Statewide Rural and Remote Clinical

Network

Assoc Prof Alan Bruce Chater Chair

Cellulitis COPD “UTI” – incl Glomerulonephritis

Diabetes complications

Heart failure AMI

Second Atlas of healthcare variation

ABORIGINAL AND TORRES STRAIT ISLANDER

SIEFA

FACILITIES Hospital and Health Services rural and remote facilities

The Torres and Cape HHS Community Clinics* Inner Cluster Thursday Island Horn Island (Ngurupai) Near Western Cluster Badu Island Kubin(Moa Island) St Pauls (Moa Island) Mabuiag Island Central Cluster Yam Island (Iama) Yorke Island (Masig) Coconut Island (Poruma) Warraber Island (Sue) Eastern Cluster Darnley Island (Erub) Murray Island (Mer) Stephen Island (Ugar) Top Western Cluster Boigu Island Saibai Island Dauan Island Northern Peninsula Cluster Bamaga Injinoo New Mapoon Seisia Umagico

* Community clinics that operate on weekdays may not operate five days per week Map does not include regional and metropolitan hospitals and health facilities Current as at 26 April 2017

HOUSE PRICES

QH DATA

• QH Data – Where treated – Can link to other data – Can isolate to treating facility

Cf • Atlas

– Where from

Analytics Team, Patient Safety and Quality Improvement Service, Department of Health, Queensland

ISSUES

• Disadvantage – Socioeconomic – Sanitation and disease – Life style

– Smoking – Obesity – Scurvy (barcoo

– Geographical access – Medicare access – Indigenous

– Skin conditions – scabies, tinea, strep – Secondary conditions

» PSGN – renal » Rheumatic fever – cardiac

• Quality – Distance

– Danger of discharge – Diagnosis

– Time e.g. overnight stay vs technology e.g. CT – Double counting

– Transfers • Clinical variation

DISTANCE TO SERVICE INDIGENOUS

SMOKING AND DISTANCE

BMI?

DIET OR EXERCISE?

SOCIO-ECONOMIC INDEXES FOR AREAS (SEIFA)

MEDICARE SPEND OVERCOMES SEIFA?

“UTI”

AMI

Counted (appropriately) at the country hospital e.g. lysis and stabilisation and city hospital e.g. stent

QUINOLONES (FIRST ATLAS)

DILEMMA

• Causality • Context – service, distance, diagnostic • Continuity – across and within services • Conscience – patient centred care • Connection – local or where lives • Clinical context • Counting – double • Clinical variation • Consultation with rural • Clinician feedback • Clinical change • Comparison with peers