The first Australian Atlas of Healthcare Variation (the first Atlas) presents a clear picture of substantial variation in healthcare use across Australia.

This Atlas, the first to be released by the Commission, illuminates variation by mapping use of health care according to where people live. As well, this Atlas identifies specific achievable actions for exploration and quality improvement.

Included in the first Atlas is health care related to: antibiotic prescribing, surgical, mental health and diagnostic services.

Priority areas for investigation and action arising from the first Atlas include use of:

  • Antimicrobials
  • Psychotropic medicines
  • Fibre optic colonoscopy
  • Knee arthroscopy
  • Hysterectomy and endometrial ablation
  • Cataract surgery.

Healthcare Variation – what does it tell us

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the Atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

View the first Atlas

The first Atlas, released in November 2015, examined six clinical themes covering prescribing, diagnostic, medical and surgical interventions.

Key findings and recommendations for action are available here.

View the maps and download the data using the interactive platform.

What does the Atlas measure?

The first Atlas shows rates of use of healthcare (prescriptions, surgical procedures, hospitalisations) in geographical local areas across Australia. The rate is age and sex standardised to allow comparisons between populations with different age and sex structures. All rates are based on the patient’s place of residence, not the location of the hospital or health service.

The first Atlas uses data from national databases to explore variation across different healthcare settings. These included the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and the Admitted Patient Care National Minimum Data Set (APC NMDS).

The geographic local areas used are Australian Bureau of Statistics (ABS) standard geographical regions known as Statistical Areas Level 3 (SA3). SA3s provide a standardised regional breakup to assist in analysing data at the regional level. A number of items are mapped at the larger Statistical Area Level 4 (SA4).

Who has developed the first Atlas?

The Commission worked with the National Health Performance Authority on the first Atlas.

The Commission consulted widely with the Australian government, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the Atlas.

Table of Contents

Chapter 1 Antimicrobial dispensing

1.1 Antimicrobial dispensing
1.2 Quinolone dispensing
1.3 Amoxycillin and amoxycillin-clavulanate dispensing

Chapter 2 Diagnostic interventions

2.1 Fibre optic colonoscopy
2.2 Prostate biopsies 40 years and over
2.3 Computed tomography of the lumbar spine

Chapter 3 Surgical interventions

3.1 Knee arthroscopy hospital admissions 55 years and over
3.2 Cataract surgery 40 years and over
3.3 Lumbar spine surgery hospital admissions 18 years and over
3.4 Radical prostatectomy hospital admissions 40 years and over
3.5 Hysterectomy and endometrial ablation hospital admissions
3.6 Tonsillectomy hospital admissions 17 years and under
3.7 Myringotomy hospital admissions 17 years and under
3.8 Hip fracture hospital admissions 65 years and over
3.9 Hip fracture average length of stay in hospital by peer group – 65 years and over

Chapter 4 Interventions for mental health and psychotropic medicines

4.1 General practitioner mental health treatment plans
4.2 Antidepressant medicines dispensing 17 years and under
4.3 Antidepressant medicines dispensing 18 to 64 years
4.4 Antidepressant medicines dispensing 65 years and over
4.5 Anxiolytic medicines dispensing 18 to 64 years
4.6 Anxiolytic medicines dispensing 65 years and over
4.7 Antipsychotic medicines dispensing 17 years and under
4.8 Antipsychotic medicines dispensing 18 to 64 years
4.9 Antipsychotic medicines dispensing 65 years and over
4.10 Attention deficit hyperactivity disorder medicines dispensing 17 years and under

Chapter 5 Opioid medicines

5.1 Opioid medicines dispensing

Chapter 6 Interventions for chronic diseases

6.1 Asthma medicines dispensing 3 to 19 years
6.2 Asthma medicines dispensing 20 to 44 years
6.3 Asthma and chronic obstructive pulmonary disease medicines dispensing 45 years and over
6.4 Asthma and related respiratory hospital admissions 3 to 19 years
6.5 Asthma hospital admissions 20 to 44 years
6.6 Asthma and chronic obstructive pulmonary disease hospital admissions 45 years and over
6.7 Heart failure hospital admissions 40 years and over
6.8 Diabetes-related lower limb amputation hospital admissions 18 years and over
6.9 Stroke average length of stay in hospital by peer group – 65 years and over
6.10 Anticholinesterase medicines dispensing 65 years and over
Technical Supplement
About the Atlas
Glossary

Australian Atlas of Healthcare Variation data set specifications are available at http://meteor.aihw.gov.au/content/index.phtml/itemId/623427