Statewide Rural and Remote Clinical Network

Assoc Prof Alan Bruce Chater Chair Second Atlas of healthcare variation

Cellulitis COPD “UTI” – incl Glomerulonephritis

Diabetes Heart failure AMI complication s ABORIGINAL AND ISLANDER

SIEFA FACILITIES

Hospital and Health Services rural and remote facilities

The Torres and Cape HHS Community Clinics*

Inner Cluster Horn Island (Ngurupai)

Near Western Cluster Kubin() St Pauls (Moa Island) Island

Central Cluster (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

Northern Peninsula Cluster 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, 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