Victorian Admitted Episodes Dataset Research Articles

Establishing thresholds for influenza surveillance in Victoria.

We aimed to review the proportion of influenza-like illness (ILI) that could be attributed to influenza infection over five consecutive influenza seasons in Victoria, to compare ILI activity with hospital admissions for influenza, and to develop thresholds that would indicate when ILI activity may coincide with increases in influenza hospitalizations. Combined nose/throat swabs from patients with ILI selected from sentinel general practices were tested for influenza and other respiratory viruses at the Victorian Infectious Diseases Reference Laboratory. The proportion of ILI attributed to laboratory-confirmed influenza was evaluated for five consecutive surveillance seasons, from 1998 to 2002. The seasonal patterns of ILI and laboratory-confirmed influenza were compared for 2000-02. ILI surveillance from sentinel general practices between 1997 and 2000 was compared with hospital admissions for influenza extracted from the Victorian Admitted Episodes Dataset between 1994 and 2000. Approximately 41% of all ILI cases from sentinel general practices were confirmed to have an influenza infection between 1998 and 2002. The seasonal pattern of ILI and confirmed influenza among patients selected from sentinel general practices was very similar over three influenza seasons. The trends for ILI rates in sentinel general practices appeared to correlate remarkably well with those of hospital admissions for influenza. Thresholds for ILI were defined as: baseline < 0.25 ILI cases/100 patients/week; normal seasonal activity 0.25-1.5; above normal seasonal activity > 1.5-3.5; and epidemic activity above 3.5. ILI rates from sentinel general practices correspond with hospital admissions coded as influenza and allow the use of threshold levels to describe seasonal influenza activity.

The Victorian ambulatory care sensitive conditions study: rural and urban perspectives.

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in the ambulatory setting. This study presents detailed analyses of ACSCs as a measure of health outcome that might vary with access to primary health care in rural and urban regions of Victoria. The Victorian Admitted Episodes Dataset (VAED), and data from the Health Insurance Commission, Medical Labour Force Annual Survey, socio-economic indexes for areas, and accessibility/remoteness index of Australia were merged to identify individual and aggregate level predictors of urban/rural differentials of ACSCs. Estimates of odds ratios and 95% confidence intervals were based on random effect multi-level generalised linear models. After adjustment for age, sex, and severity of illness, significant predictors of higher admission rates of ACSCs within rural areas include lack of insurance, emergency admissions, higher degree of remoteness, lower population density, lower number of general practitioners/10,000 population by local government area (LGA), lower number of general practitioner visits per person by LGA, and areas with lower socio-economic status, education and occupation, and economic resources. This study suggests that lack of timely and effective care may have a significant impact on rates of admissions for ACSCs in rural areas of Victoria especially in lower socio-economic groups.

Sterilisations in girls and young women: is it still happening?

Objective: To determine whether sterilising procedures — hysterectomies, endometrial ablations or tubal ligations — are being performed in minors for non-therapeutic reasons, without Family Law Court approval. Methods: Victorian Admitted Episode Dataset 1996–99 was used to identify all young women < 18 who had a sterilising procedure. Associated codes for indications and pathology were reviewed to exclude malignancies, congenital anomalies, potential miscoding and misleading codes associated with endometriosis. Results: Although 40 procedures were identified from the dataset, the majority of these can be excluded after review of the associated codes. In two cases sterilising procedures were performed without clear therapeutic indications and it is likely they were done in young women with disabilities. No Family Law Court applications were heard in this time period, thus it is likely they represent unlawful sterilisations. Conclusions: It would appear that sterilisations without Family Law Court approval are probably occurring at very low rates in Victoria.

The Victorian Ambulatory Care Sensitive Conditions study: reducing demand on hospital services in Victoria.

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable if preventive care and early disease management are applied, usually in the ambulatory setting. The Victorian ACSCs study offers a new set of indicators describing differentials and inequalities in access to the primary healthcare system in Victoria. The study used the Victorian Admitted Episodes Dataset (1999-2000) for analysing hospital admissions for diabetes complications, asthma, vaccine preventable influenza and pneumococcal pneumonia. The analyses were performed at the level of Primary Care Partnerships (PCPs). There were 12,100 admissions for diabetes complications in Victoria. There was a 12-fold variation in admission rates for diabetes complications across PCPs, with 13 PCPs having significantly higher rates than the Victorian average, accounting for just over half of all admissions (6114) and 39 per cent total bed days. Similar variations in admission rates across PCPs were observed for asthma, influenza and pneumococcal pneumonia. This analysis, with its acknowledged limitations, has shown the potential for using these indicators as a planning tool for identifying opportunities for targeted public health and health services interventions in reducing demand on hospital services in Victoria.