11 times the rate of non-Indigenous Australians, who were admitted for dialysis at 13 times the rate for other Australians in 2016-17 [1]. In 2016/17, same-day admissions for dialysis represented 76% of all same-day admissions for Indigenous Australians, however when excluding separations for dialysis, Indigenous Australians had lower same-day separation rates than other Australians in New South Wales, Queensland, Western Australia and South Australia.

References

Australian Institute of Health and Welfare (AIHW). Available at https://www.indigenoushpf.gov.au/measures/1-02-top-reasons-hospitalisation; last viewed 22 June 2021

Notes:

Introduction

The data presented are of the number of same-day admissions for dialysis for kidney disease, including both haemodialysis and peritoneal dialysis, International Classification of Disease (ICD-10-AM) codes Z49.1 and Z49.2. There are two main types of dialysis: peritoneal, which occurs inside the body and can be performed almost anywhere, usually in the home setting; and haemodialysis, which occurs outside the body and is most often conducted in a hospital or satellite setting. The reason for presenting these data separately from overnight admissions is that they represent many repeat visits by a relatively small number of patients, who may have multiple admissions in a week. Their inclusion with other (overnight) admissions can dramatically alter the geographic distribution of these other categories of admissions. This is particularly evident in regional and remote areas, where dialysis facilities are located, and where those using them may have moved to live to be near the facility.

Confidentiality of data

Counts of fewer than five admissions have been suppressed.

Data were not available for private dialysis units in Queensland, Tasmania, the Northern Territory or the Australian Capital Territory, to protect the confidentiality of the small number of private facilities in these jurisdictions. As a result, where data are published for public dialysis units and all dialysis units, the ‘all units’ data for these jurisdictions have also been confidentialised, as their publication would allow identification of the confidentialised private dialysis units. The ‘all units’ data in other jurisdictions have also been confidentialised where publication of public and all units data would allow identification of private hospital data confidentialised due to small cell sizes. The decision was made to confidentialise the ‘all units’ rather than the ‘public’ figure as admissions to public dialysis units comprise the majority of admissions, both overall and from the most disadvantaged areas.

All hospital admissions where addresses were unknown are included in the Australian total and are not represented by State/Territory.

The Population Health Areas of 30057 Brisbane Inner - North - Central and 30051 Fortitude Valley/Spring Hill have been combined at the request of Queensland Health; data displayed is the combination of values and rates for these areas.

Note that for reports and publications that results are not comparable between jurisdictions due to the variations in scope of hospitals for individual states and territories.

Impact of COVID-19 on hospitalisations in 2019-20: The Australian Institute of Health and Welfare provides comprehensive comment as to the impact of COVID-19 on hospitalisations. For example, see the details under the heading What impact has COVID-19 had on admitted patient activity. We are unable to comment on the extent to which the pandemic has impacted differentially on rates of hospitalisation across the geographic areas in the Atlas. However, a comparison of the whole-year data for 2018-19 and 2019-20 does not show any consistent differences when analysed by socioeconomic disadvantage of area, or Remoteness Area.

Exclusions

Data exclude hospitalisations in WA with a contracted patient status of 'Inter-hospital contracted patient to private sector hospital', to adjust for separations recorded on both sides of contractual care arrangements.

Geography: Data available by Population Health Area, Local Government Area, Primary Health Network, Quintile of socioeconomic disadvantage of area and Remoteness Area

Numerator: Same-day admissions for same-day dialysis for kidney disease (Z491 to Z492)

Denominator: Total population, average of 30 June 2020 and 2021 (ERP)

Detail of analysis: Indirectly age-standardised rate per 100,000 population; and/or indirectly age-standardised ratio, based on the Australian standard.

Source: Compiled by PHIDU using data from the Australian Institute of Health and Welfare, supplied on behalf of State and Territory health departments for 2020/21; and the ABS Estimated Resident Population, 30 June 2020 and 30 June 2021