Technical notes

Refer to the Data specifications table for indicator-specific information on the methods used in this report.

Refer to the Glossary for specific disease-related definitions used in this report.

Age-standardisation

Age-standardisation is a method used to eliminate the effect of differences in population age structures when comparing rates for different periods of time and/or different population groups. In this report, direct age standardisation has been used where possible. For estimates reported from the ABS National Health Survey (NHS) and National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), crude per cent were presented where variability were too large to age standardise. Where age standardised rate were presented, the standard population used to calculate the rates is the Australian estimated resident population as at 30 June 2001. For indicators 3.8.3, 4.2, 5.1.3 and 5.9 the standard population used was the Australian female estimated resident population. 

Assessing trends for the summary dashboard

Changes over time were assessed using 95% confidence intervals. Where we have undertaken the analysis from data sources such as the NHS, National Hospital Morbidity Database (NHMD) and National Mortality Database (NMD), confidence intervals have been calculated to assess the change over time. Where we have used data from other data sources such as the National Key Performance Indicators (nKPIs) data collection, confidence intervals were not provided. If data was only available for 2 time points or less, change in the data over time were not able to be assessed.

Significance testing for survey data

To assess whether differences between estimates are incompatible with a null hypothesis that the survey estimates are normally distributed and that there is no difference between the groups being compared, 95% confidence intervals were used. A difference between estimates was considered statistically significant if the 95% confidence intervals around the estimates did not overlap.

Where the 95% confidence intervals overlap slightly, a 95% confidence interval for the difference between estimates was calculated. If the 95% confidence interval for the difference between estimates included 0, then the difference was not statistically significant.

Populations used in this web report

When reporting data from the National (insulin-treated) Diabetes Register (NDR), NDSS, NHMD and NMD, the estimated resident populations derived from the ABS Census of Population and Housing are used.  The estimated resident populations used for the majority of indicators are based on the 2016 Census.

Where rate is calculated for a calendar year, the population used is the estimated resident population as reported as 30 June of that year. Where a rate is calculated for a financial year (for example with the NHMD data), the population used is at 31 December. 

Reporting data by remoteness

Data were analysed using the Australian Statistical Geography Standard (ASGS).

Where possible, comparisons of remote areas in this web report use 5 of the 6 ASGS remoteness areas. The six remoteness areas are: Major cities, Inner regional, Outer regional, Remote, Very remote and Migratory. 

When reporting data from the NDR, NDSS, NHMD, NMD and NPDC, Remote and Very remote areas have been combined, and Migratory is excluded.

In the case of the ABS Australian Health Survey and National Health Survey, data for Outer regional and Remote areas have been combined and data were not collected for Very remote areas. In the case of the ABS National Aboriginal and Torres Strait Islander Health Survey, data for Outer regional, Remote and Very remote areas have been combined.

See data tables for information about the ASGS used for the analysis of each indicator.

Reporting data by socioeconomic areas

Socioeconomic classifications in this report are based on the ABS Index of Relative Socio-economic Disadvantage (IRSD). Geographic areas are assigned a score based on social and economic characteristics of that area, such as income, educational attainment, public sector housing, unemployment, and jobs in low skill occupations.

When reporting data from the NDR, NDSS, NHMD, NMD and NPDC, socioeconomic areas are classified according to population-based quintiles using the IRSD based on Statistical Area Level 2 of usual residence.

In the case of the ABS Australian Health Survey, National Health Survey, Australian National Aboriginal and Torres Strait Islander Health Survey and National Aboriginal and Torres Strait Islander Health Survey, socioeconomic areas are classified according to area-based quintiles using the IRSD based on usual residence.

See data tables for information about the socioeconomic classifications used for the analysis of each indicator.

Data sources

The main data sources used for this update include: 

ABS Australian Health Survey (AHS) and National Health Survey (NHS)

The NHS is conducted by the Australian Bureau of Statistics (ABS) to obtain national information on the health status of Australians, their use of health services and facilities, and health-related aspects of their lifestyle. The most recent NHS was conducted in 2017–18, with previous surveys conducted in 2014–15, 2011–12 (as part of the AHS), 2007–08, 2004–05, 2001, 1995, 1989–90, 1983 and 1977–78. This web report presents results from the 2017–18, 2014–15, 2011–12, 2007–08, 2004–05 and 2001 NHS and the 2011–12 AHS.

ABS Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) and National Aboriginal and Torres Strait Islander Health Survey Health Survey (NATSIHS)

The AATSIHS and NATSIHS is conducted by the ABS to obtain information from Aboriginal and Torres Strait Islander people of all ages in non-remote and remote areas of Australia, including discrete Indigenous communities. In this web report, the ABS 2012–13 AATSIHS and 2018–19 (NATSIHS) was used for estimates of Indigenous disease and risk factor prevalence.

ABS National Aboriginal and Torres Strait Islander Social Survey (NATSISS)

The NATSISS is a six-yearly multidimensional social survey which provides broad, self-reported information across key areas of social interest for Aboriginal and Torres Strait Islander people, primarily at the national level and by remoteness. This web report presents results from the 2014–15 NATSISS.

Australian and New Zealand Dialysis and Transplant Registry (ANZDATA)

The ANZDATA collects information to monitor dialysis and transplant treatments from all renal units in Australia and New Zealand on all patients receiving kidney replacement therapy where the intention to treat is long-term. Cases of acute kidney injury are excluded. The registry is coordinated within the Queen Elizabeth Hospital in Adelaide and compiles data on incidence and prevalence of treated-ESKD, complications, comorbidities and patient deaths. All relevant hospitals and related dialysis units participate. 

For more information see the ANZDATA website.

National (insulin-treated) Diabetes Register (NDR)

The NDR collects information about people who began using insulin as part of their treatment for diabetes since 1999.

The register includes most people diagnosed with type 1 diabetes since this time, as well as those with type 2 diabetes, gestational diabetes, and other less common forms of diabetes who use insulin to manage their condition. The AIHW maintains the NDR, which is derived from 2 primary data sources:

  • The National Diabetes Services Scheme (NDSS)

    Established in 1987, the NDSS is an initiative of the Australian Government, administered with the assistance of Diabetes Australia. People with a diagnosis of diabetes by a health professional can register with the scheme. Once registered, they can access diabetes self-management information, services, and subsidised products – such as pens and needles to administer insulin, blood glucose test strips, insulin pump consumables, and continuous glucose monitoring products.

  • Australasian Paediatric Endocrine Group (APEG) state-based registers

    The APEG is a professional body that represents health professionals involved in managing and researching disorders of the endocrine system, including diabetes in children and adolescents. The APEG maintains clinic-based state and territory diabetes registers of children.

For more information see the NDR data quality statement.

National Hospital Morbidity Database (NHMD)

The NHMD is a compilation of episode-level records from admitted patient morbidity data collection systems in Australian hospitals.

The data supplied are based on the National minimum data set for Admitted patient care and include demographic, administrative and length of stay data, as well as data on the diagnoses of the patients, the procedures they underwent in hospital and external causes of injury and poisoning.

In this report, the International Statistical Classification of Diseases and Related Health Conditions, 10th revision, Australian Modification (ICD-10-AM) was used to define diagnosis codes. Diagnosis codes were defined using the following editions of ICD-10-AM:

  • NHMD 2017–18: 10th edition of ICD-10-AM
  • NHMD 2016–17: 9th edition of ICD-10-AM
  • NHMD 2015–16: 9th edition of ICD-10-AM
  • NHMD 2014–15: 8th edition of ICD-10-AM
  • NHMD 2013–14: 8th edition of ICD-10-AM
  • NHMD 2012–13: 7th edition of ICD-10-AM

National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care

The Indigenous primary health care key performance indicators (nKPIs) database contains service-level information from Aboriginal and Torres Strait Islander primary health organisations funded by the Australian Government. The AIHW maintains this database and uses it to produce public national reports, released annually, public online data visualisations and individual service-level reports for each 6-monthly reporting cycle provided back to each organisation. The collection includes Indigenous regular clients (those who attended a service 3 times in 2 years). Data are collected against 24 indicators covering maternal and child health; chronic disease risk factor monitoring and management; and health preventative activities.

For more information see the nKPI data quality statement.

National Mortality Database (NMD)

The NMD comprises information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. The cause of death data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice) and include cause of death coded by the ABS. The data are maintained by the AIHW in the NMD.

In this update, deaths registered in 2015 and earlier are based on the final version of cause of death data; deaths registered in 2016 are based on revised version; and deaths registered in 2017 and 2018 are based on preliminary version. In the NDSS-NDI linked dataset, deaths registered in 2014 are based on the revised version. Revised and preliminary versions are subject to further revision by the ABS.

For data by Indigenous status, the level of identification of Indigenous status is considered sufficient to enable analysis in 5 jurisdictions – New South Wales, Victoria, Queensland, Western Australia and the Northern Territory.

The data quality statements underpinning the AIHW NMD can be found on the following ABS internet pages:

For more information on the AIHW NMD and deaths data, see Deaths data.

National Perinatal Data Collection (NPDC)

The NPDC is a national population-based cross-sectional collection of data on pregnancy and childbirth. The data are based on births reported to the perinatal data collection in each state and territory in Australia. Midwives and other birth attendants, using information obtained from mothers and from hospital or other records, complete notification forms for each birth. A standard de-identified extract is provided to the AIHW on an annual basis to form the NPDC.

Medicare Benefits Schedule (MBS)

The Medicare program provides access to a range of medical and hospital services for all Australian residents, including services under MBS and PBS. The MBS is a listing of the Medicare services subsidised by the Australian Government. For more information on what is covered by the MBS refer to its website. MBS claims data contain information about patients, providers and services. Data does not include services to public patients in hospitals, services covered by the Department of Veteran's Affairs Treatment Account and services covered by other publicly funded programs.

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