Australia's health 2016

Steering committee

Fadwa Al-Yaman, Tim Beard, Justine Boland, Mark Cooper-Stanbury, Kerry Flanagan, Jenny Hargreaves, Andrew Kettle, Lisa McGlynn, Lynelle Moon, Geoff Neideck

Project manager

Tim Beard (July–December 2015)

Karen Hobson (January–June 2016)

Project team

Simone Brown, Karen Hobson, Jennaya Montgomery

Authoring committee

Devin Bowles
Cathy Claydon
Elizabeth Clout
Michael de Looper
Mardi Ellis
Gary Hanson
Dinesh Indraharan
Jenni Joenpera
Helen Johnstone
Graeme Morris
Indrani Pieris-Caldwell
Tomoko Sugiura
Prem Thapa
Jason Thomson
Felicity Van Der Zwan
Alison Watters
Adrian Webster

AIHW authors

Tim Adair
Ian Appleby
Devin Bowles
Sarah Bullock
Katrina Burgess
Karen Byng
Peta Craig
Julianne Garcia
Melissa Goodwin
Michelle Gourley
Barbara Gray
Jenna Haddin
Ann Hunt
Clara Jellie
Ingrid Johnston
Helen Johnstone
Jennifer Kerrigan
Claire Lee-Koo
Caleb Leung
Miriam Lum On
Adam Majchrzak-Smith
Karen Malam
Leana Mancuso
Jane McIntrye
Tony Mole
Maddeline Mooney
Deanna Pagnini
Mark Petricevic
Melinda Petrie
Sophie Pointer
Vanessa Prescott
Arianne Schlumpp
Nikki Schroder
Roslyn Seselja
John Shelton Agar
Prem Thapa
Thao Vu
Grant Waraker
Alison Watters
Jenny Webb
Melissa Wilson
Wen Xing-Yan

Many other staff from the AIHW and its collaborating units contributed time and expertise to the production of Australia's health 2016. Their contributions are also gratefully acknowledged.

AIHW publishing, design, media and web team

Juanita Dawson, Tony Francis, Cara Goodwin, Belinda Hellyer, Elizabeth Ingram, Cherie McLean, Tim Meyen, Tulip Penney, Andrew Smith, Helen Tse

External contributors

The Australian Commission on Safety and Quality in Health Care contributed to the article 'Chapter 6.14 Safety and quality in Australian hospitals'.

Silver Chain Western Australia contributed to the article 'Chapter 6.18 End-of-life care'.

External reviewers

Catherine Andersson—Productivity Commission

Tony Barnes—Northern Territory Department of Treasury and Finance, and Charles Darwin University

Frank Beard— National Centre for Immunisation Research and Surveillance

Justine Boland—Health and Disability Branch, Australian Bureau of Statistics

Julie Byles—Research Centre for Generational Health and Ageing, University of Newcastle

Liz Callaghan—Palliative Care Australia

Ching Choi—Social Policy Research Centre, University of New South Wales

Christine Connors—Northern Territory Government Department of Health

Sue Cornes—Statistical Services Branch, Queensland Government Department of Health

Paul Dietze—Centre for Population Health, Burnet Institute

Di Hetzel—Public Health Information Development Unit, Torrens University Australia

David Lawrence—Telethon Kids Institute,The University of Western Australia

John Lynch—School of Public Health, University of Adelaide

Ian Ring—Research and Innovation Division, University of Wollongong

Lyn Roberts—AIHW board member

Colin Sindall—Prevention, Population, Primary and Community Health Branch, Department of Health and Human Services Victoria

Shannon White—Health System Financing Branch, Australian Government Department of Health

Sharon Willcox—Health Policy Solutions

The following Australian Government departments and agencies were also involved in external review of Australia's health 2016 material:

• Australian Bureau of Statistics
• Department of Health
• Department of the Prime Minister and Cabinet
• Department of Social Services
• Australian Organ and Tissue Donation and Transplantation Authority.

Quality assurance

The report content was largely prepared by AIHW staff, and was subject to a rigorous internal review and clearance process. Additional external peer reviewers were used to validate and strengthen the content of the report.

Data sources

The best available information has been used to inform the report, drawn from a range of data sources that are referenced throughout the report. Most of the data sources are national collections managed by the AIHW and the Australian Bureau of Statistics (ABS). These are supplemented by other data collections, as appropriate.

Each of the data sources used in the report has strengths and limitations that affect how the data can be used and what can be inferred from the results. The AIHW takes great care to ensure that data used are correct and that the conclusions drawn are robust.

Although this report is published in 2016, many of the statistics refer to 2014 or earlier. This is because some data, such as population-based surveys, are collected every 3–5 years or even less often. Also, it can often take some time before data are fully processed and provided to the AIHW. Finally, the AIHW often needs time to analyse the data and ensure the statistics are accurate and of high quality.

Given the comprehensive nature of this report, and the time it takes to prepare a compendium report of this scale, it is possible that some other reports may be released by the AIHW or others with more recent data. Readers are referred to the latest releases in the 'Where do I go for more information?' sections of articles and snapshots.

Terminology

Common terms

Common concepts and terms that appear throughout Australia's health 2016 are described briefly here. Other concepts and terms are defined in the Glossary at the end of the report.

Admitted patient/hospitalisation: A hospital patient who has undergone a formal admission process to begin an episode of care. May involve an overnight stay or be same day. In this report, admitted patient episodes of care are referred to as hospitalisations.

Age-standardisation: A statistical procedure to adjust for different age structures of populations being compared.

Burden of disease: A term referring to the quantified impact of a disease or injury on a population, using a summary measure that combines the burden of premature death with the burden of living with ill health.

Comorbidity: The presence of two or more diseases in a person at the same time.

Health determinant: Something that can influence health in a positive way (protective factor) or negative way (risk factor). Includes social and environmental factors and health behaviours.

Incidence: A measure of the number of new cases of a disease or characteristic in a population in a specified period.

Prevalence: A measure of the level of the disease or characteristic in a population at a specific point in time.

Remoteness: A classification of areas across Australia based on physical distance to the nearest urban centre and its population size. These areas are defined as Remoteness Areas by the Australian Statistical Geographical Standard (ASGS). Remoteness Areas include Major cities, Inner regional, Outer regional, Remote and Very remote.

Describing socioeconomic disadvantage

Socioeconomic factors, including associated disadvantage, are important determinants of health and wellbeing in Australia. The higher a person's income, education or occupation level, the healthier they tend to be on average.

The ABS defines socioeconomic disadvantage in terms of people's 'access to material and social resources, and their ability to participate in society' [1].

Socioeconomic disadvantage is commonly determined using composite measures that take into account multiple determinants of health, for example the ABS's Socio-Economic Indexes for Areas (SEIFA). Socioeconomic disadvantage can also be measured using a single characteristic such as a person's education or occupation. However, because such individual measures are not always available, measures based on geographic areas, such as SEIFA, are frequently used.

The SEIFA comprises four indexes that each focus on a different aspect of socioeconomic advantage and disadvantage. This report primarily uses one of these indexes – the Index of Relative Socio-economic Disadvantage (IRSD).

The IRSD represents the socioeconomic position of Australian communities by measuring aspects of disadvantage, such as low income, low educational attainment, high unemployment, and jobs in relatively unskilled occupations. Areas are then ranked according to their level of disadvantage.

When the IRSD is used in this report, people living in the 20% of areas with the greatest overall level of disadvantage are described as living in the 'lowest socioeconomic areas'. The 20% of people at the other end of the scale—those living in areas with the least overall level of disadvantage—are described as living in the 'highest socioeconomic areas'.

It is important to note that the IRSD reflects the overall or average socioeconomic position of the population of an area; it does not show how individuals living in the same area might differ from each other in their socioeconomic position.

(See Chapter 4.1 'Social determinants of health', Chapter 5.1 'Health across socioeconomic groups').

Readers' guide

Effects of rounding

Entries in columns and rows of tables may not add to the totals shown, because of rounding. Unless otherwise stated, derived values are calculated using unrounded numbers.

Presenting dates and time spans

Periods based on full calendar years (1 January to 31 December) are written as, for example, 2001 for 1 year. When there are 2 or more calendar years in the period, the first and final years are written in full. For example, 2010–2011 is a 2 calendar-year span and 2009–2011 covers 3 calendar years.

Periods based on financial years (1 July to 30 June, as with hospital statistics) are written with a second number which is abbreviated: for example, 2010-11 for 1 financial year, 2009–11 for 2 and 2008–11 for 3. A longer span of financial years is written as 'In the 10 years from 2000–01 to 2010–11…'.

Some surveys may be based on other 12-month spans—for example, the general practice Bettering the Evaluation of Care and Health (BEACH) survey is based on collection periods from 1 April to 30 March. These are presented as for financial years; for example, 2010–11 would be a 'year' or 12-month period.

Use of icons

Icons and infographics are visual representations of data that are intended to present complex information quickly and clearly. Generally, these graphics simplify information so it can be easily understood and, as such, carry a risk of generalising or stereotyping. This is not the intention of the AIHW, which endeavours to use icons only to improve the clarity and accessibility of information.

Use of italics

Italics are used in this report:

• for remoteness categories derived using the ASGS (see 'Remoteness', in common terms). The main categories are Major cities, Inner regional, Outer regional, Remote and Very remote
• for report titles
• to indicate terms that are part of a formal medical category/classification scheme. For example, triage categories: Emergency, Urgent, Semi-urgent and Resuscitation.

References

1. Australian Bureau of Statistics (ABS) 2013. SEIFA tutorial 1—transcript. Introduction to SEIFA. Canberra: ABS. Viewed 16 March 2016.