REPORT. Chronic disease and the health of Australians

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1 REPORT Chronic disease and the health of Australians About this report This report draws on independent reports from the Australian Institute of Health and Welfare (AIHW). It is also based on Medibank data collated from members who were admitted to a private hospital in the 2014 financial year. Information on specific procedures and services does not include data from Medibank members who presented at public hospitals, or data from ahm members. What is chronic disease? Chronic diseases are illnesses which are long-lasting and typically have no cure, so require long-term management. They are caused by multiple factors, including genetic make-up, lifestyle and environment. They are not contagious and cannot be contracted from another person. Chronic diseases can range from mild conditions such as tooth decay, through to debilitating conditions such as diabetes, to life-threatening conditions such as heart disease. Once present, chronic diseases often persist throughout life, although they are not always the cause of death. The following chronic diseases were assessed as part of this report: Asthma Cerebrovascular Disease (a group of conditions that develop as a result of problems with blood vessels inside the brain) Chronic Kidney Disease Chronic Obstructive Pulmonary Disease (a condition which affects the lungs) Colorectal Cancer Coronary Heart Disease Depression Diabetes Lung Cancer Oral Disease Osteoarthritis Osteoporosis Chronic disease in Australia Chronic diseases are the leading cause of illness, disability and death in Australia, and they accounted for 90% of all deaths in 2011 i. Due to factors such as changing lifestyles and an ageing population, the prevalence of chronic diseases has increased and they now account for most of the burden of ill health. Currently, nine in 10 deaths have chronic disease as an underlying cause ii. Often, a number of chronic diseases are associated with a death - three diseases is the average. About 20% of deaths have five or more associated diseases iii.

2 Tackling chronic diseases and their causes is the biggest health challenge facing Australia today. This is not just due to the effect chronic disease has on health and quality of life, but also the added complexity of its social and economic impact iv, given the increased lifespan of those living with chronic disease. It is imperative that we work towards developing and coordinating effective management and treatment solutions, to improve the quality of life of those experiencing chronic disease and to reduce the burden on both the healthcare system and the economy. Medibank member overview In FY2014, over 423,000 Medibank members were identified as having a chronic disease, which accounts for just over 14% of Medibank s member database. Victoria and South Australia had the highest proportion of Medibank members identified with a chronic disease, with just over 17% of members in each of these states being identified. There are a number of factors potentially influencing these results, such as Victoria s typically older membership. Tasmania had the next highest proportion, with nearly 17% of members identified as having a chronic disease. The Northern Territory had the lowest proportion of chronic disease sufferers, with just over 8% of Medibank members identified. Gender breakdown was relatively equal, although overall the number of female Medibank members with chronic disease was slightly higher than the number of male members. Percentage of Medibank members identified with a chronic disease State Female Male Total ACT 14.1% 14.2% 14.1% NSW 12.2% 12.5% 12.3% NT 8.7% 9.0% 8.8% QLD 15.4% 15.1% 15.2% SA 17.9% 17.0% 17.5% TAS 17.1% 16.8% 16.9% VIC 17.5% 17.0% 17.3% WA 13.7% 12.9% 13.3% Australia 15.1% 14.8% 14.9% Disease breakdown Chronic kidney disease was the most common chronic disease causing Medibank members to present at a hospital, accounting for 36% of chronic disease related hospital admissions (where the chronic disease was the primary reason for presenting). This was followed by oral disease (18%), then depression (17%). The

3 relatively high rate of chronic kidney disease admissions is partly due to the treatment regime for people with end-stage renal disease, which requires renal dialysis three times per week. However, hospital data alone does not necessarily give a true indication of the prevalence of chronic diseases, as it is possible to live with a chronic disease without requiring hospital admission. For example, although diabetes accounted for only 1% of chronic disease admissions, diabetes self-diagnosis rates have more than doubled since 1990 and death rates have increased from 19 to 21 deaths per 100,000 in the same period v. Chronic disease hospital admissions in Medibank members (FY2014) Asthma 1% Cerebrovascular Disease 1% Chronic Kidney Disease 36% Chronic Obstructive Pulmonary Disease 1% Colorectal Cancer 2% Coronary Heart Disease 9% Depression 17% Diabetes 1% Lung Cancer 1% Oral Disease 18% Osteoarthritis 12% Osteoporosis 0.3% The cost of chronic disease Medibank paid out almost $600 million for chronic disease related claims (where the chronic disease was the primary reason for the hospital admission) on behalf of its members during FY2014. When compared with the $332 million paid out in FY2005, it is clear that the claims amount has almost doubled in the last decade. The three chronic diseases for which Medibank paid the most benefits (as a primary reason for the hospital admission) were: Osteoarthritis: $272,366,951 Coronary heart disease: $132,427,327 Depression: $48,565,928

4 $300,000,000 $250,000,000 $200,000,000 $150,000,000 $100,000,000 $50,000,000 $0 Medibank benefits paid on behalf of members for primary chronic disease claims (FY2014) However, the complex nature of chronic disease means that it may not always be the primary reason why a person presents at a hospital. Due to the huge impact chronic disease has on a person s overall health and wellbeing, they may present at hospital for another health issue, which has been exacerbated by chronic disease. This situation can be demonstrated through Medibank s diabetes claims data. Benefit outlays stand at just over $12 million for primary hospital admissions for diabetes, but increase to $362 million when secondary admissions are included. In addition to the personal impact on an individual s quality of life, chronic diseases cause a massive economic burden due to the effects of healthcare costs and lost productivity from illness. According to the Australian Institute of Health and Welfare, estimates based on allocated healthcare expenditure indicate that the four most expensive disease groups are chronic in nature cardiovascular diseases, oral health, mental disorders, and musculoskeletal, which supports Medibank s findings above. The AIHW identified that these diseases resulted in direct healthcare costs of $27 billion in , which equated to 36% of all allocated health expenditure vi. Conclusion Chronic diseases are a critical health concern in the 21 st century. As our life expectancy increases, the disadvantage is that now we often live for longer periods with debilitating and incurable conditions. Due to the impact these diseases have on health and quality of life, plus social and economic consequences, it is imperative that we coordinate effective management and treatment solutions to minimise their burden on society. i Australia s Health 2011b - Australian Institute of Health and Welfare, 2011 ii iii Australia s Health 2012c - Australian Institute of Health and Welfare, 2012

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