Rural Clinical School, ANU Medical School, The Australian National University, Canberra, ACT, Australia.
Aust J Rural Health. 2021 Feb;29(1):41-51. doi: 10.1111/ajr.12688. Epub 2021 Feb 10.
(i) To quantify geographic variation in selected health system performance indicators across local government areas of rural New South Wales and (ii) to compare relationships between sociodemographic factors and health system performance indicators across the regions.
Ecological study.
Rural New South Wales communities.
Eighty-nine local government areas in rural areas comprising 47 inner regional, 33 outer regional, 6 remote and 3 very remote areas.
Deaths from avoidable causes, public hospital admissions for potentially preventable conditions, screening program participation, immunisation coverage.
The largest geographic variation between rural areas of New South Wales was seen for avoidable mortality and potentially preventable hospital admissions. The average annual avoidable age-standardised mortality rate (2013-2017) ranged from 78.1 per 100 000 population to 493.7 per 100 000 population and the age-standardised rate of potentially preventable hospitalisations (2016-2017) ranged from 1491 to 5797 per 100 000 population. Approximately three quarters of local government areas had bowel and breast cancer screening participation rates equivalent to or better than the overall New South Wales rate; however, only 34% of local government areas met the New South Wales rate for cervical cancer screening. The least variation was seen for immunisation coverage; Byron had the lowest immunisation coverage for all 3 ages. The most common explanations for variation between rural local government areas in New South Wales were remoteness and socioeconomic characteristics.
The analysis of health system performance indicators reveals differences among New South Wales rural local government areas. The results highlight specific areas that might benefit from targeted intervention to improve inequities particularly for avoidable mortality and potentially preventable hospitalisations.
(i) 量化新南威尔士州农村地区地方政府区域内选定卫生系统绩效指标的地域差异，(ii) 比较各区域社会人口因素与卫生系统绩效指标之间的关系。
生态研究。
新南威尔士州农村社区。
新南威尔士州农村地区的 89 个地方政府区域，包括 47 个内部区域、33 个外部区域、6 个偏远地区和 3 个极偏远地区。
可避免死因、潜在可预防疾病的公立医院入院、筛查计划参与率、免疫接种覆盖率。
新南威尔士州农村地区之间的最大地域差异见于可避免死亡率和潜在可预防住院治疗。2013-2017 年平均每年可避免年龄标准化死亡率（每 10 万人中有 78.1 人）范围为 78.1 人至 493.7 人，2016-2017 年潜在可预防住院率（每 10 万人中有 1491 人至 5797 人）。大约四分之三的地方政府区域的结直肠癌和乳腺癌筛查参与率与新南威尔士州的总体水平相当或更高；然而，只有 34%的地方政府区域达到了新南威尔士州的宫颈癌筛查率。免疫接种覆盖率的变化最小；拜伦在所有 3 个年龄组的免疫接种覆盖率最低。新南威尔士州农村地区之间卫生系统绩效指标差异的最常见解释是偏远程度和社会经济特征。
对卫生系统绩效指标的分析揭示了新南威尔士州农村地区地方政府区域之间的差异。结果突出了特定领域，这些领域可能受益于有针对性的干预措施，以改善不平等现象，特别是在可避免的死亡率和潜在可预防的住院治疗方面。
