Medicare Locals Needs Assessment Report Summary of Findings 1 - PDF document

7/19/2013 Medicare Locals Needs Assessment Report Summary of Findings 1

7/19/2013 MRNWM-ML catchment area 2

7/19/2013 Data Sources  Victorian Refugee Health Network – data relating to refugee settlement in the catchment  Alzheimer's Australia – data on incidence of dementia in the catchment and projections in the future  Breast Screen Victoria - data on breast screening rates in the catchment area  Diabetes Australia – information based on the use of NDDS  Heart Foundation – Heart Foundation map which provides current data on heart related hospitalisations including standard morbidity data 3

7/19/2013 Data Sources • GPV – current data on blood borne viruses • Department of Health – data relating to use of drug and alcohol services • Inner East Melbourne portal data was compiled on patient flows for ED presentations • Department of Health produced updated local government profiles for 2013 • The National Health Performance Authority provided data reflecting patients experience of general practise 4

7/19/2013 MRNWM-ML demographics • Four LGAs ( Macedon Ranges, Brimbank, Maribyrnong and Melton) and two SLAs (Sunbury and Bacchus Marsh) • Maribyrnong and Brimbank have high proportions of residents born overseas and are currently settling refugees and asylum seekers • Brimbank and Maribyrnong comprise 55.6% of the catchment population • Melton is the sixth fastest growing municipality in Victoria • Bacchus Marsh comprises 63% of the Shire of Moorabool and is becoming a fringe urban area from a country town • Sunbury comprises 21% of the city of Hume • Macedon Ranges is all rural with Kyneton the most disadvantaged town. (ABS 2013) 5

7/19/2013 MRNWM-ML Key socioeconomic characteristics • MRNWM-ML high proportion of people over 65 on age pensions (2 nd highest in Australia) • 25% of the population have a concession card • In Sunshine 37% of the population holds a concession card • Unemployment rates higher than Victorian average, particularly in Sunshine and Braybrook. Brimbank 2 nd most disadvantaged LGA in Melbourne. • Braybrook ranks 9 th in Victoria for disadvantage & is the • second most disadvantaged LGA in Melbourne ABS (2013) 6

7/19/2013 MRNWM-ML Key socioeconomic characteristics • Median family income of $895 compared to the Victorian average of $1460 and an employment rate of 12.5% • In Sunshine 12.6% population do not speak English or do not speak it well • Relatively small number of ATSI people. Melton has highest number (530 people) • An increasing number of both refugees and asylum seekers. Over half the refugees were under 25 years of age on arrival and 43% were under 18 years of age • Of all the Medicare Local’s MRNWM has the third highest proportion of residents with a profound or severe disability • People over 18 years of age (10%) live with a restriction on a core activity • In Brimbank 63.7% per 1000 eligible are on a disability pension. The Victorian average is 55.7% per 1000. ABS (2013) 7

7/19/2013 Key Health Needs BRIMBANK • In Brimbank 25.5% of the population reported that they have fair or poor health. The highest proportion in the only Victorian LGA. • Women are more likely than men to report poor health. MELTON • 23.4% reported poor health compared to Victorian average of 18.3% ABS (2013) 8

7/19/2013 2012 Needs Assessment Priorities 1. Mental health 2. Information to community 3. Population health data for all 4. Diabetes 5. Acute/primary interface 6. Infrastructure support 7. ehealth 8. After hours primary care 9. Aboriginal Health 10. Health literacy 11. Aged care 12. Care-planning 9

7/19/2013 2013 Needs Assessment 1. Mental Health/AOD 2. Diabetes and Cardiovascular 3. Acute/primary care interface/ehealth 4. Access to quality services: Refugees Practices Allied Health Aged Care 5. Health Literacy 6. Screening & early intervention: Cancer, CKD, Heart 7. Musculoskeletal conditions 8. Injuries 9. Breastfeeding support 10

7/19/2013 Priority 1: Mental Health/AOD MRNWM-ML had 2 nd highest rate of very high or high • psychological distress of all MLs (PHIDU 2013) • Sunshine had 16% of the adult population with very high or high psychological distress • Higher levels of psychological distress correlated with higher levels of socio-economic disadvantage: Brimbank 16.7% (3 rd highest in Victoria) Melton 15.5% Maribyrnong 13.9% • Incidence of drinking is not correlated with socio-economic status as it was higher in the outer parts of the catchment; Sunbury, Kyneton, Bacchus Marsh & Melton having higher rates than the Victorian average. 11

7/19/2013 Priority 1: Mental Health/AOD • Data showed mental health conditions had highest prevalence after hypertension • In addition mental health conditions in people aged 65 and over was higher than the national average 12

7/19/2013 Priority 2: Diabetes • Data from Diabetes Australia suburbs in western Melbourne have some of the highest prevalence of diabetes in Melbourne. • LGA’s of Brimbank and Hume are amongst the top 5 diabetes hotspots • Nearly one in five people in Brimbank LGA aged 55 and over has type 2 diabetes 13

7/19/2013 Priority 2: Diabetes/CVD (Department Health 2009, Diabetes Victoria 2013) • Region Prevalence diabetes Brimbank LGA 6.1% Hume LGA 8.5% Melton LGA 9.3% Maribyrnong LGA 4.5% Macedon Ranges LGA 3.9% Moorabool LGA 5% Victoria 4.5 % 14

7/19/2013 Priority 2:Heart Disease • Residents in Brimbank and Melton hospitalised at much higher rate for heart conditions than Victorian average. • Brimbank has 1.49 times the rate of heart failure compared to Victoria • Macedon Ranges residents experiencing more than average number of hospitalisations due to heart attacks compared to the rest of Victoria. (National Heart Foundation 2013) 15

7/19/2013 Priority 2: Heart Disease • General Practice data (2012) showed that hypertension was the disease with the highest prevalence (10.3%) • Overweight and obese people in Melton (57.9%), Macedon Ranges (53.4%) and Brimbank (52.3%). Higher than Victorian average of 48.6% (Department Health Victoria 2012). 16

7/19/2013 Priority 3: Acute/primary care interface • Major hospitals Sunshine and Western General • Other hospitals include, Bendigo, Ballarat, RCH. • Highest demand for category 4s (semi urgent) and 5s (non urgent) at major hospitals came from Maribyrnong (66%) and Brimbank (59%) • Macedon Ranges had lowest proportion of 4s and 5s (only 46% of all ED presentations to 6 major hospitals) (Department Health Victoria 2013) 17

7/19/2013 Priority 4: Access to quality Services a. Refugees/asylum seekers SLAs in Victoria showing refugee numbers Total Greater Dandenong (C) 7,275 Hume (C) 4,648 Brimbank (C) 4,324 Maribyrnong (C) 1,580 Melton (S) 542 Total 35,191 39,262 for all of Victoria • Brimbank is third highest settlement area in Victoria • For 2012/13 anticipated number refugees will increase as quota has been increased Australia wide from 13,400 to 20,000 a year (Asylum seekers/refugees, numbers 2001-2011 (DIAC settlement data on Refugee Health Network, 2013) 18

7/19/2013 Priority 4: Access to quality services b. General practitioners • 131 general practices • 533 GPs • GP population ratio highest in Melton ( 1FTE GP: 1272 pop) and Bacchus Marsh ( 1FTE GP:1272 pop). Vic mean is 1:872 (MRNWMML survey 2012) 19

7/19/2013 Priority 4: Access to quality services • 24% population MRNWM-ML stated that they waited too long for GP appointment. This was the highest proportion for Metropolitan Medicare Locals in Australia • 78% had a preferred GP (lowest proportion for MLs in Australia) • 83% reported that their GP listened carefully (lowest proportion nationally) (National Health Performance Authority 2013) 20

7/19/2013 Priority 4: Access to quality Services c. Allied health Shortages • To date have identified 551 AHPs in MRNWM-ML • Shortage of speech pathologists (paediatric) • Shortage of dieticians in Brimbank and Bacchus Marsh • Shortage of Occupational Therapists in Sunbury and Bacchus Marsh (Medicare Local Survey 2013) 21

7/19/2013 Priority 4: Access to quality Services Waiting Times • Long waiting times compared to Victorian average in Community Health, HACC services in Brimbank, Macedon Ranges, Melton and Bacchus Marsh • Longest waiting times for After Hours for physiotherapy are at Brimbank (8-24 weeks) and Maribyrnong (17 weeks) • Longest waiting times for speech therapy in the ML is Sunbury (26 weeks) • Also long waiting times for dietetics and audiology in Sunbury and audiology in Brimbank. (Medicare Local survey 2013) 22

7/19/2013 Priority 4: Access to quality services d. Aged Care • 49 aged care facilities in MRNWM-ML • Shortage of high care beds in Melton, 38.6 places per 1000 eligible population compared to Victorian average 41.3 • Shortage low care beds in Brimbank, 31.2 places per 1000 eligible population compared to Victorian average of 46 (Department Health Victoria 2012) 23