Data, evidence and understanding

Thursday, 28 August 2014

The latest quarterly meeting between the NRHA and the Australian Institute of Health and Welfare (AIHW) provided the opportunity for discussion on a range of issues relating to rural and remote health data and evidence.

Staff of the AIHW reported progress with its burden of disease project. Burden of disease is a combined measure of death, disability and illness which provides low-mortality conditions (such as mental illness and lower back pain) with an importance that, compared with other metrics, better reflects their impact on affected individuals and society. Where possible (but this is not the case for all illnesses and risk factors) the AIHW burden of disease work will involve some reporting at the sub-national level, including by remoteness or similar.

There was discussion of the summary provided by NRHA staff to its Council of recent AIHW publications which have particular relevance to rural and remote health and wellbeing. It is sometimes the case that the practical experience of members of the NRHA Council can provide useful insights into what lies behind 'mere numbers'. This interpolation can help convert data into much better understanding.

Those at the meeting speculated about some of the changes that might follow from the replacement next year of Medicare Locals by Primary Health Networks. Some of the recent reporting of data by Medicare Local has highlighted the fact that substantial differences across a region can be hidden in Medicare Local averages.

The NRHA described some of its ongoing concerns about the apparent difference in the figures for GP and 'primary care practitioner' numbers by region, as between the publications of the AIHW and COAG (which is based on Medicare data). The NRHA (and, independently, the NHPA) is considering some methods by which doctor numbers might be considered in the context of health need. There was also discussion of the data collected by the Australian Health Professional Registration Authority and its potential to contribute to a better understanding, over time, of the distribution of registered health professions.

The purposes and scope of the forthcoming Rural and Remote Health Scientific Symposium (2-3 September), at which the AIHW will make presentations, were considered.

Finally, Andrew Phillips, NRHA Policy Adviser, reported progress with the NRHA/ABS work on tobacco smoking by SEIFA, age, remoteness and time. The work shows that the bulk of the national decline in smoking has occurred amongst the young, those in Major Cities and those in higher SES groups, with young people in rural and remote areas with low SES showing little or no tendency to quit or not commence smoking in the first place.

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