June 26, 2017

The 2nd Australian Atlas of Healthcare Variation – findings and recommendations for COPD

The Australian Atlas of Healthcare Variation series produced by the Australian Commission on Safety and Quality in HealthCare illuminates variation by mapping use of health care according to where people live. Each Atlas identifies specific achievable actions for exploration and quality improvement.

The second edition has recently been released with the report showing that there was substantial variation in the health care delivered between local areas for patients. Almost half (47%) of potentially preventable hospitalisations (PPH) were due to five conditions and Chronic Obstructive Pulmonary Disease (COPD) was one of the five. COPD was the second most PPH with 66,250 admissions. In 2013-14, COPD accounted for 355,328 hospital bed days, and 15% of all potentially preventable hopsitalisations.

Amongst chronic conditions however, COPD had the greatest variation in the care delivered with hospitalisation rates in one area of 63 people per 100,000 compared to 990 people per 100,000 in another area (almost 16 fold). The report identified that, the early identification and implementation of individualised health interventions in the primary care setting is an area where work can be progressed to reduce PPHs. The following recommendations were put forward:

  • Promotion of appropriate care for the management of people with COPD by:
    • Using The COPDX Plan (Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease) as the routine model of care
    • Targeted anti-smoking programs for populations with high smoking rates.
  • Development of culturally appropriate pulmonary rehabilitation programs for Aboriginal and Torres Strait Islander Australians.

The atlas also highlighted other areas for actions including:

  • Improving communication about COPD at the clinician level
  • Increasing access to community pulmonary rehabilitation or physiotherapy services and multidisciplinary care
  • Increasing patient health literacy and ability to self-manage exacerbations
  • Reducing diagnostic error
  • Increasing access to secondary prevention programs, such as support for regular physical activity and a healthy diet
  • Increasing rates of influenza and pneumococcal vaccination
  • Increasing clinicians’ focus on smoking cessation.

Lung Foundation Australia has many clinical resources available to support health professionals including the Stepwise Management of Stable COPD, COPD Action Plan and COPDX Concise Guide for Primary Care, click here.

We also have many patient resources to improve health literacy and support patients to self-manage, click here.

To access the 2nd Australian Atlas of Healthcare Variation click here.