Australian Atlas of Healthcare Variation Series

This series explores how healthcare use in Australia varies depending on where people live. It investigates reasons for variation that may be unwarranted, and provides specific achievable actions to reduce unwarranted variation.

 

 

Atlas Series logo

Introduction

Maps of variation in care, derived from information routinely gathered by the health system, show how healthcare use differs across the country and to raise important questions about why this variation might be occurring. The aim is to prompt further investigation into whether the observed variation reflects differences in people’s healthcare needs, in the informed choices they make about their treatment options, or in other factors.

Find out more:

  • Why measure variation in healthcare use?
  • The Atlas Series
  • What is included in the Atlases
  • Complete list of topics in the Atlas series

Why measure variation in healthcare use?

Getting the best outcomes for patients and reducing harm are the goals of the Atlas. Where we see substantial variation in use of a particular treatment, it is an alarm bell that should make us stop and investigate whether appropriate care is being delivered.

Variation in itself is not necessarily bad, and it can be good if it reflects health services responding to differences in patient preferences or underlying needs. When a difference in the use of health services does not reflect these factors, it is unwanted variation and represents an opportunity for the health system to improve.

Looking at how healthcare use varies between people living in different areas, between people with and without socioeconomic disadvantage, and between Aboriginal and Torres Strait Islander Australians and other Australians can show who in our community is missing out. Fundamental changes to address the underlying determinants of ill health, as well as better service delivery for those with existing disease, are needed where these inequities are found.

The Atlas series

  • The first Atlas was published in 2015 and focused on care related to antibiotic prescribing, surgical, mental health and diagnostic services. 
  • The second Atlas, released in 2017, examined chronic disease and infection – potentially preventable hospitalisations, cardiovascular conditions, women’s health and maternity and surgical interventions.
  • The third Atlas published in 2018 examined neonatal and paediatric health, thyroid and gastrointestinal investigations and treatments and cardiac tests. It also focused on changes over time in prescribing behaviour, with a repeat analysis of prescribing over four years for antimicrobial, opioid and psychotropic medicines. 

               Atlas 1

                Atlas 2

                  Atlas 3

Atlas 1 (2015) map image
Uploaded Atlas 2 (2017) map image
Atlas 2 (2018) map image

What is included in the Atlases?

Each Atlas includes data, maps, graphs, clinical commentaries and recommendations for each chapter. The following can be viewed or downloaded for each Atlas via the website and the interactive platform:

  • Download of the full Atlas as a PDF
  • Download of individual chapters for each Atlas
  • Download of data sheets for each clinical item that include data by local geographical Statistical Area Level 3 (SA3), remoteness and socioeconomic status
  • Maps of Australia and capital city areas of rates by SA3, graphs showing by state and territory and remoteness and socioeconomic status
  • Additional analyses for some clinical items, such as data by age, sex, Aboriginal and Torres Strait Islander status, public or private funding, and prescriber type.
  • Data by Primary Health Network (PHN) is also available for some items.
  • View interactive data with maps and graphs through the interactive platform here.

First Atlas - published 2015

Antimicrobial dispensing
1.1 Antimicrobial dispensing
1.2 Quinolone dispensing
1.3 Amoxycillin and amoxycillin-clavulanate dispensing
Diagnostic interventions
2.1 Fibre optic colonoscopy
2.2 Prostate biopsies 40 years and over
2.3 Computed tomography of the lumbar spine
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
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
Opioid medicines
5.1 Opioid medicines dispensing
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

Second Atlas - published 2017

Chronic disease and infection: potentially preventable hospitalisations
1.1 Chronic obstructive pulmonary disease (COPD)
1.2 Heart failure
1.3 Cellulitis
1.4 Kidney and urinary tract infections
1.5 Diabetes complications
Cardiovascular conditions
2.1 Acute myocardial infarction admissions
2.2 Atrial fibrillation
Women’s health and maternity
3.1 Hysterectomy
3.2 Endometrial ablation
3.3 Cervical loop excision or cervical laser ablation
3.4 Caesarean section ages 20 to 34 years
3.5 Third- and fourth-degree perineal tear
Surgical interventions
4.1 Knee replacement
4.2 Lumbar spinal decompression
4.3 Lumbar spinal fusion
4.4 Laparoscopic cholecystectomy
4.5 Appendicectomy
4.6 Cataract surgery

Third Atlas - published 2018

Neonatal and paediatric health
1.1 Early planned caesarean section without medical or obstetric indication
1.2 Antibiotics dispensing in children 9 years and under
1.3 Proton pump inhibitor medicines dispensing 1 year and under
Gastrointestinal investigations and treatments
2.1 Proton pump inhibitor medicines dispensing 18 years and over
2.2 Colonoscopy hospitalisations
2.3 Gastroscopy hospitalisations
Thyroid investigations and treatments
3.1 Thyroid stimulating hormone tests 18 years and over
3.2 Thyroid function tests 18 years and over
3.3 Neck ultrasound 18 years and over
3.4 Thyroidectomy hospitalisations 18 years and over
Cardiac tests
4.1 Cardiac stress tests and imaging (exercise ECG, stress echocardiography, myocardial perfusion scans, computed tomography coronary arteries) 18 years and over
4.2 Stress echocardiography 18 years and over
4.3 Myocardial perfusion scans 18 years and over
4.4 Standard echocardiography 18 years and over
Repeat Analysis
Antimicrobial medicines
5.1 Antimicrobial medicines dispensing
5.2 Amoxycillin and amoxycillin-clavulanate dispensing
Psychotropic medicines
5.3 Antipsychotic medicines dispensing 17 years and under
5.4 Antipsychotic medicines dispensing 18 to 64 years
5.5 Antipsychotic medicines dispensing 65 years and over
Opioid medicines
5.7 Opioid medicines dispensing

Contact us

You can contact the Atlas team via email: atlas@safetyandquality.gov.au