4363.0.55.001 - National Health Survey: Users' Guide, 2001
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 27/05/2003
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CONTENTS
Health-related actions topics included in sparse NHS(I) were:
For practical reasons (i.e. limited interview time and the difficulties in defining every possible type of action a person may have taken in relation to his/her health), the survey covered only the limited range of actions listed above. These actions reflect the main areas known to be of interest to data users and cover the more common actions people take in relation to their health. However, care should be taken not to interpret the data as comprehensive of all actions taken. Except for stays in hospital the reference period used for actions data is the two weeks prior to interview; stays in hospital uses both a 12 month and a two week reference period. A two week reference period was used in this and previous NHSs as an acceptable compromise between enabling respondents to accurately recall and report actions taken in the period while ensuring sufficient observations were recorded in the survey to support reliable results. While the two week period is used for consistency across all actions it is more appropriate to some types of action such as doctor consultations which are more frequently taken actions than to other types such as dental consultations which tend to be taken much less frequently. This will impact on the relative reliability of the estimates across action types. Estimates are available for the number of persons taking a particular action in a two week period, and the number of occasions on which the action was taken in that period - e.g. the number of consultations or number of days away from work. Service use data from other sources are commonly compiled on an annual basis. Because the 2001 NHS(G) was conducted over a 10 month period, the results represent an average two weeks in that enumeration period. This enables 'annualised' estimates of the number of occasions to be produced from 2001 NHS(G) data simply by multiplying the two week estimate by 26. Although the 'annual' estimates produced will be approximates only, they are considered suitable for general comparative purposes. However this approach should be used with care in relation to producing 'annualised' estimates of persons taking a particular action, because it takes no account of the frequency patterns of actions taken by individuals. The 2001 NHS(I) was conducted over a 6 month period, so this 'annualised' approach is not considered to be suitable because of seasonal effects on the data. Unlike previous NHSs, information about the medical condition or other reasons (e.g. test, checkup) for taking the action was not generally obtained in 2001; however limited linkage between actions taken and medical condition was recorded for persons reporting asthma or diabetes. Details are provided within the action descriptions below. In previous NHSs information was collected about all medications used in the previous 2 weeks, and medications usage was included in actions data from the survey, and included in counts of persons taking action. In the 2001 NHS information was collected only about medications used for selected conditions (i.e. asthma, cancer, heart and circulatory conditions and diabetes) and for mental well-being only. Details of medications use are therefore available separately for each of these conditions, but because of the restricted coverage of the data, medications use has been removed from counts of actions taken. Information on mental well-being was excluded in the 2001 NHS(I) because the mental health measures used for the 2001 NHS(G) were considered to be culturally inappropriate to the Indigenous population, therefore there are no medication details for mental health from the NHS(I). Specific details regarding type of medication used were not collected in sparse NHS(I), although whether medication was used for the selected conditions was collected. Apart from the points noted above, the actions data from the 2001 survey are broadly similar to those collected in the 1989–90 and 1995 surveys. However the following changes introduced for the 2001 survey should be noted:
All changes, and their implications for comparability between the surveys, are discussed under the relevant individual topic headings which follow. The data items available from this section of the survey are listed under the particular topic to which they relate. In addition a set of data items which combine various actions taken, enabling analysis of action levels and patterns in respect of population groups, etc are also available. Some of these have been defined: see Actions Summary, in Output Data Item List. Other combination items can be derived on request. Definition This topic refers to admissions to hospital as an inpatient (including same day patients). For the purposes of this survey, a hospital was defined as an institution which offers residential health care, other than a nursing or convalescent home. In order to be counted the stay in hospital must have commenced with formal admission and ended in formal discharge, with discharge taking place in the 12 months prior to interview. However, in some cases persons who had not been discharged were included; this occurred when persons technically still admitted patients were enumerated when home on day release or as hospital at home patients. Methodology Respondents were asked whether they had been admitted to hospital in the 12 months prior to interview, and the number of times admitted in that 12 month period. Further details were obtained about the respondent's most recent inpatient episode in the last 12 months, including length of stay (number of nights in hospital), whether discharged in the two weeks prior to interview and whether admitted as a Medicare or Private patient. Reasons for hospitalisation were not recorded. See Q717 to Q721 in 2001 NHS(G) Adult form. These questions were asked after questions about recent visits to casualty and outpatients units and hospital, and questions about recent visits to day clinics, to minimise the risk of respondents reporting these visits as hospital admissions. Population Information was obtained for all persons. Data items
In respect of the most recent admission in the last 12 months:
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. The Indigenous output data items list indicates whether each item is available for non-remote only or both non-remote and remote. Interpretation Points to be considered when interpreting data from the survey relating to stays in hospital include:
Comparability with 1995 Data relating to hospital episodes collected by the 2001 NHS differ in a number of ways from data obtained in the 1995 survey, and therefore comparisons between surveys should be made with caution:
The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. VISITS TO CASUALTY/EMERGENCY AND OUTPATIENTS UNITS AT HOSPITAL Definition This topic refers to visits to casualty/emergency and/or outpatients units at a hospital in the two weeks prior to interview. For the purposes of this survey, a hospital was defined as an institution which offers residential health care, other than a nursing or convalescent home. Only visits related to the respondent's health were included; visits such as taking another sick or injured person to emergency are excluded. Also excluded are situations where the respondent was admitted to hospital through a casualty/emergency ward; these instances were recorded as stays in hospital. Visits to dental hospitals, which are sometimes attached to a hospital as part of the outpatients section are also excluded from this topic; these cases were recorded under dental consultations. Methodology Respondents were asked whether they had visited a casualty/emergency or outpatients unit/ward for their own health in the two weeks prior to interview, and the number of visits in that period. People who reported visiting an outpatients unit/ward were asked whether their most recent visit in that 2 week period was related to a previous or expected admission to hospital. In sparse NHS(I), information regarding casualty/emergency or outpatients were collected as one item and not separated as per 2001 NHS(G) and non-sparse NHS(I). Information about the medical condition(s) or other reasons for visiting the casualty/emergency or outpatients unit/ward was not collected in the survey.See Q710 to Q714 in 2001 NHS(G) Adult form. Population Information was obtained for all persons. Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. The Indigenous output data items list indicates whether each item is available for non-remote only or both non-remote and remote. Interpretation Points to be considered when interpreting data from the survey relating to casualty/emergency and outpatients visits include:
Comparability with 1995 Similar concepts and methodology were used to obtain data relating to visits to casualty/emergency and outpatients units in the 2001 NHS to those used in the 1995 survey. As a result, data are considered directly comparable for items common to both surveys. The comparability outlined above for NHS(G) also applies to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. VISITS TO DAY CLINICS Definition This topic refers to visits to day clinics in the 2 weeks prior to interview for the respondent's own health. Day clinics, which are often attached to or operate as part of a hospital, offer minor surgery or diagnosis procedures such as scans, ultrasounds, endoscopies, cardiac tests, etc. They do not offer residential health care in the same way as hospitals but in some cases a visit may result in an overnight stay. Included in the survey are all reported visits to day clinics, except those visits solely for the purpose of an X-ray. Methodology Respondents were asked whether in the last two weeks they had visited a day clinic for minor surgery or diagnostic tests (other than an X-ray). The number of times they had visited a day clinic in that period was also recorded. No distinction was made as to whether the day clinic was part of or separate from a hospital facility. See Q715 and Q716 in 2001 NHS(G) Adult form. Population Information was obtained for all persons. This information was not collected in the sparse NHS(I). Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. Interpretation Points to be considered when interpreting data from the survey relating to visits to day clinics include:
Comparability with 1995 Similar concepts and methodology were used to obtain data relating to visits to casualty/emergency and outpatients units in the 2001 NHS to those used in the 1995 survey. As a result, data are considered directly comparable for items common to both surveys. The comparability outlined above for NHS(G) also applies to non-remote NHS(I). For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. DOCTOR CONSULTATIONS Definition This topic refers to any occasion in the two weeks prior to interview on which a respondent discussed his/her own health with, or received treatment from, a doctor. Included are consultations by telephone or having someone else consult a doctor on behalf of the respondent (such as a relative or friend, or doctor’s nurse or receptionist), but excluded are consultations during a visit to casualty/emergency or outpatient unit at a hospital or during a stay in hospital, or during a visit to a day clinic. As defined for this survey, ‘doctor’ includes general practitioners and specialists such as surgeons, pathologists, gynaecologists, radiologists, psychiatrists, etc. This item includes all consultations with a doctor in the reference period, regardless of the type of treatment/service provided. For example, a consultation with a doctor at which acupuncture or physiotherapy was performed has, where identified, been included in this item. However, visits to a doctor only to deliver a sample or collect a prescription, without seeing the doctor, are excluded. Methodology Respondents were asked whether during the two weeks prior to interview they had:
Respondents in 2001 NHS(G) and non-sparse NHS(I) were asked "When was the last time you consulted a doctor about your own health" whereas the question for respondents in sparse NHS(I) was slightly altered to read "When was the last time you saw a doctor because you were hurt or sick". Those who had not consulted either a general practitioner or specialist in that two week period were asked the time since they had last consulted a doctor (general practitioner or specialist) about their own health (other than as a hospital inpatient or at a visit to a hospital casualty/emergency or outpatients unit, or at a day clinic). Information about the medical condition or other reason for consultation was not recorded. See Q725 to 730 in 2001 NHS(G) Adult form. Population Information was obtained for all persons. Data items
Interpretation When interpreting data from the survey relating to doctor consultations the following should be considered:
Comparability with 1995 The methodology adopted for recording information about doctor consultations was similar to that used in the 1995 NHS, and therefore data from the two surveys are considered to be broadly comparable. Both surveys separately identified whether respondents had consulted a general practitioner and/or a specialist in the last 2 weeks. However, whereas the 2001 survey collected number of consultations separately for general practitioners and specialists, the 1995 survey obtained only a total number of consultations. While data at the total consultations level can therefore be compared between surveys, the effect of separately reporting general practitioner and specialist consultations may have tended to increase the number of reported consultations in 2001. The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. DENTAL CONSULTATIONS Definition Dental consultations refer to any occasion in the two weeks prior to interview on which a respondent consulted a dentist or other dental professional (e.g. orthodontist, dental nurse, dental technician, dental mechanic) about their teeth, dentures or gums. Consultations at dental hospitals are included, but dental consultations during a hospital inpatient stay or visit to casualty/emergency, outpatients or day clinic are excluded. Persons who consulted a doctor about a dental problem are included under the item Doctor Consultations. Methodology Respondents were asked whether during the two weeks prior to interview they had consulted a dentist or anyone about their teeth, dentures or gums, and the number of times consulted in that period. In sparse NHS(I) the questions were just in relation to teeth. Persons who did not consult in that period were asked the time since their last dental consultation. See Q722 to 724 in 2001 NHS(G) Adult form. Population Information was obtained for all persons. In sparse NHS(I), information was only collected from those persons two years and over and for output purposes children under two were presumed not to have consulted a dentist. Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. The Indigenous output data items list indicates whether each item is available for non-remote only or both non-remote and remote. Interpretation The following points should be considered when interpreting dental consultations data provided by this survey:
Comparability with 1995 NHS Data provided by this survey about dental consultations are comparable with those provided by the 1995 survey for those items and populations common to both surveys. However,
The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. CONSULTATIONS WITH OTHER HEALTH PROFESSIONALS (OHPs) This topic refers to occasions in the 2 weeks prior to interview on which respondents consulted a nominated health professional other than a doctor or dentist/dental professional; specifically one or more of the following health professionals: Definition
For sparse NHS(I) the following were specifically considered other health professionals:
This item refers to consultations at which some discussion and/or treatment of a health-related matter or medical condition took place, or was arranged. Excluded are:
Consultations were recorded against the type of OHP involved, not the type of treatment provided at a particular consultation. For example, if a chiropractor performed physiotherapy, the consultation was recorded under chiropractor. If a practitioner was considered by the respondent to fit more than one of the types listed above, the visit has been recorded against that type of OHP most closely associated with the most recent consultation in the two week period. Methodology Using a prompt card, respondents were asked whether they had consulted any of the listed OHPs in the two weeks prior to interview. If so, the respondent was asked to identify which types of OHP had been consulted. For up to two OHPs (the two most recently visited), respondents were asked to report the number of consultations they had in that period. Information about medical condition(s) or other reason(s) for visiting that OHP was not recorded. See Q731 to Q738 in 2001 NHS(G) Adult form. In sparse NHS(I) prompt cards were not used, and the only data collected was on type of other health professional consulted. Information regarding number of consultations was not obtained. Population Information was collected in respect of all persons in scope of the survey. Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. The Indigenous output data items list indicates whether each item is available for non-remote only or both non-remote and remote. Interpretation Points to be considered when interpreting data on OHP consultations from this survey include:
Comparability with 1995 Data for this topic are broadly comparable between the 1995 and 2001 NHS, for those items common to both surveys. Three additional types of OHP were covered in the 2001 survey: Aboriginal health worker (not elsewhere classified), accredited counsellors and alcohol and drug worker (not elsewhere classified). The inclusion of these categories will have increased total OHP consultations reported relative to 1995 results, but is not expected to have effected results for other types of OHP. The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. DAYS AWAY FROM WORK OR SCHOOL/STUDY Definition This topic refers to days, during the 2 weeks prior to interview, on which respondents stayed away from their school/study or work:
In sparse NHS(I), information was only collected for days away due to the respondent's own illness. Methodology As appropriate to the age, educational and employment circumstances previously recorded at the interview, respondents were asked separately whether in the last two weeks they had stayed away from work or school/study because of an illness/injury they had, and whether in the last two weeks they had stayed away from work or school/study to care for someone else who was sick or injured (days away for caring was not collected in sparse NHS(I)). The number of days away was recorded for each of these actions as appropriate. Information about the medical condition involved was not collected in the 2001 NHS. See Q700 - Q709 in 2001 NHS(G) Adult form. In sparse NHS(I), the number of days away from work or school for own illness was not recorded. Population Information about time away from work or school/study for populations as follows:
Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. The Indigenous output data items list indicates whether each item is available for non-remote only or both non-remote and remote. Interpretation Points to be considered when interpreting data on days away from work or study/school include:
Comparability with 1995 Data for this topic are considered to be directly comparable between the 1995 and 2001 NHS, for those items and populations common to both surveys. However, it should be noted that:
The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. OTHER DAYS OF REDUCED ACTIVITY Definition This topic refers to days during the two weeks prior to interview on which a person cut-down on his/her usual activities for all or most of the day due to an illness/injury which they had, excluding days away from work or school/study because of own illness/injury. Note that these (other) days of reduced activity exclude days cut down on activities to care for another person. Methodology Respondents were asked whether on any days in the previous 2 weeks they had cut down on anything they usually did because of an illness or injury they had, and the number of days they had cut down. For respondents who were employed or at school/study, these questions followed questions on days away from work or school/study, and respondents were asked to exclude those days they had already reported. See Q700 - Q709 in 2001 NHS(G) Adult form. Information about the medical conditions or other reason(s) for other days of reduced activity was not collected. Population Information was collected for all persons aged 5 years or more. This information was not collected in the sparse NHS(I). Data items
Output categories for the 2001 NHS(G) and 2001 NHS(I) are available from the ABS web site, through links provided in the Health and Indigenous theme pages to the respective output data items lists. Interpretation Points to be considered when interpreting data for this item include:
Comparability with 1995 Data for this topic from the 2001 NHS are considered comparable with those available from the 1995 survey once adjustments are made to ensure common age groups are used. The age group for which data on (other) days of reduced activity was collected was 5 years or more in 2001 compared with ages 2 years or more in 1995. The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7. USE OF MEDICATIONS Definition This topic refers to the consumption or other use (for specific conditions only) of any medications, pills or ointments during the two weeks prior to interview, including vitamins, mineral supplements and herbal or natural medications, and including both prescribed and non-prescribed medications. Unlike previous NHSs, the medication data collected in the 2001 survey do not relate to all medications used, but only to those reported by respondents as used for the following medical conditions/reasons:
Medications refers to all reported medications, including pharmaceutical medications, vitamin and mineral supplements and natural and herbal medicines. Pharmaceutical medications refers to reported medications excluding those reported by respondents as vitamin or mineral supplements, and those reported as natural or herbal medicines. Methodology The methodology used and the information collected differed for each of the 5 NHPA groups above for NHS(G) and non-sparse NHS(I):
Except in the case of medications used for mental well-being, provision was made to record up to a maximum of 3 separate medication names for each of the reported conditions, as specified above. In cases where 4 or more medications were reported, only the 3 medications regarded by the respondent as the "main" medications they use for that condition were recorded. Provision was made to record the fact that more than 3 medications were used. In responding to questions on medication use interviewers encouraged respondents to collect and refer to medication bottles, packets, etc. This served to both assist respondents in reporting all medications used for a particular conditions, and assist interviewers in accurately recording the medication name. The name recorded may have been a brand or generic name. The names of the medications reported as used for asthma, cancer, heart and circulatory conditions and diabetes/high blood sugar were office coded to a classification of generic type of medication. Outputs from this classification can be compiled in accordance with WHO's Anatomical Therapeutic Chemical Classification (ATCC), and the Australian Medicines Handbook (AMH); see Appendix 6. Medicine name was not recorded for those medications used for mental well-being; the 6 broad types of medication used in the question is the finest level of detail available for these. Although these types reflect reasons for use rather than generic type, where possible interviewers recorded the use against the type of medication most appropriate to the generic type, rather than the type as reported by respondents; for example, if a respondent reported they had used Serepax for sleeping, interviewers recorded this against the category "tablets for anxiety or nerves" rather than against the category "sleeping tablets or capsules". The "generic" based classification for common medications was shown on the prompt card provided to respondents; a more detailed list was available to interviewers. Except for medications used for mental well-being, medications data are available for persons of all ages who had reported they currently had asthma, cancer, heart and circulatory conditions or diabetes (excl. diabetes insipidus)/high sugar levels in blood or urine, which had or was expected to last six months or more. Use of medications for mental well-being was collected only for persons aged 18 years and over The population was the same for 2001 NHS(I) except medications were not collected for mental well-being, and in sparse NHS(I) there was not a requirement for the condition to have lasted or be expected to last six months or more. Please see respective comments for each condition in Chapter 3 regarding this requirement. Data items For persons with asthma:
For persons with cancer:
For persons in the NHS(G) using medication for mental well-being:
For further details of the items available, and for details of the standard output categories see the relevant illness topic descriptions.
Interpretation Points to be considered when interpreting data from this survey on the use of medications include:
The methodology for collecting data on medication use in the 2001 NHS, and the classification of generic type of medication, differ markedly from those used in the 1995 NHS. Overall this means that there is little direct comparability between surveys, and even though there are some specific points of commonality which may enable some comparisons to be made, this should be done with care. The main differences between the surveys are:
In addition to the specific survey issues noted above, other factors which may potentially affect comparability of medications data between surveys include the availability of medications (coming onto or leaving the market), changes effecting accessibility (e.g. prescription requirements), access to/arrangements for pharmaceutical benefits, evolving practices for the treatment/management of conditions, etc. The comparability issues outlined above for NHS(G) also apply to non-remote NHS(I). Data are not available for remote areas in the 1995 NHS so time series comparisons are only possible for non-remote areas. For other general comparability issues between 1995 NHS and the 2001 NHS(I) refer to Chapter 7.
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