Hazelinks Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data: Time Series Analyses Version 2.0 September 2020 Hazelinks MBS and PBS data extraction. Version 2.0 September 2020 Contact: Yuming Guo Page 1 Authors Monash University School of Public Health and Preventive Medicine Dr Amanda Johnson Assoc Professor Yuming Guo Dr Joanna Dipnall Dr Jillian Ikin Dr Caroline Gao Ms Christina Dimitriadis Professor Michael Abramson Please direct inquiries to: Associate Professor Yuming Guo, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Vic 3004 Tel: (03) 99056100 E-mail: [email protected] Acknowledgements The Hazelwood Health Study is a large program of work that comprises a number of research streams in addition to this Hazelinks stream. Those research streams are run by a multidisciplinary group of academic and administrative staff from several Institutions including Monash University, the University of Tasmania, Federation University and the Commonwealth Scientific and Industrial Research Organisation. All of these staff are thanked for their contribution to this collaborative work. We would like to take this opportunity to thank the following researchers and clinicians who have provided important input to the research presented in this report: Dr Fred Edwards, Professor Alexander McFarlane, Dr Dion Stub, Professor Malcolm Sim, Dr Fay Johnston, Dr Matthew Carroll, Ms Catherine Smith and Dr Grant Williamson. This research was funded by the Victorian Department of Health and Human Services. However, the report presents the views of the authors and does not represent the views of the Department. Hazelinks MBS and PBS data extraction. Version 2.0 September 2020 Contact: Yuming Guo Page 2 Abbreviations and key terms ACE Angiotensin Converting Enzyme ATC Anatomical Therapeutic Chemical classification CSIRO Commonwealth Scientific and Industrial Research Organisation DHS Commonwealth Department of Human Services EREC External Request Evaluation Committee GLM Generalised linear model GP General Practitioner MBS Medicare Benefits Schedule Mine fire The 30-day period from 9 February to 10 March 2014 when the modelled daily PM2.5 period concentration, averaged across the Latrobe Valley SA3 area, exceeded 1μg/m3 PBS Pharmaceutical Benefits Scheme Particulate matter with an aerodynamic diameter of 2.5 micrometres (thousandths of a PM 2.5 millimetre) or less Particulate matter with an aerodynamic diameter of 10 micrometres (thousandths of a PM 10 millimetre) or less RR Relative Risk SA Statistical area level 95% CI 95% Confidence Interval Hazelinks MBS and PBS data extraction. Version 2.0 September 2020 Contact: Yuming Guo Page 3 Table of Contents Authors .................................................................................................................................................... 2 Acknowledgements ................................................................................................................................. 2 Abbreviations and key terms .................................................................................................................. 3 1. Executive Summary ......................................................................................................................... 7 2. Introduction .................................................................................................................................... 9 3. Background ..................................................................................................................................... 9 4. Aim and objectives ........................................................................................................................ 10 5. Human Research Ethics Committee and other approvals ............................................................ 10 6. Methods ........................................................................................................................................ 10 6.1. Datasets ................................................................................................................................ 10 6.2. Definition of outcomes ......................................................................................................... 13 6.3. Statistical analyses ................................................................................................................ 14 7. Results ........................................................................................................................................... 16 7.1. MBS health service usage ..................................................................................................... 16 7.2. PBS medication dispensing ................................................................................................... 25 8. Discussion...................................................................................................................................... 32 8.1. Summary of main findings .................................................................................................... 32 8.2. Relationship to previous published work ............................................................................. 33 8.3. Strengths & weaknesses ....................................................................................................... 35 8.4. Conclusion ............................................................................................................................. 37 References ............................................................................................................................................ 38 Appendix 1: Supplementary Tables ...................................................................................................... 40 Appendix 2: Parameters used in the time series analysis models ........................................................ 48 Hazelinks MBS and PBS data extraction. Version 2.0 September 2020 Contact: Yuming Guo Page 4 Tables Table 1 Total number of MBS health service visits by service type for the Latrobe Valley ................. 16 Table 2 Median number of daily health service visits by service type for the Latrobe Valley ............ 17 3 Table 3 The association between a 10 μg/m increase in mine fire-related PM2.5 and GP consultations in the Latrobe Valley. ..................................................................................................... 22 3 Table 4 The association between a 10 μg/m increase in mine fire-related PM2.5 and specialist/consultant health service visits in the Latrobe Valley .......................................................... 23 Table 5 Attributable fraction and attributable counts for lag 21 days of health service use due to coal mine fire-related PM2.5 in the Latrobe Valley SA3, during period of the coal mine fire ....................... 25 Table 6 Numbers of medications dispensed by medication type in the Latrobe Valley SA3 .............. 26 Table 7 Median of medications dispensed daily by medication type for the Latrobe Valley SA3 ....... 26 Table 8 Cumulative RR of daily PBS medication dispensing associated with 10 μg/m3 increases in fire- related PM2.5. ........................................................................................................................................ 30 Table 9 Attributable fractions and attributable counts for lag 3-7 days of PBS medication dispensing due to mine fire-related PM2.5 in the Latrobe Valley SA3, during the period of the coal mine fire. .... 31 Hazelinks MBS and PBS data extraction. Version 2.0 September 2020 Contact: Yuming Guo Page 5 Figures Figure 1 Geographical location of the Latrobe Valley SA3 area........................................................... 13 Figure 2 Time series plots of weekly medical service utilisation counts in the Latrobe Valley for the period July 2012 to 30 June 2016. ........................................................................................................ 18 Figure 3 Time series plots of daily medical service utilisation counts in the Latrobe Valley for the 30 days during the fire, the 30 days before the fire, and the 30 days after the fire. ................................ 19 Figure 4 Time series plots of daily medical service utilisation counts (given as rate per 10,000 population) in the Latrobe Valley for the 30 days during the fire and the same 30-day period one year before the fire and one year after the fire. .................................................................................. 20 Figure 5 Exposure response relationships between 10 μg/m3 increases in mine fire-related PM2.5 and health service use, at lags of 0-21 days after controlling for seasonality, public holidays, day of the week, long-term temporal trends and daily maximum ambient temperature. ............................. 21 Figure 6. Overall and age stratified cumulative 21 day RR and 95% CIs for medical service utilisation 3 per 10 μg/m increase in mine fire-related fine PM2.5. ......................................................................... 24 Figure 7 Time series plots for PBS medications dispensed in the Latrobe Valley, 1 Jan 2013 to 31 Dec 2016. ..................................................................................................................................................... 27 Figure 8 Time series plots of daily medications dispensed in the Latrobe Valley for the 30 days during the fire, 30