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«Use of routinely collected national data sets for reporting on induced abortion in Australia Copyright of “Use of routinely collected national data ...»

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Use of routinely collected

national data sets for reporting

on induced abortion in

Australia

Copyright of “Use of routinely collected national data sets for reporting on induced abortin

in Australia” is the property of AIHW National Perinatal Statistics Unit and its content may

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holder’s express written permission. However, users may print, download, or email this

report for individual use.

The Australian Institute of Health and Welfare (AIHW) is Australia’s national health and welfare statistics and information agency. The Institute’s mission is better health and wellbeing for Australians through better health and welfare statistics and information.

The AIHW National Perinatal Statistics Unit (NPSU) is a collaborating unit of the AIHW, and was established in 1979. The NPSU is a formally affiliated institution of the University of New South Wales and is linked to the Faculty of Medicine, School of Women’s and Children’s Health. It is located at the Sydney Children’s Hospital. The NPSU aims to improve the health of Australian mothers and babies by monitoring reproductive and perinatal health. It is also involved in perinatal data development activities and epidemiological research. The NPSU maintains national data collections on perinatal health, maternal deaths, congenital anomalies and assisted reproductive technology.

PERINATAL STATISTICS SERIES

Number 17 Use of routinely collected national data sets for reporting on induced abortion in Australia Narelle Grayson Jenny Hargreaves Elizabeth A Sullivan December 2005 AIHW National Perinatal Statistics Unit Sydney AIHW Cat. No. PER 30 © Australian Institute of Health and Welfare 2005 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Business Promotion and Media Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.

This publication is part of the Australian Institute of Health and Welfare National Perinatal Statistics Unit’s Perinatal Statistics Series. A complete list of the Institute’s publications is available from the Business Promotion and Media Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra, ACT 2601, or via the Institute’s web site at http://www.aihw.gov.au.

ISBN 1 74024 522 9 ISSN 1321-8336

Suggested citation:

AIHW NPSU: Grayson N, Hargreaves J & Sullivan EA 2005. Use of routinely collected national data sets for reportingon induced abortion in Australia. AIHW Cat. No. PER 30.

Sydney: AIHW National Perinatal Statistics Unit (Perinatal Statistics Series No. 17).

Australian Institute of Health and Welfare Board Chair Hon. Peter Collins, AM, QC Director Dr Richard Madden Published by the AIHW National Perinatal Statistics Unit Printed by Elect Contents Foreword

List of tables

Acknowledgments

Abbreviations and symbols

Executive summary

1 Introduction

2 Methods

3 Induced abortion estimate

4 Induced abortion in the NHMD

5 Medicare data

6 Induced abortion at or after 20 weeks gestation

7 Other national routinely collected data sets

8 Data development

Glossary

References

–  –  –

The lack of national data on induced abortion in Australia represents a gap in health statistics. The AIHW’s Reproductive Health Indicators in Australia 2002 report included an indicator on induced abortions in Australia, but national data were not reported for it because data on induced abortion were not available on a routine basis Australia-wide.

This report comprehensively assesses the extent to which different forms of routinely collected data can be used to quantify the incidence of induced abortion in Australia. The innovative use of data combined from hospital and non-hospital sources helps to provide a more complete picture of reproductive health in Australia, as well as providing a basis for regular reporting in the future.

The compilation of the data contained in this document represents the best effort to date to provide a factual database on the incidence of induced abortion. The report does not include any analysis of the legal, social or moral issues often raised in discussion of abortion.

Richard Madden Director

–  –  –

Table 2.1: ICD-10-AM disease classification – pregnancy with abortive outcome.

.............. 7 Table 2.2: Fourth character subdivision used with ICD-10-AM categories O03–O06......... 9 Table 2.3: ICD-10-AM procedure codes that may be related to induced abortion............. 11 Table 2.4: Number of separations with an induced abortion-related procedure and proportion with a diagnosis of O04.5–O04.9 Medical abortion, complete or unspecified, by procedure, 2003

Table 2.5: Comparison of the number of induced abortions reported to the SAASC and the NHMD for South Australia, by 5-year age group, 2002 and 2003.

....... 18 Table 2.6: Comparison of the number of in-hospital induced abortions reported to the WAANS and the NHMD for Western Australia, by 5-year age group, 2002 and 2003





Table 2.7: MBS-item numbers associated with induced abortion

Table 2.8: MBS-item numbers that may be associated with induced abortion

Table 2.9: Number of separations with induced abortion in the NHMD and number of services for MBS-item 35643 Evacuation of the contents of the gravid uterus by curettage or suction curettage in the Medicare data, state and territory of service provider, 2003.

Table 3.1: Estimated number of induced abortions, state and territory of service provider, 2003

Table 3.2: Estimated number of induced abortions, by state and territory of usual residence, 2003

Table 3.3: Estimated number of induced abortions, by Remoteness Area of usual residence, 2003

Table 3.4: Estimated number of induced abortions, by 5-year age group, 2003.

................ 34 Table 4.1: Summary of separation, patient day and average length of stay statistics for separations with induced abortion, by hospital sector/type, 2003.............. 36 Table 4.2: Separations with induced abortion by admitted patient election status and funding source, 2003

Table 4.3: Separations with induced abortion by 5-year age group and hospital sector, 2003

–  –  –

Table 4.5: Separations with induced abortion by Remoteness Area of usual residence, 2003

Table 4.6: Separations for the 20 principal diagnoses with the highest number of separations with induced abortion, 2003

Table 4.7: Separations with induced abortion by duration of pregnancy, 2003.

................ 42 Table 4.8: Separations with induced abortion and a diagnosis of Maternal care for known or suspected fetal abnormality or damage, 2003

Table 4.9: Separation and procedure statistics for the 20 procedures with the highest number of separations with induced abortion, 2003

Table 4.10: Number of separations with induced abortion by abortion-related procedure, 2003

Table 4.11: Separations with induced abortion by hospital sector, 2000–2003

Table 5.1: Number of Medicare services for MBS-item 35643 Evacuation of the contents of the gravid uterus by curettage or suction curettage, by service type and 5-year age group, 2003

Table 5.2: Number of Medicare services for MBS-item 35643 Evacuation of the contents of the gravid uterus by curettage or suction curettage, by service type and Remoteness Area of usual residence, 2003

Table 5.3: Number of Medicare services for MBS-item 35643 Evacuation of the contents of the gravid uterus by curettage or suction curettage, by type of medical practitioner, 2003

Table 5.4: Number of Medicare services provided per patient for MBS-item 35643 Evacuation of the contents of the gravid uterus by curettage or suction curettage, 2003

viiiAcknowledgments

The Australian Institute of Health and Welfare National Perinatal Statistics Unit (AIHW NPSU) is a formally affiliated institution of the University of New South Wales (UNSW) and is linked to the Faculty of Medicine, School of Women’s and Children’s Health.

We would like to acknowledge the support of the NPSU by the School of Women’s and Children’s Health, UNSW and the Sydney Children’s Hospital.

This report was made possible by the valued cooperation and effort of those who provided data for this report. The Medicare data were provided by the Medicare Benefits Branch, Department of Health and Ageing. The data from the Western Australian Abortion Notification System were provided by Vivien Gee, Manager, Maternal and Child Health Unit, Information Collection and Management, Western Australian Department of Health.

The AIHW Hospitals and Mental Health Services Unit provided the National Hospital Morbidity Database data.

We would also like to acknowledge Peter Callanan from the Private Health Industry Branch, Department of Health and Ageing for his advice on the definitions of hospitals for Medicare purposes; Meegan Snell from Queensland Health for her advice on the definitions of hospitals in Queensland; the Health and Vitals Statistics Unit, Australian Bureau of Statistics, Queensland for advice on the ABS Perinatal mortality data; and the Medicare Benefits Branch, Department of Health and Ageing for advice on the use of MBS item numbers.

The National Centre for Classification in Health contributed time and expertise to provide advice on the classification and coding of induced abortion using ICD-10-AM. The Victorian Department of Human Services provided advice on coding induced abortion in Victorian private free-standing day hospital facilities.

The NPSU would like to express its appreciation to Dr Chris Bayly, Professor Michael Chapman, Dr Ching Choi, Hon Peter Collins, Professor Michael Humphrey, Professor James King, Dr Richard Madden, Professor Michael Peek and Associate Professor Sally Tracy for peer reviewing the report and providing valuable comments.

The report was prepared by Narelle Grayson and Elizabeth Sullivan from the AIHW NPSU and Jenny Hargreaves from the AIHW.

Cecilia Burke and Ainsley Morrissey from the AIHW coordinated the printing and publication process.

ixAbbreviations and symbols

ABS Australian Bureau of Statistics ACAS Australian Congenital Anomalies System ACS Australian Coding Standards ACT Australian Capital Territory ACT MPIN Australian Capital Territory Maternal and Perinatal Information Network AIHW Australian Institute of Health and Welfare ALOS Average length of stay Anaes. Anaesthesia ANZACPM Australian and New Zealand Antecedent Classification of Perinatal Mortality ANZARD Australian and New Zealand Assisted Reproduction Database APFA Abortion Providers Federation of Australasia ARM Artificial Rupture of Membranes ART Assisted Reproductive Technology ASA American Society of Anesthesiologists Physical Status Classification ASHR Australian Study of Health and Relationships Assist. Assisted CCOPMM Consultative Council on Obstetrics and Paediatric Mortality and Morbidity (Vic) COPMM Council of Obstetric and Paediatric Mortality and Morbidity (Tas) D&C Dilation and curettage D&E Dilation and evacuation DHS Department of Human Services DoH Department of Health DoHA Department of Health and Ageing FIGO Federation of International Gynecologists and Obstetricians HIC Health Insurance Commission ICD International Classification of Diseases ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th Revision ICD-10-AM International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification Incl. Including MBS Medicare Benefits Schedule x n.a. Not available n.p. Not published NHDC National Health Data Committee NHDD National Health Data Dictionary NHMD National Hospital Morbidity Database NMDS National Minimum Data Set NMMD National Maternal Mortality Database NPDC National Perinatal Data Collection NPSU National Perinatal Statistics Unit NSW New South Wales NT Northern Territory PIMCWA Perinatal and Infant Mortality Committee of Western Australia PSANZ PDC Perinatal Society of Australia and New Zealand Perinatal Death Classification Qld Queensland QMPQC Queensland Maternal and Perinatal Quality Council RACP Royal Australasian College of Physicians RANZCOG Royal Australian and New Zealand College of Obstetricians and Gynaecologists RCOG Royal College of Obstetricians and Gynaecologists SA South Australia SAASC South Australian Abortion Statistics Collection SABDR South Australian Birth Defects Register SLA Statistical Local Area Tas Tasmania UNSW University of New South Wales USA United States of America USSR Union of Soviet Socialist Republics Vic Victoria WA Western Australia WAANS Western Australian Abortion Notification System WHA Women’s Health Australia WHO World Health Organization.. Not applicable

xiExecutive summary

This report examines the utility of the available routinely collected national data sources for enumerating induced abortion in Australia. It outlines a methodology for estimating the number of induced abortions in Australia using the Medicare data and the National Hospital Morbidity Database (NHMD) data. Both data sets were used because neither has complete ascertainment of induced abortion.

The Medicare data includes information on services provided to patients other than those admitted to hospital, and to private patients admitted to hospital, for which Medicare claims have been presented and processed. The NHMD data includes information on almost all hospitalisations in Australia. Private patients treated as admitted patients in hospitals are included in both data sets.



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