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Volume 37 Number 3: >>  Public Health Information
 
Hospital Planning: the risks of basing the future on past data
Sandra G Leggat p6 [ pdf ]

Abstract
Planning for capital development of public hospitals in Victoria is guided by a multi-stage process with comprehensive data analysis and thorough approval processes at each of the stages. The long development timeframes and the limitations in the data available to project service utilisation may negatively impact upon the service planning processes, and in some cases newly developed hospitals have not been sufficiently planned to meet community needs. This paper suggests that service utilisation forecasts derived from administrative databases require a more detailed verification process than currently exists. The process requires consideration of the drivers of demand to document the core assumptions about the future drivers, benchmarks with other jurisdictions, epidemiological, comparative and corporate needs assessment to explain the differences in utilisation rates, and sensitivity analysis. Given the cost of hospital construction and the rate of change in the healthcare sector, it is important that future hospital planning processes do not accept current utilisation trends as valid for future planning without this level of
verification.

 


Emergency department presentations of Victorian Aboriginal and Torres Straight Islander people
Nadia Costa, Mary Sullivan, Rae Walker and Kerin M Robinson p15 [ pdf ]

Abstract
This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non- Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.

 


Issues in the measurement of social determinants of health
Gavin Mooney and Nubong G. Fohtung p26 [ pdf ]

Abstract
This article focuses on the measurement of the social determinants of health, and specifically on issues relating to two key variables relevant to the analysis of public health information: poverty and inequality. Although the paper has been written from the perspective of economics, the discipline of the two authors, it is also of relevance to researchers in other disciplines. It is argued that there is a need to ensure that, when considering measurement in this largely neglected area of research,
sufficient thought is given to the relationships that are being examined or assessed. We argue further that any attempt at measurement in this area must take into account the historical backdrop and the complex nature of the relationships between these key variables.

 
Recorded categories of non-principal diagnoses in Victorian public hospital transient ischaemic attack and stroke admissions
Shyamala G. Nadathur p33 [ pdf ]

Abstract
Information about the number and types of non-principal diagnoses (NPDs) would make an important contribution to prediction of outcome and hence patient management. The study reported here is based on analysis of three fiscal years of the Victorian public hospital transient ischaemic attack (TIA) and stroke admissions. The incidence of NPDs and co-occurrence of NPD-associated prefix categories (that identify the onset or relevance of each condition to the episode) are described in each of the broad stroke subtypes. The distributions of length of stay and in-hospital deaths in the cohorts without and with NPDs and in the various prefix categories are determined. The study also compares the age and gender distribution in the various subpopulations of interest. The importance of collecting complete and accurate data on nature of NPDs and its potential in describing the complexity of presentation are discussed.


2009 Health Information Management Journal of the Health Information Management Association of Australia Ltd