aroc 16 years old and going strong!!conference.co.nz/files/docs/aocprm/1600 frances simmonds.pdf ·...

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— AUSTRALASIAN REHABILITATION OUTCOMES CENTRE —SOCIAL AND SPATIAL DIMENSIONS OF ACCESS TO REHABILITATION

AOCPRM & RMSANZ 2018 AUCKLAND 21-24 NOVEMBER

AROC — 16 YEARS OLD AND GOING STRONG!!

• AROC was the brainchild of two well known and highly respected medical rehabilitation physicians, Ben Marosszeky and Garry Pearce.

• Established 1 July 2002 as a joint initiative of the whole Australian rehabilitation sector with support from key New Zealand providers– The Australasian Faculty of Rehabilitation Medicine (AFRM) is the auspice body– The Australian Health Services Research Institute (AHSRI) at the University of

Wollongong is the data manager and responsible for AROC’s day to day operations

• AROC, as the clinical quality registry and outcomes benchmarking arm of AFRM and the rehabilitation sector:– plays an important role in driving continued improvement in rehabilitation outcomes– contributes to the evidence underpinning the value of rehabilitation

• From a twinkle in Ben and Garry’s eyes all those years ago; today rehabilitation is leading the way in the measurement and benchmarking of outcomes

November 2018 2

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AROC PURPOSE

The purpose of AROC was established as, and continues to be:

• Develop a national benchmarking system to improve clinical rehabilitation outcomes for patients.

• Produce information on the effectiveness of interventions through the systematic collection of outcomes information in both the inpatient and ambulatory settings.

• Provide annual reports that summarise the Australasian data.

3

AROC COVERAGE – 292 INPATIENT SERVICES

North Island 25

South Island 14

AROC DATA, financial year 2018 4

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3

GROWTH IN AROC INPATIENT DATA

AROC DATA, financial years 1999-2018 5

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2009(n=62,645)

2010(n=70,840)

2011(n=77,549)

2012(n=83,765)

2013(n=97,826)

2014(n=106,832)

2015(n=112,457)

2016(n=120,765)

2017(n=124,785)

2018(n=126,648)

2013(n=9,327)

2014(n=11,567)

2015(n=12,273)

2016(n=12,110)

2017(n=12,251)

2018(n=12,165)

AU NZ

Pro

po

rtio

n o

f ep

iso

des

dis

char

ged

eac

h y

ear

Stroke Brain Neuro Spine Amputee

Arthritits Pain Ortho fracture Ortho replacement Soft tissue injury

Other ortho Cardiac Pulmonary Burns Congenital

Other MultTrauma Developmental Re-conditioning/restorative

INPATIENT EPISODES BY IMPAIRMENT

OVER TIME BY COUNTRY


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4

LOS & FIM CHANGE OVER TIME BY COUNTRY

7AROC DATA, financial years 2014-2018

-2

-1.5

-1

-0.5

0

0.5

1

1.5

2014 2015 2016 2017 2018

Cas

emix

-ad

just

ed r

elat

ive

mea

n

Australia - Financial year

Casemix-adjusted relative mean FIM scoresCasemix-adjusted relative mean LOS

-2

-1.5

-1

-0.5

0

0.5

1

1.5

2014 2015 2016 2017 2018

Cas

emix

-ad

just

ed r

elat

ive

mea

n

New Zealand - Financial year

GROWTH IN AROC AMBULATORY DATA

0

10

20

30

40

50

60

0

2,000

4,000

6,000

8,000

10,000

12,000

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Nu

mb

er

of

serv

ice

s

Nu

mb

er

of

ep

iso

de

s

Financial year of discharge

Episodes

Services


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AMBULATORY EPISODES BY IMPAIRMENT OVER TIME

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2014 (n=8,351) 2015 (n=8,858) 2016 (n=9,424) 2017 (n=10,506) 2018 (n=10,893)

Proportion

of episodes

Re-conditioning

Developmental disability

Multiple trauma

Other disabling imp.

Congenital deformity

Burns

Pulmonary

Cardiac

Ortho - others

Ortho - soft tissue injury

Ortho - replacements

Ortho - fractures

Pain

Arthritis

Amputee

Spinal cord

Neurological

Brain

Stroke


SOCIAL AND SPATIAL DIMENSIONS

OF ACCESS TO REHABILITATION

IN AUSTRALIA AND NEW ZEALAND

10

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MEASURES OF SOCIAL AND SPATIAL DIMENSIONS USED

• GEOGRAPHIC LOCATION OF PATIENT AND REHABILIATION SERVICE– Australia: ABS Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA)

– New Zealand: Stats NZ Urban-Rural Index (URI)

• SOCIO-ECONOMIC DISADVANTAGE OF PATIENT AND REHABILIATION SERVICE– Australia: ABS Socio-Economic Indexes for Areas – Index of Relative Disadvantage (SEIFA-IRSD)

– New Zealand: Stats NZ Index of Relative Socioeconomic Deprivation (NZDep)

• DISTANCE PATIENT HAS TO TRAVEL TO REHABILITATION SERVICE– Australia and New Zealand: Determined using latitude and longitude of postcode

11

OBTAINING POSTCODE LEVEL DATA

• Australia: Data from the Australian Bureau of Statistics 2016 census was used. The ASGC-RA and SEIFA-IRSD provide measures mapped to Australian postcodes.

• New Zealand: Data from the Stats NZ 2013 census was used. The URI and NZDepdata (obtained from Otago University) provides measures mapped to meshblock(the smallest statistical area in NZ of ~80-100 people). Meshblocks are not directly mappable to NZ postcodes. To map to postcode geospatial data containing postcode and meshblock for each address in NZ was used (obtained from Koordinates). Meshblocks that crossed over postcodes were assigned the postcode with the most addresses. Postcode level data was obtained by weighting the data by the meshblock population – within each postcode the URI with the highest population and the median NZDep were identified and assigned to the postcode.

12

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7

GEOGRAPHIC LOCATION

• Australia: The ASGC-RA classifies postcodes into geographically similar categories, depending on the ‘remoteness’ of the area.– Major Cities of Australia

– Inner Regional Australia

– Outer Regional Australia

– Remote Australia

– Very Remote Australia

• New Zealand: The URI classifies meshblocks into geographically similar categories, based on measures of rurality. – Main Urban Area (population of 30,000 or more, e.g. cities)

– Secondary Urban Area (population of 10,000 to 29,999)

– Minor Urban Area (population of 1,000 to 9,999 )

– Rural Centre (population of 300 to 999 people)

– Other Rural

– Other (Inland Water, Inlet and Oceanic) 13

GEOGRAPHIC LOCATION

14

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WHERE ARE REHABILITATION SERVICES LOCATED


15AROC DATA, financial year 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

Major Cities ofAustralia /

NZ Main urbanare

Inner RegionalAustralia /

NZ Secondaryurban area

Outer RegionalAustralia /

NZ Minor urbanarea

Remote Australia/

NZ Rural Centre

Very RemoteAustralia /

NZ Other rural

Pro

po

rtio

n o

f se

rvic

es

Australia (n=252) New Zealand (n=39)Inpatient facilities:

0

10

20

30

40

50

60

70

80

90

100

Major Cities ofAustralia

Inner RegionalAustralia

Outer RegionalAustralia

RemoteAustralia

Very RemoteAustralia

Nu

mb

er

of

serv

ice

s

Australia Public (n=128) Australia Private (n=124)Inpatient facilities:

AU and NZ AU Public & Private

WHERE ARE REHABILITATION BEDS LOCATED



0%

10%

20%

30%

40%

50%

60%

70%

80%

Major Cities ofAustralia /

NZ Main urbanare

Inner RegionalAustralia /

NZ Secondaryurban area

Outer RegionalAustralia /

NZ Minor urbanarea

RemoteAustralia /

NZ Rural Centre

Very RemoteAustralia /

NZ Other rural

Pro

po

rtio

n o

f b

ed

s

Australia (n=7,430) New Zealand (n=1,076)Inpatient rehab beds:

0

500

1,000

1,500

2,000

2,500

3,000

3,500




RemoteAustralia


Nu

mb

er

of

be

ds

Australia Public (n=3,658) Australia Private (n=3,772)Inpatient rehab beds:


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WHERE DO PATIENTS RECEIVING REHABILITATION

LIVE IN AUSTRALIA AND NEW ZEALAND

17

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Major Cities ofAustralia / NZ

Main urban are

Inner RegionalAustralia / NZ

Secondaryurban area

Outer RegionalAustralia / NZMinor urban

area

RemoteAustralia / NZRural Centre

Very RemoteAustralia / NZ

Other rural

Pro

po

rtio

n o

f e

pis

od

es

AU (n=126,318) NZ (n=11,537)

AROC DATA, financial year 2018

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%




RemoteAustralia


Pro

po

rtio

n o

f e

pis

od

es

Public (n=49,158) Private (n=77,160)


DO PATIENTS LIVE WHERE INPATIENT

REHABILITATION SERVICES ARE LOCATED

18

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


(n=105,685)


(n=17,028)

Outer RegionalAustralia(n=2,872)

Remote Australia(n=80)

Very RemoteAustralia (n=2)

Australian facilities (episodes in 2018 = 125,667)

Pro

po

rtio

n o

f ep

iso

des

Major Cities of Australia Inner Regional Australia Outer Regional AustraliaRemote Australia Very Remote Australia

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

NZ Main urbanarea (n=8,809)

NZ Secondaryurban area(n=1,070)

NZ Minor urbanarea (n=652)

NZ Rural Centre(n=0)

NZ Other rural(n=971)

New Zealand facilities (episodes in 2018 = 11,502)

Pro

po

rtio

n o

f ep

iso

des

NZ Main urban area NZ Secondary urban area NZ Minor urban areaNZ Rural Centre NZ Other rural


29/11/2018

10

VARIATION IN WHERE PATIENTS LIVE BY IMPAIRMENT

19

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Stro

ke (

n=9

,74

3)

Bra

in (

n=3

,11

3)

Neu

ro (

n=4

,447

)

Spin

e (n

=1,0

01)

Am

put

ee (

n=1

,450

)

Art

hrit

its

(n=3

90

)

Pai

n (n

=4,7

17

)

Ort

ho

fra

ctur

e (n

=19,

596

)

Ort

ho

rep

lace

men

t (n

=30,

874

)

Soft

tis

sue

inju

ry (

n=1

,548

)

Oth

er o

rth

o (n

=8,1

85)

Car

diac

(n

=3,9

01)

Pulm

ona

ry (

n=2

,51

6)

Oth

er (

n=8

47)

Mu

ltTr

aum

a (n

=1,1

50)

Re-

cond

itio

nin

g (n

=32

,72

9)

Stro

ke (

n=1

,84

4)

Bra

in (

n=4

14)

Neu

ro (

n=2

14)

Spin

e (n

=201

)

Am

put

ee (

n=1

71)

Art

hrit

its

(n=4

0)

Pai

n (n

=21

4)

Ort

ho

fra

ctur

e (n

=3,8

34)

Ort

ho

rep

lace

men

t (n

=23

4)

Soft

tis

sue

inju

ry (

n=39

1)

Oth

er o

rth

o (

n=1

33)

Car

diac

(n

=10

9)

Pulm

ona

ry (

n=6

9)

Oth

er (

n=2

72)

Mu

ltTr

aum

a (n

=44

)

Re-

cond

itio

nin

g (n

=3,3

34

)

Australia New Zealand

Pro

po

rtio

n o

f e

pis

od

es

Major Cities of Australia Inner Regional Australia Outer Regional Australia Remote Australia Very Remote AustraliaNZ Main urban area NZ Secondary urban area NZ Minor urban area NZ Rural Centre NZ Other rural


IMPACT OF GEOGRAPHIC LOCATION ON LENGTH OF STAY

20

0

5

10

15

20

25

30

35

Maj

or C

itie

s o

f A

ustr

alia

Inn

er R

egio

nal

Aus

tral

ia

Ou

ter

Reg

ion

al A

ustr

alia

Rem

ote

Aus

tral

ia

Ver

y R

emot

e A

ustr

alia

NZ

Mai

n u

rban

are

a

NZ

Seco

ndar

y u

rban

are

a

NZ

Min

or u

rban

are

a

NZ

Ru

ral C

ent

re

NZ

Oth

er r

ura

l

2009 2014 2018

Ave

rag

e L

OS

(days

)

AROC DATA, financial years 2009, 2014, 2018

0

5

10

15

20

25

30

35

Maj

or

Cit

ies

of

Aus

tral

ia

Inn

er R

egio

nal

Aus

tral

ia

Ou

ter

Reg

ion

al A

ustr

alia

Rem

ote

Aus

tral

ia

Ver

y R

emo

te A

ustr

alia

Maj

or

Cit

ies

of

Aus

tral

ia

Inn

er R

egio

nal

Aus

tral

ia

Ou

ter

Reg

ion

al A

ustr

alia

Rem

ote

Aus

tral

ia

Ver

y R

emo

te A

ustr

alia

Treated at a public hospital Treated at a private hospital

29/11/2018

11

IMPACT OF GEOGRAPHIC LOCATION ON

CHANGE IN FUNCTION

21

0

5

10

15

20

25

30

Maj

or

Cit

ies

of

Au

stra

lia

Inn

er R

egio

nal

Au

stra

lia

Ou

ter

Re

gio

nal

Au

stra

lia

Rem

ote

Au

stra

lia

Ve

ry R

emo

te A

ust

ralia

NZ

Mai

n u

rban

are

a

NZ

Seco

nd

ary

urb

an a

rea

NZ

Min

or

urb

an a

rea

NZ

Ru

ral C

entr

e

NZ

Oth

er

rura

l

2009 2014 2018

0

5

10

15

20

25

30

Maj

or

Cit

ies

of

Au

stra

lia

Inn

er R

egio

nal

Au

stra

lia

Ou

ter

Re

gio

nal

Au

stra

lia

Rem

ote

Au

stra

lia

Ver

y R

emo

te A

ust

ralia

Maj

or

Cit

ies

of

Au

stra

lia

Inn

er R

egio

nal

Au

stra

lia

Ou

ter

Re

gio

nal

Au

stra

lia

Rem

ote

Au

stra

lia

Ver

y R

emo

te A

ust

ralia


Ave

rag

e F

IM c

hange (

poin

ts)


SOCIO-ECONOMIC DISADVANTAGE

• Deprivation is a state of observable and demonstrable disadvantage relative to the local community or the wider society or nation to which an individual, family or group belongs (Townsend, 1987).

• Index interpretation: the lower the SEIFA and NZDep index scores the more disadvantaged an area.

• The SEIFA and NZDep scores from all postcodes were divided into population based quintiles to enable comparative analysis. – The quintiles represent five socioeconomic levels from low (most disadvantaged) through to high (least

disadvantaged), with each quintile representing approximately 20% of their national populationi.e. 20% of the population live in the lowest socioeconomic postcodes and 20% in the highest.

• Patients were assigned a socioeconomic category based on their postcode.

22

29/11/2018

12

REHABILITATION SERVICES IN AUSTRALIA AND

NEW ZEALAND BY LEVEL OF SOCIAL DISADVANTAGE


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

AU (n=252) NZ (n=39) POPULATION Public (n=128) Private (n=124)

Pro

po

rtio

n o

f se

rvic

es

High

4

Medium

2

Low(most disadvantaged)

(least disadvantaged)

SOCIAL DISADVANTAGE OF PATIENTS RECEIVING

REHABILITATION AUSTRALIA AND NEW ZEALAND


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Australia (n=126,300) New Zealand (n=11,537) POPULATION Public (n=49,146) Private (n=77,154)

Country Australia

Pro

po

rtio

n o

f e

pis

od

es

High

4

Medium

2

Low(most disadvantaged)


29/11/2018

13

VARIATION IN LEVEL OF SOCIAL DISADVANTAGE

BY IMPAIRMENT

25

0%

20%

40%

60%

80%

100%

Stro

ke (n

=9,7

43)

Bra

in (n

=3,1

13

)

Neu

ro (

n=4

,44

7)

Spin

e (n

=1,0

01)

Am

pu

tee

(n=1

,450

)

Art

hri

tits

(n

=390

)

Pai

n (

n=4

,717

)

Ort

ho

fra

ctu

re (

n=1

9,5

96)

Ort

ho

re

pla

cem

ent

(n=3

0,8

74

)

Soft

tis

sue

inju

ry (

n=1

,548

)

Oth

er o

rth

o (

n=8

,18

5)

Car

dia

c (n

=3,9

01)

Pu

lmo

nar

y (n

=2,5

16)

Oth

er (

n=8

47)

Mu

ltTr

aum

a (n

=1,1

50

)

Re-

con

dit

ion

ing

(n=3

2,72

9)

Stro

ke (n

=1,8

44)

Bra

in (n

=414

)

Neu

ro (

n=2

14)

Spin

e (n

=201

)

Am

pu

tee

(n=1

71

)

Art

hri

tits

(n

=40)

Pai

n (

n=2

14)

Ort

ho

fra

ctu

re (

n=3

,83

4)

Ort

ho

rep

lace

men

t (n

=234

)

Soft

tis

sue

inju

ry (

n=3

91)

Oth

er o

rth

o (

n=1

33)

Car

dia

c (n

=10

9)

Pu

lmo

nar

y (n

=69)

Oth

er (

n=2

72)

Mu

ltTr

aum

a (n

=44)

Re-

con

dit

ion

ing

(n=3

,33

4)


Pro

po

rtio

n o

f e

pis

od

es

High

4

Medium

2

Low


(most disadvantaged)


IMPACT OF SOCIAL DISADVANTAGE ON LENGTH OF STAY

26

0

5

10

15

20

25

30

Low 2 Medium 4 High Low 2 Medium 4 High


2009 2014 2018


0

5

10

15

20

25

30



Ave

rag

e L

OS

(days

)

(most (least

disadvantaged) disadvantaged)

(most (least

disadvantaged) disadvantaged)(most (least


(most (least


29/11/2018

14

IMPACT OF SOCIAL DISADVANTAGE ON

CHANGE IN FUNCTION

27

0

5

10

15

20

25



2009 2014 2018

0

5

10

15

20

25




Ave

rag

e F

IM c

hange (

poin

ts)

(most (least


(most (least



(most (least


DISTANCE PATIENT HAS TO TRAVEL

• Distance between the patient’s home and the facility where they received rehabilitation was estimated using the geographical locators of longitude and latitude. – for both Australia and New Zealand longitude and latitude of postcodes were

obtained from AGGDATA (www.aggdata.com). Any postcodes missing longitude and latitude were then obtained using DISTANCESTO.COM (www.distancesto.com … Find Coordinates).

• Straight line distance between the centre points of each pair of postcodes was used as an approximation of the distance.

• We acknowledge that the straight-line distance is likely to be underestimate of the patient’s actual travel distance however it was considered a suitable approximation.

28

29/11/2018

15

HOW FAR DO PATIENTS RECEIVING REHABILITATION

NEED TO TRAVEL IN AUSTRALIA AND NEW ZEALAND


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Australia (n=56,653) New Zealand (n=136) Public hospital (n=17,993) Private hospital (n=38,660)

Country Australia

Pro

po

rtio

n o

f e

pis

od

es

more than 250km

up to 250km

up to100km

up to 50km

up to 30km

up to 20km

up to 15km

up to 10km

up to 5km

same postcode

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Stro

ke (

n=9

,66

7)

Bra

in (n

=3,1

02)

Neu

ro (

n=4

,407

)

Spin

e (n

=993

)

Am

pu

tee

(n=1

,44

7)

Art

hri

tits

(n=3

87

)

Pai

n (

n=4

,692

)

Ort

ho

fra

ctu

re (

n=1

9,4

70)

Ort

ho

rep

lace

men

t (n

=30,

742)

Soft

tis

sue

inju

ry (

n=1

,539

)

Oth

er o

rth

o (

n=8

,147

)

Car

dia

c (n

=3,8

80

)

Pu

lmo

nar

y (n

=2,5

03)

Oth

er (

n=8

42)

Mu

ltTr

au

ma

(n=1

,142

)

Re-

con

dit

ion

ing

(n=3

2,3

63

)

Stro

ke (

n=1

,88

4)

Bra

in (n

=42

7)

Neu

ro (

n=2

19)

Spin

e (n

=203

)

Am

pu

tee

(n=1

72)

Art

hri

tits

(n=4

1)

Pai

n (

n=2

19)

Ort

ho

fra

ctu

re (

n=3

,911

)

Ort

ho

re

pla

cem

ent

(n=2

37)

Soft

tis

sue

inju

ry (

n=4

00)

Oth

er o

rth

o (

n=1

38)

Car

dia

c (n

=11

0)

Pu

lmo

nar

y (n

=70

)

Oth

er (

n=2

76)

Mu

ltTr

aum

a (n

=45

)

Re-

con

dit

ion

ing

(n=3

,44

0)


Pro

po

rtio

n o

f e

pis

od

es

more than 250km

up to 250km

up to100km

up to 50km

up to 30km

up to 20km

up to 15km

up to 10km

up to 5km

same postcode

VARIATION IN PATIENT TRAVEL DISTANCE BY IMPAIRMENT


29/11/2018

16

PATIENT TRAVEL DISTANCES BY GEOGRAPHIC

LOCATION OF THE PATIENT AND COUNTRY


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Major Citiesof Australia(n=95,339)

InnerRegionalAustralia

(n=22,245)

OuterRegionalAustralia(n=6,868)

RemoteAustralia(n=608)

Very RemoteAustralia(n=372)

NZ Mainurban area(n=8,435)


NZ Minorurban area(n=1,160)

NZ RuralCentre(n=129)

NZ Otherrural (n=693)


Pro

po

rtio

n o

f e

pis

od

es

more than 250km

up to 250km

up to100km

up to 50km

up to 30km

up to 20km

up to 15km

up to 10km

up to 5km

same postcode

PATIENT TRAVEL DISTANCES BY GEOGRAPHIC

LOCATION OF THE REHABILITATION SERVICE & COUNTRY


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


(n=105,507)


(n=16,996)

Outer RegionalAustralia(n=2,851)

Remote andVery Remote

Australia (n=82)

NZ Main urbanarea (n=8,904)


NZ Minor urbanarea (N=653)

NZ Other rural(n=972)

Location of facility in Australia Location of facility in New Zealand

Pro

po

rtio

n o

f e

pis

od

es

more than 250km

up to 250km

up to100km

up to 50km

up to 30km

up to 20km

up to 15km

up to 10km

up to 5km

same postcode

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PATIENT TRAVEL DISTANCES BY LEVEL OF SOCIAL

DISADVANTAGE BY COUNTRY


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Low(n=17,254)

2 (n=20,860) Medium(n=24,683)

4 (n=24,983) High(n=37,643)

Low(n=1,877)

2 (n=2,599) Medium(n=2,609)

4 (n=2,323) High(n=2,094)


Pro

po

rtio

n o

f e

pis

od

es

more than 250km

up to 250km

up to100km

up to 50km

up to 30km

up to 20km

up to 15km

up to 10km

up to 5km

same postcode

(most (least



IN SUMMARY

• Patients mostly go to their local inpatient rehab unit

– SCI, BI and MMT patients travel further

• Patients attending rehabilitation are equally represented across all levels of socioeconomic backgrounds in NZ

– Australia has slightly more patients from less disadvantaged areas

• The more disadvantaged and the more remote an area is

– the greater the distance travelled to attend rehab

– the longer the length of stay

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AROC IN ACTION: BENDIGO HEALTH CRITICAL CARE

DATATHON (SEPTEMBER 2018)

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AROC IN ACTION:BENDIGO HEALTH CRITICAL CARE DATATHON (SEPT’18)• First datathon covering the full patient journey — ED

admission to ICU to recovery in rehabilitation to community

– 140 Million records (Victorian public services only)

– patient linked data across 7 sources

• Data custodians agreed on anonymization rules before linkage

– most demographic information removed or rolled up (eg. age groups)

– all facility information removed

• Data linkage: Centre for Victorian Data Linkage (CVDL)

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AROC IN ACTION:BENDIGO HEALTH CRITICAL CARE DATATHON (SEPT’18)• AROC data

– 10 years of Victorian public services data (~170,000 episodes)

• Linked with– Dept. Health and Human Services Victoria

• VEMD (Emergency Department)• VINAH (Non-Admitted)• VAED (Admitted)• VCR (Victorian Cancer Registry)• HACC (Home and Community Care)

– ANZICS: Australia New Zealand Intensive Care Society• reported by contributing ICUs for benchmarking

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AROC IN ACTION:BENDIGO HEALTH CRITICAL CARE DATATHON (SEPT’18)

• 18 teams looked at different topics, for example– Team CARDIAC ARREST looked at What happened next for the 52.1% of

patients that presented to ICU following a cardiac arrest and survived

– As intensivists, they wanted to know how many of their patients went on to have rehabilitation and what their outcomes looked like

– They were very surprised to learn most patients going on to rehabilitation showed improved function, were able to return home and very few die – this was an unexpected finding for them

– This team learnt just how beneficial rehabilitation is

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AROC IN ACTION:BENDIGO HEALTH CRITICAL CARE DATATHON (SEPT’18)

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AROC CONTACT DETAILS

Australasian Rehabilitation Outcomes Centre (AROC)

Australian Health Services Research Institute (AHSRI)

iC Enterprise 1, Innovation Campus

University of Wollongong NSW 2522

Phone: +61 2 4221 4411

Email: [email protected]

Web: aroc.org.au

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