Quality of healthcare outcomes varies between states

The quality of healthcare outcomes has major discrepancies around the nation.

Which state has worst healthcare?

A new report into the nation’s health systems has shown NSW lagging behind other states in terms of hospital queues for elective surgery and radiotherapy.

That state’s citizens are also more likely to clog up hospital emergency departments with non-urgent visits than in other states.

Compared with the national average of 75 days, NSW patients were made to wait 211 days for eye surgery, including cataract operations, according to the Bureau of Health Information’s latest Healthcare in Focus study.

The review of 2015-2016 statistics showed that people living in NSW had to wait twice as long for orthopaedic surgery, about 120 days, compared with the rest of the nation.

NSW and Queensland patients requiring radiotherapy waited more than a month for the service, followed by 27 days for Victorians and Tasmanians, and just 14 days in the Northern Territory.

The study also compared NSW queues for hip and knee replacements with those in other developed countries, including the US and the UK, and found that the state made people wait longer for these procedures – between 207 and 291 days.

NSW hospitals also recorded higher rates of post-operative blood clots and sepsis than in many other countries. Clots often result from hip and knee surgery.

Proportionally, people in NSW were more likely to visit their GP than those from other states. But the margin is slim with Victorians not far behind, followed by Queenslanders and South Australians. Fewer West Australians as a proportion of that state’s population visited their GPs.

Of the big states, NSW had more patients per 100,000 arriving at hospital emergency departments for non-urgent treatment. West Australians used ambulances the least for non-urgent trips, followed by Victorians, South Australians and Queenslanders.

And while those living in NSW use emergency departments and visit GPs relatively more than in other states, they spend less time being treated before discharge from emergency departments and the admission costs more.

The median amount of time spent in emergency around the nation ranged from 121 minutes in NSW to 150 minutes in South Australia.

The average cost of an emergency visit was more expensive in NSW ($1116) than in Queensland, Western Australia, South Australia and Victoria, which had the cheapest cost of $857.

On balance, patients in NSW had a better chance of surviving a cardiac arrest after resuscitation was performed in hospital (32 per cent) than those in other states, but they were more likely to contract golden staph.

In relation to falls during hospitalisation, NSW patients were more likely to trip up, with 5.6 falls per 1000 visits, than those in Queensland, South Australia and Victoria, where only 3.6 out of 1000 admissions ended in a fall.

Opinion: All Australian lives matter

The latest Bureau of Health Information report is an eye-opener into the disparity of healthcare among the nation’s largest states.

Rich in statistical analysis across many forms of medical care and procedures, it provides the basis for a fair question: Why do healthcare outcomes vary so much around Australia? Surely all Australian lives matter.

The evidence shows that if you live in NSW and require medical or hospital attention you are likely to fare worse than if you live in a less populous, less wealthy state.

There is one exception to this generalisation, however. If you are unlucky to suffer a cardiac arrest in NSW, you are more likely to survive after resuscitation than if you live elsewhere.

But this advantage does have costs. NSW patients are more likely to fall in hospital, contract sepsis and golden staph, suffer a blood clot after hip replacement surgery and wait longer for elective surgery.

What is going on in NSW? Could it be that it is the most hypochondriac state? Is its  healthcare system bogged down by its citizens seeking out urgent hospitalisation when they don’t need it? At least, that is what the data analysis reveals. As a proportion of the population, more people in NSW use an ambulance to catch a ride to hospital for non-urgent conditions.

That could be fixed with a couple of education campaigns. One to train those dispensing ambos to better assess whether an emergency vehicle is warranted to take a caller to hospital or some other type of transport. Citizens also need to hear the message that they should not be ambulance hogs and if they are not in an urgent, life-threatening situation, they should request non-emergency transport.

However, regardless of their attitudes to accessing emergency treatment, one thing is certain. NSW patients are entitled to the same level of quality hospitalisation as the rest of the nation. Its population should be asking why their government is not benchmarking itself against the best-practice standards elsewhere, from waiting times for surgery, patient falls and cross-infection measures in hospital, to length and cost of admission.

Have you had a bad hospital experience? How often do you visit your GP? How long did you have to wait for surgery?

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    COMMENTS

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    Deenick
    28th Sep 2017
    10:01am
    Wow so ACT is the best all round since it dissent even rate a mention. How can this report claim integrity when it ignores
    Joy B
    28th Sep 2017
    12:10pm
    I was going to say the same thing with ACT data missing.
    Olga Galacho
    28th Sep 2017
    11:10am
    Hi Deenick. I will pool the ACT data for you in a little while. Cheers, Olga.
    KB
    28th Sep 2017
    11:39am
    During the flu season elective surgery is cancelled. Ramping at major hospitals is on the increase Some hospitals are or have closed sown so the has the writer of above article checked these fact?

    28th Sep 2017
    11:40am
    NSW being worst off is probably on account of it being the most populous state - not to mention being run into the ground by an incompetent Li(e)beral government (state and federal).
    Jim
    28th Sep 2017
    12:03pm
    Having lived in NSW for 50 years which has seen many changes of government in that time, NSW has seemed to have always had the worst performing healthcare system, I say seems to have had the worst because I'm not sure if the criteria has always been the same, but I commented in an earlier post that it was Premier Carr that first stated he would reduce the waiting times in hospitals or he would resign, waiting times actually increased, but somehow he tried to convince us that waiting times had decreased. So in essence I don't think you can blame one side of government for the decline in NSW healthcare if we are using the same criteria across Australia to rate our hospitals and our healthcare in general in NSW we seem to have been the worst performing for as long as I can remember, I don't believe the stats and think there maybe another explanation, but somebody smarter than me would have to figure it out.
    ray @ Bondi
    28th Sep 2017
    1:39pm
    NSW residents have always had the short (shitty) end of the stick, the spin doctors of both parties tell us in an Orwellian way that things have never been better, do they really believe their own propaganda, a person only has to access the public hospital system to know there is something wrong. That may be the problem as I am sure our politcans have only the best and paid for by you and I
    Jim
    28th Sep 2017
    11:46am
    Are we comparing apples with apples? I recall premier Carr stating if he didn't reduce waiting times in hospitals he would resign, obviously he didn't, and it appears that NSW doesn't fair too well in the healthcare stakes, I also recall when JBP was the premier in Queesland, waiting times in that state were non existing, people from NSW would slip across the border to get quicker treatment in Queensland, has that situation changed? Do we have more hospitals per capita in NSW compared to other states, I would have thought that other states would have more remote hospitals than NSW which you would think are less efficient to run? How are the hospitals funded, are they entirely funded by the states or is there some contribution from the federal government through GST or some other source of revenue?
    Tib
    28th Sep 2017
    12:29pm
    I believe hospitals are funded using state and federal funds. I think it should be managed federally to get a more consistent approach also the funds being used to support unnecessary levels of government could be used for healthcare. Besides it would make it easier to pin down who is responsible for an inefficient service.
    I have lived in a few states and I always found the Qld health system the best to deal with, I believe JBP supported the hospitals with I think some gambling revenue. Anyway it was very effective. Imagine if we didn't allow any private gambling in the country and all profits went to hospitals. Get a splinter and get picked up by a stretch limo to the hospital.
    Jim
    28th Sep 2017
    1:30pm
    Thanks Tib, do you know how each state is allotted funds and the criteria used, ie are we in NSW being dudded, or have out pollies been that bad at running our healthcare system for the last 50 years' or which I think is the most likely cause is that the boards running our hospitals are the ones that have got it wrong, keeping in mind these people have perhaps been there for years, are unelected and seem to answer to no one. I am sure these people are very dedicated and well paid professionals.
    ray @ Bondi
    28th Sep 2017
    1:46pm
    about 20 plus years ago the government of the day decided that Sydney did not need so many hospitals, I live in the eastern suburbs and know of 3 in this area that was closed and big ones in my consideration, 2 that come quickly to mind is the women's hospital that was located in Paddington, another near the gaol at long bay and an inner city one that may have been in the Waterloo area but could be wrong, and that was only in this small area I am sure it happened all over Sydney, now we are reaping the crop as the population is a magnitude larger and the public hospital system is not coping.
    Tib
    28th Sep 2017
    2:04pm
    Dim I haven't got into all the details but I'd be very surprised if it couldn't be better run than it is now with more accountability.
    4b2
    28th Sep 2017
    11:47am
    Public Hospitals should be a first in receives the treatment they need regardless of the level of Private health cover. Private hospitals can have their own priority list on a pay for servic basis.
    Ever since the Healt Funds became for profit organisations the helat system has gone backwards. Bring back a non for profit healt care system.
    If the Government thinks the private health care system (for profit organisations) is the way to go stop subsidising them and let a non for profit system compete. Why do Governments regulate price increases to a private industry anyway. Isn't t5his Socialism.
    ray @ Bondi
    28th Sep 2017
    1:48pm
    yes I agree completely in this age where every business has to survive on it own with no government help why is the health industry a protected species
    Sen.Cit.90
    28th Sep 2017
    12:10pm
    I live on the Sunshine Coast Qld. With no complaints about health care. I have a Pacemaker fitted the waiting time was negligible also it is checked annually. I have nothing but praise for Nambour Hospital
    Hobbit
    28th Sep 2017
    12:46pm
    Nambour Hospital was great, so far the new Sunshine Coast hospital seems very good.
    Tib
    28th Sep 2017
    2:09pm
    I have family on the Sunshine Coast Nambour is very good. Qld's hospital system has always been pretty good. The rest of the country is a bit of a train wreck.
    Hobbit
    28th Sep 2017
    12:43pm
    I've had two major procedures in Queensland's Public system, both went well, both prompt. Heart surgery admitted immediately, prostate cancer surgery two-week wait.
    ray @ Bondi
    28th Sep 2017
    1:51pm
    lucky you, it sounds like I should be living there, I nearly died waiting for my heart operation, I went in for it and was sent home so many times as there are limited resources in the public system.
    Tib
    28th Sep 2017
    2:12pm
    I've lived in Tasmania which I think is about the worst. If you get anything serious down there. Spend your money on a flight out of there and you may make it out alive.
    Eddy
    28th Sep 2017
    1:12pm
    I assume these figures relate to Medicare funded patients rather than privately insured.
    Tib
    28th Sep 2017
    2:22pm
    I've lived in a few states Queensland was the best hospital system Tasmania the worst. I remember sitting at the emergency at Launceston , big lineup at the counter one guy with an enormous fish hook through his hand bleeding everywhere ,a woman who had a serious operation a few days before was all but staggering and the young nurse behind the counter was ignoring them all talking to her friends, you know I had a great weekend I got so wasted. Couldn't give a dam.
    Dee
    28th Sep 2017
    2:53pm
    Not surprised, coming back to NSW after 30 years in Victoria is like travelling back 50 years in time. Hospitals I have seen are run down and inefficient. Their administrative systems are reminiscent of the old USSR.
    Maggie
    28th Sep 2017
    3:48pm
    How interesting! Did you actually live in the old USSR?
    floss
    28th Sep 2017
    4:42pm
    Perhaps our forced population policy has more than caught up with us.Our population has increased but our hospitals have not, not really rocket science every one can see it but not our thick leaders.
    Anonymous
    28th Sep 2017
    5:57pm
    I agree with you floss I live in the North of Melbourne and it is absolutely disgraceful what the so called leaders are doing. The north of Melbourne Epping, Craigieburn, Doreen etc etc are exploding with houses. Our infra structure is stuffed especially the hospitals. I have attended the Northern Hospital on many occasions and it is a disgrace, waiting times are unacceptable and the quality of care is dropping. It is a scary situ with our ever growing population. We need to stand up to the leaders and say no more immigration only accept the ones that can contribute to the economy. By the way I found out due to interpreters having to spend time with patients at the hospital this is a reason for long wait times. Go figger why are people let into Australia if they cannot speak English?
    Anonymous
    29th Sep 2017
    4:28pm
    Well if you voted Dan the Dunce in you have nothing but to blame yourself Jannie the areas you are talking about are all left wingers and love labor.

    As regards the immigration how many boat people where let in by Gillard and Rudd they are all free loaders and clog up the hospital system.
    Ella
    28th Sep 2017
    4:53pm
    My son's been waiting nearly 3 years for a spinal operation in Qld. He has significant nerve pain and unable to sit or stand for very long. He's 27 years old with 2 young children. I think the public health system in qld is poor unless one has life threatening problems and or cancer.
    Tib
    29th Sep 2017
    12:51pm
    Sorry to hear that they don't give back pain the support or priority it deserves.

    28th Sep 2017
    5:58pm
    Blame the dickhead leaders.
    Jan
    29th Sep 2017
    8:06am
    As usual, the nation's capital doesn't rate a mention
    alinejordan
    29th Sep 2017
    11:23am
    i had to wait 8 months to have a hip replacement in Victoria...where do the 120 days come from? private hospitals?
    Crimmo
    29th Sep 2017
    1:39pm
    Australia has a dysfunctional health system. Some 1% of our health system is at the forefront of medical breakthroughs, so the Einsteins running this country think our health system is great. More than half our GPs are incompetent. Our public hospitals are incompetent. Many of our local doctors are foreign rejects.

    29th Sep 2017
    2:01pm
    the A C T is worse After my wife had a heart attack while traveling on returning to Canberra had to wait about 12 month to get in to see a hospital cardiologist . I had to wait about 9 months to have a colonoscopy after the bowel scan came back positive . I am presently waiting to see a doctor for internal problems have been waiting 5 months already so when this current labor government says there are no problems with the A C T health system they are down right lies lies lies .
    Anonymous
    29th Sep 2017
    2:05pm
    They have the money to waste on Barr and the Rat bury tram that a small number of Canberran's will get to use the 1 billion + would have been better put into the health system to help a lot more people
    Anonymous
    29th Sep 2017
    4:24pm
    Hey folks what about you pay your own way then there is no waiting time.
    52-KID
    1st Oct 2017
    12:30pm
    I have to put in my 2 cents worth here. I had two falls in the last couple of years - in the first one I smashed my wrist pretty well, requiring a plate and screws. The ambulance people were so caring, I was admitted straight away and my wrist was repaired the next day - the care during my stay was also excellent.

    My second fall was a complete accident and I smashed my hip this time. It was a bit of a mission getting me into the ambulance, but thanks to the "green whistle" I don't remember any of if until I woke up in a hospital bed. Again I was operated on the next day with lots of metal holding me back together. The hospital staff once again were wonderful.

    Both times, I had no delays and top class surgeons, I was extremely impressed.

    On the other hand, my hip needs to be re-done to remove some of the extra metal, and that won't happen until next year. I'm lucky that it's not causing me too much bother and I'm happy to wait because the cost of hospital cover is way out of my affordability range.

    My experience with John Hunter hospital has been impressive to say the least. That said, it's not always that way. My daughter snapped her achilles tendon with a 90% tear and they sent her home, told her it would heal itself. Well, that didn't happen did it - it tore again. The second time she had to search around and found a doctor who would operate on her in the public system, and he repaired the achilles which was a bit mess of scar tissue by this stage. She still had to pay some, but it was the only way to heal her leg.

    So, I don't know what the moral of this story is, I guess you just have to be lucky.
    maggie
    6th Oct 2017
    11:05am
    My husband had Head & Neck radiation for tongue cancer 5 yrs ago. He has developed a rather rare but serious condition - osteoradionecrosis of the mandible (jaw). This requires the lower jaw bone being replaced using his fibula bone. The operation can take over 12 hrs. We have been backwards and forwards to Newcastle (300 Klm each way) 5 time since March. We finally got a date for 13th October at a private hospital, the public one is too busy. This was cancelled 2 weeks ago. We now do not have a date. In the meantime his jaw bone is exposed, his bottom teeth are slowly falling out, and he is in constant pain and he cannot chew. He is living on puree foods and fluids and regular opioids. He is slowly loosing weight and I am concerned he will be in poor physical condition when we finally do get a date. You would not leave an animal in this state.


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