MEDICUS FEBRUARY 2016

O P I N I O N

Continued from page 31

Insights from an unusual source Professor Jeanette Ward

Rate of potentially preventable hospitalisations for chronic conditions per 100,000 people, age-standardised, by local area* (SA3) Potentially preventable hospitalisations, chronic conditions Year of data: 2013–14 Calculating a formula for determining the size of the reward itself might also be important. Achieving the most precise determination of longitude imagi able yielded as reward an amount in excess of $3 million in today’s terms. Reducing WA’s rate of potentially preventable PHN’s achievement of reduced hospitalisations directly to these local stakeholders better placed to address ‘upstream determinants’, thereby realising the most virtuous of virtuous cycles. Everyone will want the PHN to succeed because of the unprecedented reward to ensue. By creating conditions for local stakeholders with a significant vested interest in actual success, any centralist tendency of the Canberra- based bureaucracy that might still be tempted yet to micro-manage the PHNs is cleverly counteracted. These thoughts are only a sketch of what the Longitude Act could inspire today. It will be critical to establish a credible rate for potentially preventable hospitalisations which, when achieved, elicits the reward.

hospitalisations would yield millions of dollars in savings every year. Some further attention to dynamic counterpoints and constructive shareholder tension is required. As did the National Commission of Audit in 2014, my hopes were once pinned on a Health Productivity and Performance Commission proposed to soar more strategically in health policy and tewa dship than the sum of the entities proposed to create it. However this was not to be. Perhaps through the COAG Health Council and its working groups, WA has better representation and influence to initiate this conversation. Wherever it takes place, the very best intellectual rigour and vigorous policy savvy could draft the legal framework and start the race.

DARWIN

LEARNING FROM HISTORY

My summer sojourn in the 17 th century was quite something. Borne of the tragedies of

BRISBANE

PERTH

that century, concern for the ‘greater good’

SYDNEY

spurred one of the most extraordinary

CANBERRA

ADELAIDE

uses by government of its legislative prerogative in the next. When holiday reading is that riviting, who needs to travel anywhere? ■ References available on request.

1,609 – 4,687 per 100,000 1,401 – 1,608 1,288 – 1,400 1,195 – 1,287 1,112 – 1,194 1,054 – 1,111 991 – 1,053 903 – 990 794 – 902 539 – 793 not available for publication

MELBOURNE

HOBART

PHN boundary

SA3 boundary

Source: National Health Performance Authority, Healthy Communities: Potentially preventable hospitalisations in 2013–14

32 M E D I C U S F E B R U A RY 2 0 1 6 * Results are presented by local area (SA3) with Primary Health Network (PHN) boundaries overlaid. The term local area (SA3) refers to an Australian Bureau of Statistics geographic region known as a Statistical Area Level 3 (SA3). Notes: There are 22 conditions for which a hospitalisation is considered to be potentially preventable. Hospitalisations from both public and private hospitals are included. For more information on this measure, refer to this report’s Technical Supplement and Glossary. Sources: National Health Performance Authority analysis of Admitted Patient Care National Minimum Data Set 2013–14, data supplied March 2015, and Australian Bureau of Statistics Estimated Resident Population 30 June 2013.