Planning and Evaluating Health Services in the State of Cook - Report Example

PLANNING AND EVALUATING HEALTH SERVICES Number: 92847 Autumn Semester Assignment BRIEF OVERVIEW Purpose of this paper Following the establishment of the new state of Cook, comprising of the state of New South Wales (NSW) and Queensland, this paper has been developed to provide an overview of the healthcare services available within this new state and identify success factors and challenges in the region that would help to plan and develop future health care services. Scope of this paper This paper will focus on identifying the population trends in the state of Cook and gather and analyse specific information pertaining to hospital beds, residential aged care places, supply of health care professionals and trends in Medicare services. Assumptions Since health services’ planning involves projecting data into the future, the data presented below is based on the assumption that the current trends would continue. Therefore service planners need to take into account external factors that can significantly change the projections. Population projections and other ABS data related calculations for the states have been made using Australian Bureau of Statistics (Series B) projections since it largely reflects the current trends in fertility and life expectancy at birth. In this paper the states of Queensland and NSW will be referred to as North Cook and South Cook respectively. Limitations Some of the data presented in this paper is only an approximation and may not be accurate because data from two sources may have been combined. Secondly there are differences in the way data is reported by NSW and Queensland. ABOUT COOK STATE Geographic Location Cook state is located on the eastern side of Australia and comprises of the states previously known as NSW and Queensland. The main land area of Cook state is about 2,524,564 square kilometres with an additional 6,726 square kilometres in islands.1 Therefore Cook state has a total area of 2,531,290 square kilometres (Figure 1). Figure: 1 Source: http://www.thefullwiki.org/Geography_of_Australia Demographics Australia is estimated to have a population of 22,569,765, while Cook state is estimated to have a population of 11,862,769.2 Therefore Cook state accounts for almost 52.6% of the country’s population. Table: 1 Projected population in age groups for Cook State Age group 2010 2015 2020 2025 0 - 14 years 2,227,333 2,347,497 2,511,097 2,655,620 15 - 64 years 7,769,072 8,229,837 8,630,387 9,018,504 65 - 85 years 1,589,862 1,899,621 2,231,279 2,584,371 85 years and over 206,744 254,678 2,85,783 332,702 Total 11,793,011 12,731,633 13658546 14,591,197 Source: Australian Bureau of Statistics, 2008 Graph: 1 The population of Cook is a growing population with 76% of the population within the 15- 64 years age group and a median age of 37 years (Table 1 & Graph 2). Currently there are 100 women for every 99 men in the state. The population density of North Cook is approximately 2.6 people per sq km while that of South Cook is approximately 8.9 people per square km.3 The population density is low across most of the regions within Cook state and has been found to gradually increase to as high as 340 people per sq km in Brisbane and 370 people per sq km in Sydney (Figure 2 & 3). 3 Therefore it can be inferred that most of the population growth is occurring in major cities located along the eastern coast of Cook State. Figure: 2 Sydney with a population density of 370 people per sq km Source: Regional Population Growth, Australia, 2008-09 Figure: 3 Brisbane with a population density of 340 people per sq km Source: Regional Population Growth, Australia, 2008-09 In addition to Brisbane and Sydney there are four other regions within Cook state that have reported a significant population growth in recent years – Hervey Bay (5.1%), Mackay (3.7%), Gold Coast-Tweed (3.6%) and Sunshine Coast (3.8%) (ABS Year Book Australia, 2008) Burden of disease The burden of disease is greater among those in the lower socio economic status (SES) with significantly higher rates of diabetes, injuries and mental disorders. The risk factors contributing to this are: tobacco and alcohol use, unsafe sex, illicit drug use, physical inactivity, high blood pressure and high cholesterol (Begg et al. 2007). Indigenous Australians within Cook have also been found to exhibit higher rates of rheumatic heart disease, diabetes, tuberculosis and invasive pneumococcal disease (Australian Institute of Health and Welfare, 2010). This disparity of disease gets more pronounced in light of the fact that Indigenous Australians typically live in remote geographic areas with limited access to healthcare services. Based on the DALY calculations, coronary heart disease ranks number one in North Cook while infectious disease ranks number one in South Cook. The diseases that account for nearly half of all ambulatory care services in Cook state are diabetes with complications, lung cancer, mental disorders, coronary heart disease, chronic obstructive pulmonary disease, asthma and congestive heart failure (Australian Institute of Health and Welfare, 2010). HEALTH CARE SERVICES Hospitals South Cook has more private and public hospitals compared to North Cook (Table 2).4 Hence the disparity in infrastructure and associated workforce between the two region is evident. Table: 2 Public and Private Hospitals in Cook (2008-2009)   South Cook North Cook Public hospitals   Public acute hospitals 219 166 Public psychiatric hospitals 8 4 Total 227 170 Private hospitals   Private free standing day hospitals 89 53 Other private hospitals 84 53 Total 173 106     All hospitals 400 276 Source: Australian Institute of Health and Welfare South Cook has substantially larger number of hospital beds compared to North Cook (Table 3). 4 The bed per person ratio in Cook State is approximately one bed per 264 persons. Table: 3 Average available or licensed beds (2008 – 2009)   South Cook North Cook Public hospitals   Public acute hospitals 18,844 10,347 Public psychiatric hospitals 961 458 Total 19,805 10,805     Private hospitals   Private free standing day hospitals 644 411 Other private hospitals 6,070 6,003 Total 6,714 6,414     All hospitals 26,519 17,219 Source: Australian Institute of Health and Welfare (2009) Residential aged care places The total number of residential aged care places in the state of Cook is 118,059 with South Cook accounting for 66% of the facilities (Table 4 & Graph 2).5 Table: 4 Distribution of residential aged care places     South Cook   North Cook Residential Aged Care 61,224 31,755 CACP 13,677 7,087 EACH / EACH D 2,107 1,048 TCP 772 389 Total   77,780   40,279 Source: Australian Institute of Health and Welfare (2009) Graph: 2 Percentage distribution of residential aged care places in Cook Table 5 shows the distribution of residential aged care places in the state of Cook based on region and remoteness. 5 Access and distance to services offered in urban areas (as used by the ASGC) have been used to classify remoteness. Table: 5 Residential aged care places by region and remoteness Source: Australian Institute of Health and Welfare (2009) Healthcare personnel Of the 193,735 people in the healthcare workforce in Cook State, nearly 43% are in nursing occupation (Table 6). 5 There are 1672 healthcare workers for every 100,000 people living in Cook State and nearly 50% of this workforce is based in hospitals. Table: 6 Current Healthcare personnel in the state of Cook Healthcare personnel Number General & Other Medical 18,092 Specialist Medical & Surgical 8,663 Other Medical 1,641 Diagnostic 5,507 Dental 14,194 Nursing 84,225 Pharmacy 1,148 Allied Health 21,507 Alternate Therapies 7,182 Health and Welfare Managers 1,657 Aboriginal Health Workers 347 Other Health and Medical 29,572 Total 193,735 Source: Australian Institute of Health and Welfare (2009) MEDICARE SERVICES Trends Medicare has been the health insurance scheme that has been providing free or subsidised health care services to the people in Australia. Over the past five years there has been a significant increase in the use of Medicare services (Table 7 & Graph 3). Table: 7 Five year comparison of number of services and value of benefits processed Financial Year 2005/06 2006/07 2007/08 2008/09 2009/10 Number of services processed 247,366,876 257,892,389 278,718,317 294,008,888 308,400,916     Value of benefits processed $10,976,260,110 $11,735,563,791 $13,006,526,270 $14,321,927,175 $15,477,140,545     Average value of benefit processed per service $44.37 $45.51 $46.67 $48.71 $50.19 Graph: 3 Trend in use of Medicare services The five year comparison of average number of services processed per Australian resident reveals that females use the Medicare services much more than their male counterparts (Table 8).6 The most used Medicare service is Pathology followed by diagnostic imaging and operations while the least used service is assistance at operations (Table 9). 6 Table: 8 Average number of services processed per Australian resident Financial Year 2005/06 2006/07 2007/08 2008/09 2009/10 Male 9.99 10.23 10.87 11.26 11.58 Female 14.03 14.31 15.22 15.64 15.94 All Persons 12.02 12.28 13.06 13.46 13.77 Source: Medicare Australia, June 2010 Table: 9 Financial Year 2005/06 2006/07 2007/08 2008/09 2009/10     Unreferred Attendances 104,306,663 107,096,941 114,743,383 118,512,704 124,278,006 Other Allied Health 536,327 1,554,302 3,857,480 6,933,364 9,934,199 Specialist Attendances 21,335,485 21,689,154 22,275,348 23,125,366 23,834,254 Obstetrics 1,431,566 1,499,554 1,523,555 1,576,894 1,659,371 Anaesthetics 2,091,448 2,164,018 2,330,717 2,450,535 2,571,364 Pathology 82,889,458 87,542,167 95,750,936 100,444,931 103,718,115 Diagnostic Imaging 14,921,662 15,654,585 16,524,741 17,331,366 18,153,146 Operations 7,137,273 7,245,011 7,542,026 7,929,357 7,876,338 Assistance at Operations 343,999 354,156 373,353 396,096 413,892 Optometry 5,259,324 5,473,235 5,691,229 6,137,638 6,409,222 Radiotherapy and Therapeutic Nuclear Medicine 834,118 873,120 940,711 1,271,970 1,432,771 Miscellaneous 6279553 6746146 7164838 7438976 7697452 Dental Benefits Schedule 0 0 0 459,691 422,786     Total 247,366,876 257,892,389 278,718,317 294,008,888 308,400,916 Number of services by broad type of service Source: Medicare Australia, June 2010 The number of services processed increased by nearly 25% while the value of benefits processed increased by 41% in the past five years from (Table 7). The number of Medicare benefits schedule items also increased from 3903 to 5765 (47.7%) which probably explains the increase in use of Medicare services over the past five years. However, there are some alarming trends in business practice within the health care industry as identified in Medicare Australia (2009): There is a widespread shortage of general practitioners in Australia which is also reflected in Cook within increasing number of GPs working part-time or across multiple sites. Patients are seeing more providers since services are being provided in group practices. Medical records are fragmented with patients deciding which information can be shared between their general practitioners and health care providers resulting in repeat consultations, tests and investigations. RECOMMENDATIONS 1. Local health networks offering comprehensive medical care services should be distributed evenly through out the state to address the needs of the lower SES group and Indigenous Australians. 2. More residential aged care facilities should be established in North Cook to meet the needs of the geriatric population. 3. Focus on health education, preventive and early detection strategies to address alcohol and substance abuse, unsafe sex, high blood pressure and cholesterol to reduce the burden of disease within the state. 4. Policy changes need to be made at the state and federal level to address the shortage of General Practitioners in Cook State and the country as a whole. 5. Data collection systems should be standardised and made more efficient so that it can provide accurate information to assist health services planning within the state of Cook. 6. Additional funding should be requested from the Commonwealth to support infrastructure and health care network development within the state. CONCLUSION The information that has been provided in this paper has provided a synopsis of the health care trends, challenges and opportunities in the state of Cook based on which health services can be designed. With the health care resources that are already available within the state and some careful planning based on the recommendations made above, Cook Health can aim to meet the growing needs of the state. REFERENCE LIST Australian Bureau of Statistics.(2008). Year Book Australia, 2008. Accessed on April 1, 2011from http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/ 0/8D6ED0E197FE38A6CA2573E7000EC2AD/$File/13010_2008.pdf. Australian Institute of Health and Welfare (2009). Australian hospital statistics. Accessed on March 28, 2011from www.aihw.gov.au/publications/hse/hse-71-10776/hse-71-10776.pdf. Australian Institute of Health and Welfare (2010). Australia’s health 2010. Australia’s health series no. 12. Cat. no. AUS 122. Canberra: AIHW. p. 84-147. Begg S, Vos T, Barker B. et al.(2007). The burden of disease and injury in Australia. Accessed on March 26, 2011from www.aihw.gov.au/publications/index.cfm/ title/10317 Geoscience Australia. Area of Australia – States and Territories. Accessed on March 30, 2011from www.ga.gov.au/ education/geoscience-basics/dimensions/area-of-australia-states-and-territories.html Medicare Australia (2009) Annual Report Accessed on April 1, 2011from www.medicareaustralia.gov.au/about/governance/reports/08-09/stats/index.jsp Medicare Australia (2010) Annual Report Accessed on April 1, 2011 from http://www.medicareaustralia.gov.au/about/governance/reports/09-10/index.jsp Regional Population Growth, Australia, 2008-09. Accessed on March 27, 2011from www.abs.gov.au/ausstats/abs@.nsf/Previousproducts/ 3218.0Main%20Features62008-09?opendocument&tabname=Summary&prodno =3218.0&issue=2008-09&num=&view= Read More