health.wa.gov.au
Epidemiology profile of neurological conditions in Western Australia 2015
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DISCLAIMER STATEMENT
Important Disclaimer:
All information and content in this Material is provided in good faith by the Western Australian (WA) Department of Health, and is based on sources believed to be reliable and accurate at the time of development. The State of Western Australia, the WA Department of Health and their respective officers, employees and agents, do not accept legal liability or responsibility for the Material, or any consequences arising from its use.
ACKNOWLEDGEMENT Health Strategy and Networks Branch, WA Department of Health would like to sincerely thank the data providers across WA Department of Health, including the Epidemiology Branch, Emergency Data Collection and Data Integrity Directorate. Special acknowledgement also goes to all the organisations which provided information for the Community Neurological Services in WA – A Professional Resource. Joanne Cronin is acknowledged for the preparation of the report. SUGGESTED CITATION Western Australian Department of Health. (2015). Epidemiology profile of neurological conditions in Western Australia, Health Strategy and Networks Branch, Department of Health, Perth.
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Executive summary This report provides an overview of the number of people with neurological conditions who use public hospital and non-admitted outpatient services and/or community services in Western Australia (WA). It is an attempt to identify potential sources of data on the prevalence and incidence of neurological conditions. Currently there is no central collection of neurological data and a limited ability to identify how many people in WA have a neurological dysfunction or disease. The intention is to provide information that can be used by service planners and procurement agencies to ensure high quality, equitable and cost effective services can be provided for neurological patients across WA.
In this report, data is presented across a range of different areas such as burden of disease and disability, hospital separations and costs, emergency department (ED) presentations and non-admitted outpatients appointments. Estimates of client contacts and membership numbers have been accessed from community based organisations which provide services and support to people with neurological conditions.
There are a number of limitations with the available data, and this impacts on the reliability of the data and potentially underestimates the number of people with neurological conditions across WA1. For example, comprehensive data on neurological conditions is not currently available for people receiving services from primary care, private health care, aged care, community nursing and generalist home nursing organisations. Similarly there are limitations in the available data on rare neurological conditions (those which are chronically debilitating but with a prevalence of less than 1 in 2000 in the population). Additionally, the report does not include consideration of people indirectly affected by neurological conditions such as carers and family members.
The following data sources have been included in this report:
• Australian and international research • WA Burden of Disease Study 20102 • Hospitalisation rates for the WA Department of Health3 • hospital costs, length of stay and bed-days occupied3 • emergency department presentations4 • non-admitted outpatients5 • community neurological services in WA6 • consideration of other data sources: Home and Community Care minimum data set7,
Disability Services Commission8 and Impact of Rare Diseases on the WA Health System.
The report attempts to identify areas where data quality could be improved, where there are discrepancies between data sources and where there are gaps in the available data. Future efforts should focus on establishing a statewide linked data system for neurological conditions, with particular attention being given to improving the reliability and validity of the data across all systems of care.
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Contents
Executive summary 2
Summary of findings 5
Limitations in the data available 6
Australian and international research 7
WA burden of disease study 2010 10
Burden of disease by sex 10
Burden of disease WA 2006 for Aboriginals by sex 11
Projected disease burden 11
Burden of disability WA 2006 by sex 11
Burden of disability WA 2006 for Aboriginals by sex 12
Burden of disability WA 2006 for nervous system and senses organ disorder 13
Hospitalisation rates for nervous system diseases 15
Hospital costs 17
Emergency department attendance 18
Non-admitted outpatients clinics 20
Mortality 23
Community services and supports 25
Home and community care 27
Disability Services Commission 28
Impact of rare diseases study 30
Conclusion 31
Appendix 1: List of conditions serviced in WA 32
Appendix 2: Data summary for major conditions 34
Cerebral palsy 35
Dementia 39
Epilepsy 45
Huntington’s disease 50
Hydrocephalus 52
Migraine 57
Motor neurone disease 61
Multiple sclerosis 65
Muscular dystrophy 69
Parkinson’s disease 73
Spina bifida 77
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Stroke 82
Transient ischaemic attack 87
Traumatic acquired brain injury 92
Appendix 3: Additional emergency department codes 97
References 98
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Summary of findings • Disorders of the nervous system and senses organs were the third major cause of
disease burden in WA in 2006.9 • It is predicted that in 2016, disorders of the nervous system and senses organs will
continue to be third major cause of disease burden.9 • Dementia was the first leading cause of disease burden in WA for females and the
second for males in 2006.9 • In 2006, disorders of the nervous system and senses organs were the second leading
cause of disability burden in WA.2 • In WA in 2006, the leading causes of disability due to nervous system and senses organ
disorder for females were dementia (44.2%), adult onset hearing loss (10.2%) and migraine (8.4%). For males the leading causes of disability were dementia (27.1%), adult-onset hearing loss (29.8%) and Parkinson’s disease (7.3%).2
• For WA, nervous system diseases hospitalisations accounted for 2.4 % of all hospitalisations by principal diagnosis between 2008 and 2012.10
• Between 2001 and 2012, the rate of nervous system disease hospitalisations increased significantly.10
• The age group most affected by nervous system diseases is 45-64 year olds.10 • In 2012, there were 31,804 occasions of hospital admission for conditions due to nervous
system diseases.3 These admissions totalled 340,627 bed-days at an approximate cost of $307,114,587.3
• The percentage of Aboriginal people who were hospitalised for the following causes were; epilepsy (22%) cerebral palsy(13%), hydrocephalus (7%), spina bifada (11.5%) and traumatic brain injury (10%).3
• In 2013, 18 953 patients attended 30 608 appointments at public neurology non-admitted outpatient clinics in WA.5
• Between 2004-2014, there were 111 433 ED attendances across WA with a primary diagnosis of a neurological condition.4 The conditions with the highest frequency of ED attendance for specific neurological diagnosis were acquired brain injury (25%), epilepsy (24%), migraine (18%), transient ischaemic attacks (14%) and stroke (6%).4
• In WA, nervous system diseases accounted for 8.8% of all deaths between 2007 and 2011.11 The average number of deaths due to nervous system diseases in WA between 2007 and 2011 was 1107 per year.11
• It is estimated that there are over 19 800 people who are currently members of WA based community neurological organisations and/or receive services and supports from these agencies. Services provided may be of a clinical or non-clinical nature.6
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Limitations in the data available Interpretation of the data in this report must take into account the following:
• The report does not consider people receiving services from primary care, private health care, allied health outside of non-admitted outpatients clinics, aged care or residential nursing organisations as data specific to neurological conditions is largely unavailable from these services.
• Some neurological conditions progress slowly and may not require ongoing medical support. Therefore, people with these conditions may not be included in the data.
• People may not seek treatment or support for their condition. Therefore they are not included within the data.
• Some neurological conditions are rare and not adequately represented in health datasets such as hospital morbidity and ED data.
• Data on hospitalisation rates, length of stay and costs within the report, only relate to occasions where a neurological condition was the principal diagnosis.
• ED admissions data may only identify people who present with a complication from a diagnosed neurological condition and/or their presentation at ED results in a primary coding diagnosis of a neurological condition at the conclusion of a patient’s attendance at ED.
• Community based organisations use a number of different data systems to collect data on their client contacts and member numbers, therefore the figures should only be used as an indication of potential contacts and numbers.
• The impact of neurological conditions is not just restricted to the sufferer. Other people affected by neurological conditions include carers and family members. Data on these groups of people is limited and was not included in this report.
• Due to continuous quality improvement processes with data collection, historical comparisons may in some cases be misleading.
Estimates of prevalence (that is the total number of people with that condition per 100 000 of the population), provide the best indicator of the numbers of people with chronic neurological conditions. For other acute neurological conditions such as stroke or brain injury estimates of incidence (the numbers of new cases per year) provide a better indication of patient numbers.
We are unable at this stage to quantify the total cost of neurological conditions to the WA economy in terms of health system costs, lost productivity, lost quality of life, carer costs and premature mortality.
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Australian and international research There is considerable research which aims to estimate the incidence and prevalence of neurological conditions in Australia and internationally. Several key studies are summarised below.
Australia In Australia, diseases of the nervous system accounted for 6 884 deaths in 2012, representing 4.7% of all registered deaths.12 There has been an increase in deaths attributable to diseases of the nervous system from 2003 where there were 4 324 deaths recorded.12 Females (3 861) experienced a higher number of deaths due to diseases of the nervous system than males (3 023).12 The median age at death was 80.8 for males and 85.3 for females.12
Neurological conditions were the fourth highest ranked contributor to the fatal burden of disease in Australia in 2010.13 Neurological conditions accounted for 6% of the total fatal burden of disease, with females showing a higher contribution to this total (53% of the total for neurological conditions).13 The proportion of total years of life lost due to neurological conditions increased with age; this was more noticeable among females.13
Acquired Brain Injury (ABI) Over 700 000 Australians are estimated to have a brain injury, which limits their daily activities and restricts their participation.14 Between 2004–05, 22 000 Australians were hospitalised as a result of a traumatic brain injury.14 These hospitalisations resulted in over 26 000 episodes of inpatient care totalling nearly 206 000 days, and estimated direct costs of hospital care of $184 million.15 In 2003, 1 in 45 Australians (432 700 people) had an ABI with activity limitations or participation restrictions due to disability and almost 157 500 people had an ABI and a severe or profound core activity limitation.15 It was estimated that approximately 20 000 children aged under 15 years had an ABI.15 In WA, it was estimated that there was 21 800 people with an ABI in 2003.15
Dementia/Alzheimer’s disease Alzheimer's disease was identified to account for 44.2% (3 046) of all deaths in Australia due to diseases of the nervous system and 2.1% of all registered deaths in 2012.12 Females (2 128) experience a higher number of deaths due to Alzheimer's disease than for males (918).12 The median age at death due to Alzheimer's disease was 87.5 years.12
Alzheimer’s Australia commissioned a report to estimate the number of people with dementia in Australia in 2011, and future projections until 2050.16
Table 1: Dementia Prevalence Estimates in WA 2011-5 016
2011 2012 2015 2020 2030 2040 2050
23 931 25 177 29 041 36 500 46 332 57 781 68 708 It is estimated that in 2010, 1.2 million people were involved in the care of a person with dementia in Australia.16 In 2009-10, the total direct health and aged care system expenditure on people with dementia in Australia was $4.9 billion.16
Epilepsy Epilepsy Action Australia and the George Institute for International Health are currently undertaking a major epidemiological research project to measure the impact and incidence of
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epilepsy in Sydney. This study known as the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) will explore the incidence, psychosocial impact and the household economic burden of epilepsy in a large population. The study was due for completion by the end of 2014 with the results yet to be released. The study estimates that there is an annual incidence of 50 per 100 000 in developed countries equating to approximately 10 750 people newly diagnosed with epilepsy in Australia last year.17
Migraine Headache Australia reports that the incidence of migraine is 9-10% of the Australian population, with 17% of females affected and 6% of the male population.18 This equates to about 2 million Australians who suffer from migraines.18 Studies show that 50% of migraine sufferers have not been diagnosed by a medical professional.18
Muscular dystrophy In Australia, it is estimated that there are more than 20 000 people who have some form of neuromuscular disease.18 There is an Australian registry for muscular dystrophy with more than 10 000 of these Australian and New Zealand patients currently registered.18
Multiple sclerosis In 2009, it was estimated that there are now 23 700 Australians living with multiple sclerosis and of these 11,400 (48%) had a profound or severe core activity limitation.19 66.7% or 15 800 Australians living with multiple sclerosis need assistance with at least one of the ten everyday activities.19 This figure has been used to determine that the cost of multiple sclerosis to individuals and the Australian community totals over $1 billion each year.20
Parkinson’s disease In 2011 it was estimated that 1 in 350 Australians are affected by Parkinson’s disease which is an increase of 17% since 2005.21 In 2011, over 64 000 Australians were living with Parkinson’s disease.21 The cost of Parkinson’s disease in Australia was valued at $775 million in 2011-12, with approximately $480 million in health system costs and $110 million in lost productivity.21 The estimated burden of disease is valued at $7.6 billion in terms of lost quality of life and premature mortality for people with Parkinson’s disease.21
Parkinson's Disease accounted for 20.2% of all nervous system deaths and 0.9% of all deaths registered in 2012 in Australia.12 The number of male deaths (788) from Parkinson's disease was higher than the number of female deaths (604).12 There were 1 392 deaths from Parkinson’s disease in 2012, with a median age at death of 83.5 years.12
Stroke The National Stroke Foundation regularly commissions reports regarding the prevalence and impact of stroke. A recent report released in November 2014 estimated that there will be around 90 000 stroke survivors living in WA by 2050.22 The number of strokes in WA is also predicted to rise from 4652 in 2014 to 11 889 in 2050. 22 The cost of stroke in Australia in 2012 was estimated to be $5 billion which includes $3 billion of productivity losses, $881 million in health system costs and $222 million in carer costs.22 The estimated burden of disease cost in 2012 for Australia was $49.3 billion.22 In 2009, an estimated 381 400 Australians (1.8% of the total population) reported they had suffered a stroke.19 Of this, 35% had at least one impairment which lasted for six months or longer as a result of a stroke.19
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Regional WA There is limited data on the prevalence and incidence of neurological conditions in regional WA. In 2008, a cohort of 160 patients were studied who attended clinics with a neurologist in the Geraldton and Midwest areas over a 12 month period. Parkinson’s disease was the most common condition with an estimated prevalence of 187.5 persons per 1000. Other conditions observed were epilepsy (16.87%), neuromuscular disorders (13.75%); multiple sclerosis (7.5%); cerebrovascular disease (6.25%); headaches (4.37%); neurodegenerative disorders (4.37%); dementia (3.75%); memory dysfunction (3.75%); gait disorders (2.5%); vestibular syndrome (1.87%); pain syndrome (1.87%); sensory syndrome (1.25%); brain injury (0.62%) and other various conditions (7.5%)23.
United Kingdom In the United Kingdon (UK), it is estimated that each year 600 000 people or 1% of the population are newly diagnosed with a neurological condition.24 Over 1 million people or 2% of the population in the UK have a disbility associated with their neurological condition.24 Another 8 million people are affected by a neurological condtion, although are able to manage with limited support.24 Approximately 350 000 people in the UK with neurological condtions require help for most of their daily activities.24 10% of the presentations to ED in the UK are for neurological problems.24
United States of America The incidence and prevalence for 12 neurological disorders experienced within the United States of America were published in 2007.25 The estimated prevalence for autism spectrum disorder in children was identified to be 5.8/1000 and 2.4/1000 for cerebral palsy.25 In the general population, the prevalence for migraine was estimated at 121/1000, 7.1/1000 for epilepsy, and 0.9/1000 for multiple sclerosis.25 Among the older population (65+ years) the prevalence of Alzheimer’s disease was estimated at 67/1000 and 9.5/1000 for Parkinson’s disease.25 The incidence, or number of new cases each year of stroke were 183/100 000, 101/100 000 for major traumatic brain injury, 4.5/100 000 for spinal cord injury, and 1.6/100 000 for amyotrophic lateral sclerosis.25
Canada An estimate of the prevalence of eight neurological conditions including Alzheimer's disease, Parkinson's disease, epilepsy, traumatic brain injury, multiple sclerosis, cerebral palsy, Huntington's disease, and amyotrophic lateral sclerosis was undertaken in non-acute health care settings in Canada. This included nursing homes, home care, complex continuing care and psychiatric hospitals. The conditions with the highest estimated prevalence in these care settings were Alzheimer's disease and related dementias, Parkinson's disease, epilepsy, and traumatic brain injury.1 It was noted that the proportion of people with neurological conditions in these settings were substantially higher than that reported for the general population.1
Additionally it was identified that prevalence estimates from acute hospital administrative data were comparatively lower for all conditions evaluated.1 The researchers concluded that the use of hospital or ED records alone, is likely to substantially underestimate the true prevalence of neurological conditions.1
#N.B.: Due to time constraints a comprehensive literature review was not included in this report.
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WA burden of disease study 2010 The WA Department of Health Epidemiology Branch conducted a Burden of Disease Study in 2010 based on 2006 hospital separations data. Burden of disease reflects the impact of an illness or disability on a population's life expectancy and quality of life. Disability Adjusted Life Year (DALY) is a measure of burden of disease in the population, which integrates both mortality (Years of Life Lost, YLL) and disability (Years Lost due to Disability, YLD). One DALY equates to one year of healthy life lost. The sum of DALYs in the population is a gap measure used to quantify the difference between current health and ideal health situations.
Burden of disease by sex Total disease burden is measured using DALYs, and to compare DALYs across different population groups (for example males vs females) age standardised rates (ASRs) have been created.
In WA in 2006, the leading causes of total disease burden in males were malignant neoplasms, cardiovascular disease and nervous system and senses organ disorders. In females, the leading causes of burden were malignant neoplasms, mental disorders and nervous system and senses organ disorders. While females had a higher burden of nervous system and senses organ disorders than males, this difference was not statistically significant.2
Figure 1: Burden of disease WA 2006 by sex 2
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Burden of disease WA 2006 for Aboriginals by sex Burden of disease for nervous system and senses organ disorders were ranked 7th in Aboriginal males, and 6th in Aboriginal females, although the difference between the sexes was not statistically significant. 2 While the burden of disease rates for nervous system and senses organ disorders were similar in Aboriginal males compared to non-Aboriginal males, and in Aboriginal females compared to non-Aboriginal females, the rankings were much lower in Aboriginal males and Aboriginal females.2 Therefore while nervous system and senses organ disorders accounted for a similar rate of DALYs per 100,000 population in both Aboriginal and non-Aboriginals, the relative ranking of these disorders compared to other diseases was higher in the non-Aboriginal population.2
Projected disease burden It is predicted that in 2016, nervous system and senses organ disorders will continue to be the third major cause of disease burden.9 For the top 15 specific conditions, it was projected that in 2016 Dementia will be the first leading cause of disease burden for females and the second for males.9
Burden of disability WA 2006 by sex In 2006 the leading causes of disability burden in WA males were mental disorders, nervous system and senses organ disorders and diabetes mellitus.2 The same pattern was observed in females.2 The disability rates for nervous system and senses organ disorders were very similar in males and females.2
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Figure 2: Burden of disability WA 2006 by sex 2
Burden of disability WA 2006 for Aboriginals by sex In WA in 2006 the leading causes of disability burden in Aboriginal males were mental disorders, diabetes mellitus and chronic respiratory disease.2 In Aboriginal females the leading causes were mental disorders, diabetes mellitus and cardiovascular disease.2 Nervous system and senses organ disorders were ranked 5th in both sexes, with similar rates of YLDs.2
In non-Aboriginal males the leading causes of disability were mental disorders, nervous system and senses organ disorders and diabetes mellitus.2 In non-Aboriginal females the leading causes of disability were mental disorders, nervous system and senses organ disorders and musculoskeletal diseases.2
Comparing the sexes by Aboriginality, non-Aboriginal males had a significantly higher burden of disability for nervous system and senses organ disorders compared to Aboriginal males.2 The same pattern was noted for females.2
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Burden of disability WA 2006 for nervous system and senses organ disorder In WA in 2006, the leading causes of disability due to nervous system and senses organs disorder for the total population were dementia (36.3%), adult onset hearing loss (19.3%) and Parkinson’s disease (7.1%).2 For females the leading causes of disability were dementia (44.2%), adult onset hearing loss (10.2%) and migraine (8.4%). For males the leading causes of disability were dementia (27.1%), adult-onset hearing loss (29.8%) and Parkinson’s disease (7.3%).2
Table 2: Number and percentage of total disability adjusted life years (DALYs) lost to nervous system and senses organ disorders in WA in 2006 by sex 2
Cause Male (N)
Male (%)
Female (N)
Female (%)
Total (N)
Total (%)
Dementia Male N
4082 Male percentage
27.1 Femal e N
7749 Femal e percentage
44.2 Total N
11 832 Dementi a T otal percentag e
36.3
Epilepsy Male N
911 Male percentage
6.1 Femal e N
623 Femal e percentage
3.6 Total N
1534 Epil epsy T otal percentage
4.7
Huntington’s chorea Male N
82 Male percentage
0.5 Femal e N
76 Femal e percentage
0.4 Total N
158 Huntington’s disease Total percentage
0.5
Migraine Male N
479 Male percentage
3.2 Femal e N
1472 Femal e percentage
8.4 Total N
1951 Migraine T otal percentage
6.0
Motor neurone disease Male N
457 Male percentage
3.0 Femal e N
210 Femal e percentage
1.2 Total N
667 Motor neurone disease Total percentage
2.0
Multiple sclerosis Male N
186 Male percentage
1.2 Femal e N
432 Femal e percentage
2.5 Total N
618 Multipl e scl erosis Total percentage
1.9
Muscular dystrophy Male N
37 Male percentage
0.2 Femal e N
2 Femal e percentage
0.0 Total N
39 Muscular dystr ophy Total percentage
0.1
Parkinson’s disease Male N
1093 Male percentage
7.3 Femal e N
1204 Femal e percentage
6.9 Total N
2297 Par ki nson’s disease Total percentage
7.1
Senses organ disorders Male N
6493 Male percentage
43.2 Femal e N
4399 Femal e percentage
25.1 Total N
10 891 Senses organ disorders T otal percentage
33.5
Senses organ disorders • Glaucoma related
blindness
Male N
122
Male percentage
0.8 Femal e N
132 Femal e percentage
0.8 Total N
254 Glaucoma r elated blindness Total percentage
0.8
Senses organ disorders • Cataract related
blindness
Male N
96
Male percentage
0.6 Femal e N
152 Femal e percentage
0.9 Total N
248 Cataract rel ated bli ndness T otal percentag e
0.8
Senses organ disorders • Macular degeneration
Male N
407
Male percentage
2.7 Femal e N
705 Femal e percentage
4.0 Total N
1113 Macul ar degenerati on T otal percentage
3.4
Senses organ disorders • Adult-onset hearing
loss
Male N
4488
Male percentage
29.8 Femal e N
1792 Femal e percentage
10.2 Total N
6279 Adult-onset heari ng loss Total percentage
19.3
Senses organ disorders • Refractive errors
Male N
848 Male percentage
5.6 Femal e N
1026 Femal e percentage
5.9 Total N
1875 Refracti ve err ors T otal percentage
5.8
Senses organ disorders • Other vision loss
Male N
532 Male percentage
3.5 Femal e N
591 Femal e percentage
3.4 Total N
1123 Other visi on loss T otal percentage
3.4
Other nervous system and sense disorders
Male N
1226 Male percentage
8.2 Femal e N
1346 Femal e percentage
7.7 Total N
2573 Other ner vous system and sense disorders T otal percentag e
7.9
All nervous system and senses organ disorders
Male N
15 046 Male percentage
100 Femal e N
17 514 Femal e percentage
100 Total N
32 559 All ner vous system and senses organ disor ders Total percentage
100
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#N.B.: The burden of disease and disability studies are based on 2006 public hospital separations data. It would be useful to repeat these studies using more recent data. Additionally, it should be noted that the studies do not consider data from private hospitals. It is also likely to underrepresent the burden of nervous system and senses organ disorders, particularly rare conditions since data is limited regarding these conditions.
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Hospitalisation rates for nervous system diseases The data on hospitalisation rates covers the period from 2001-12, however the 2012 data should be considered as preliminary. All data is for the state of WA but only includes hospitalisations in public hospitals.
Disease specific data has been presented in Appendix 2 for prominent neurological conditions.
• For WA, nervous system disease hospitalisations accounted for 2.4% of all hospitalisations by principal diagnosis between 2008-12.10
• During the ten year period the male rate of nervous system disease hospitalisation increased significantly (p <0.0001). The average annual percentage change in the rate was 7.8%.10
• For females the rate of nervous system diseases hospitalisation also increased significantly (p< 0.0001).10 The average annual percentage change in the rate was 8.4%.10
• Hospitalisations decreased significantly for the total population for dementia, epilepsy, Huntington’s disease, muscular dystrophy, motor neurone disease and Parkinson’s disease. Hospitalisations also decreased for the total population for stroke and cerebral palsy however these were not significant. A significant increase was identified for the total population over the last five years for migraine and multiple sclerosis.3
Figure 3: Nervous diseases hospitalisations in WA a ge standardised rate by sex and year 10
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Figure 4: Age specific nervous system diseases hosp italisations rates in WA 2008-12 10
The age group most affected by nervous system diseases is the 65+ age group.10
#N.B.: The hospitalisation rates presented only include consideration where nervous system diseases were the principle diagnosis. The data only includes rates of hospitalisation from public hospitals.
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Hospital costs The Epidemiology Branch provided a report on the costs of hospitalisations in 2012 where nervous system conditions were listed as the major cause of hospitalisation. In 2012, there were 31 804 occasions of hospital admission for conditions due to nervous system diseases in WA.3 These admissions totalled 340 627 beddays at an approximate cost of $307,114,587.3
Table 3: Hospitalisations, length of stay and costs of neurological conditions in WA 3
Condition Average length of stay (days)
Number of separations Beddays Total cost
Epilepsy Aver age l ength of stay
10.49 Number of separ ati ons
2787 Beddays
29 224 Epil epsy T otal cost
$20,106,254
Cerebral palsy Aver age l ength of stay
3.97 Number of separ ati ons
1277 Beddays
5065 Cerebral palsy total cost
$7,586,833
Dementia Aver age l ength of stay
15.6 Number of separ ati ons
7955 Beddays
124 133 Dementi a total cost
$85,225,176
Huntington’s Aver age l ength of stay
17.4 Number of separ ati ons
35 Beddays
609 Huntington’s total cost
$291,408
Hydrocephalus Aver age l ength of stay
14.86 Number of separ ati ons
416 Beddays
6181 Hydrocephalus total cost
$11,735,562
Migraine Aver age l ength of stay
3.46 Number of separ ati ons
1742 Beddays
6022 Migraine total cos t
$6,942,465
Motor neurone disease
Aver age l ength of stay
10.07 Number of separ ati ons
217 Beddays
2185 Motor neurone disease total cost
$2,088,975
Multiple sclerosis Aver age l ength of stay
2.27 Number of separ ati ons
4037 Beddays
9175 Multipl e scl erosis total cost
$12,189,179
Muscular dystrophy
Aver age l ength of stay
7.9 Number of separ ati ons
108 Beddays
853 Muscular dystr ophy total cost
$1,358,364
Parkinson’s Aver age l ength of stay
19.76 Number of separ ati ons
1870 Beddays
36 943 Par ki nson’s total cos t
$21,245,898
Spina bifida Aver age l ength of stay
15.16 Number of separ ati ons
143 Beddays
2168 Spi na bifi da total cost
$2,089,702
Stroke Aver age l ength of stay
14.75 Number of separ ati ons
5479 Beddays
80 820 Stroke total cos t
$78,107,937
Transient ischemic attack
Aver age l ength of stay
5.19 Number of separ ati ons
1545 Beddays
8012 Transi ent ischemic attack total cos t
$9,669,957
Traumatic brain injury
Aver age l ength of stay
6.97 Number of separ ati ons
4193 Beddays
29 237 Traumatic brai n i njur y total cos t
$48,476,877
*Costs are based on Australian National Diagnostic Related Groups (ANDRG) National Public costweights as published by Commonwealth Department of Ageing.
#N.B.: Table 3 only includes occasions where the “condition” was listed as the major cause of hospitalisation. It does not include less prevalent neurological conditions, although as a combined group ‘other disorders’ were identified to account for 7.9% of the total disability adjusted life years lost to nervous system and senses disorders.2 The contribution of nervous system diseases to overall hospitalisation costs would be expected to be considerably higher as it should include patients with neurological conditions who are admitted with a primary diagnosis for an alternative health condition and/or patients who have a less prevalent type of neurological condition than those listed in the table above.
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Emergency department attendance The following data relates to primary diagnosis of a neurological condition established at the conclusion of a patient's attendance in an ED. A code is provided following consideration of the clinical assessment of the patient.
Between 2004-14, there were 111 433 ED attendances across WA with a primary diagnosis of a neurological condition.4 The conditions with the highest frequency of ED attendance for specific neurological diagnosis were acquired brain injury (25%), epilepsy (24%), migraine (18%), transient ischaemic attack (TIA) (14%) and stroke (6%).4 Further data on ED attendance for prominent neurological conditions has been presented in Appendix 2.
In 2014 there were 13 033 presentations to ED with a primary diagnosis of a neurological condition compared to 10 364 presentations in 2010.4
The following table identifies the relative rank of the neurological principle diagnosis in comparison to all ED presentations coded between 2004–14 in WA. Intracranial injury, epilepsy and migraine were the highest ranked from the list of neurological diagnoses considered below.
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Table 4: Primary diagnosis of a neurological condit ion and relative rank in WA 2004–14
Primary diagnosis at character level Attendance Principal diagnosis rank
Primar y diagnosis at char acter level
(S06) Intracranial injury Attendance
25 772 Principal diag nosis rank
55 Primar y diagnosis at char acter level
(G40) Epilepsy Attendance
25 290 Principal diag nosis rank
56 Primar y diagnosis at char acter level
(G43) Migraine Attendance
20 283 Principal diag nosis rank
72 Primar y diagnosis at char acter level
(G45) Transient cerebral ischaemic attacks & related syndromes
Attendance
15 415 Principal diag nosis rank
90
Primar y diagnosis at char acter level
(F05) Delirium, not induced by alcohol and other psychoactive substances
Attendance
8488 Principal diag nosis rank
126
Primar y diagnosis at char acter level
(F03) Unspecified dementia Attendance
3873 Principal diag nosis rank
210 Primar y diagnosis at char acter level
(I61) Intracerebral haemorrhage Attendance
3153 Principal diag nosis rank
235 Primar y diagnosis at char acter level
(G41) Status epilepticus Attendance
1746 Principal diag nosis rank
314 Primar y diagnosis at char acter level
(I60) Subarachnoid haemorrhage Attendance
1714 Principal diag nosis rank
317 Primar y diagnosis at char acter level
(I62) Other non-traumatic intracranial haemorrhage Attendance
1322 Principal diag nosis rank
353 Primar y diagnosis at char acter level
(G20) Parkinson’s disease Attendance
1072 Principal diag nosis rank
375 Primar y diagnosis at char acter level
(F07) Personality and behavioural disorders due to brain disease, damage and dysfunction
Attendance
1005 Principal diag nosis rank
382
Primar y diagnosis at char acter level
(G35) Multiple sclerosis Attendance
958 Principal diag nosis rank
393 Primar y diagnosis at char acter level
(G93) Other disorders of brain Attendance
686 Principal diag nosis rank
448 Primar y diagnosis at char acter level
(G91) Hydrocephalus Attendance
290 Principal diag nosis rank
552 Primar y diagnosis at char acter level
(G12) Spinal muscular atrophy and related syndromes Attendance
136 Principal diag nosis rank
650 Primar y diagnosis at char acter level
(G80) Cerebral palsy Attendance
118 Principal diag nosis rank
668 Primar y diagnosis at char acter level
(Q03) Congenital hydrocephalus Attendance
43 Principal diag nosis rank
766 Primar y diagnosis at char acter level
(G21) Secondary parkinsonism Attendance
37 Principal diag nosis rank
782 Primar y diagnosis at char acter level
(G71) Primary disorders of muscles Attendance
19 Principal diag nosis rank
818 Primar y diagnosis at char acter level
(Q05) Spina bifida Attendance
13 Principal diag nosis rank
843 Primar y diagnosis at char acter level
(Q76) Congenital malformations of spine and bony thorax Attendance
<5 Principal diag nosis rank
930
#N.B. The codes used for the above data have not been approved by a clinical coder and therefore may not be an accurate representation of true number of ED attendances. Secondary diagnosis of patients attending an ED are not captured in this data. The International Classification of Diseases (ICD) codes used for the ED data are the same as those used for the hospital separations as listed in Appendix 2 as well as some additional codes listed in Appendix 3. ICD10-AM Primary Diagnosis is not captured in all WA EDs, so the counts above are predominantly based on Perth metropolitan hospitals. ICD10-AM Primary diagnosis has not been captured at all sites for the entire period 2004-14, so increased counts over time may be related to the capture of data from additional hospitals. ICD10-AM Version 2 has been captured at 8 metropolitan EDs since 2002 and at 1 metropolitan and 1 rural hospital since 2008. ICD10-AM V6/7 has been captured at 6 rural sites since November 2012 and 3 rural sites since September 2014. ICD10-AM primary diagnosis was not captured at one metropolitan site during the period 2004-14.
20
Non-admitted outpatients clinics In 2013, 18 953 patients attended 30 608 appointments at public neurology non-admitted outpatient clinics in WA.5
From this:
• 11 335 patients accessed one neurology non-admitted outpatient clinic • 4330 patients accessed two clinics • 1789 patients accessed three clinics • 734 patients accessed four clinics • 765 patients accessed five or more clinics.5
Figure 5: The percentage of patients accessing publ ic neurology non-admitted outpatient clinics in WA in 2013. 5
The above figure highlights the percentage of patients accessing one (60%), two (23%), three (9%), four (4%) or five or more (4%) public neurology non-admitted outpatient clinics in WA in 2013.5 65% of the patients are identified to return to the same clinic for follow-up, with the remainder accessing a range of different types of clinics. The number of clinics attended each year by a patient has remained relatively consistent between 2008-12.5
One clinic60%
Two clinics23%
Three clinics9%
Four clinics4%
Five or more4%
21
The following table identifies the number of patients attending neurology non-admitted outpatient clinics across all public metropolitan hospitals in WA.
Table 5: Number of attendances at non-admitted neur ology outpatient clinics in WA by type of clinic in 2013 5
Clinic category 2013
Clinical Measurement 2013 N
2533
Epilepsy 2013 N
2555
Minor Medical Procedures 2013 N
208
Neurology 2013 N
15 312
Neuropsychology 2013 N
8
Neurosurgery 2013 N
6150
Nutrition/Dietetics 2013 N
48
Occupational Therapy 2013 N
22
Pain Management 2013 N
687
Physiotherapy 2013 N
941
Rehabilitation 2013 N
1814
Social Work 2013 N
56
Speech Pathology 2013 N
269
Total (all) 2013 N
30 608
Table 6: Number of attendances at WA non-admitted n eurology outpatient clinics by type of clinic in 2013 5
Clinic Number of attendances
Fremantle Hospital Number of attendances
3395
Hedland Health Campus Number of attendances
13
Osborne Park Hospital Number of attendances
396
Nickol Bay Hospital-Karratha Number of attendances
27
Princess Margaret Hospital Number of attendances
4704
Rockingham Hospital Number of attendances
404
Royal Perth Hospital, Shenton Park Campus Number of attendances
681
Royal Perth Hospital Number of attendances
7270
Sir Charles Gairdner Number of attendances
10 364
Swan District Hospital Number of attendances
3371
In addition, Royal Perth Hospital had a total of 402 telehealth neurology clinics in 2013 servicing a range of health districts across regional WA. It should be noted that the metropolitan figures would also include regional patients who travelled to the metropolitan area to attend a clinic.5
22
In Albany, Amity Health a non-government organisation primarily funded by the Australian Government Department of Health had 59 patients attend neurology clinics between June to December 2014.
Figure 6: Total number of patients accessing neurol ogy clinics 2008-12 in WA 5
The above graph highlights the numbers of patients attending non-admitted neurology outpatient clinics from 2008-12. There has been an increase in attendances from 17 752 in 2008 to 19 909 in 2012.5 There was a slight decline in the number of outpatient appointments attended in 2013 with 18 953 appointments.5
#N.B.: Clinics that had five or less attendances in one year were not included in the data summaries. The grouping of clinics in Table 5 was pre-determined using clinic identification and clinic category codes and in some instances the coding varied between hospitals.
17752
18607
1957919789 19909
18953
17000
18000
19000
20000
2008 2009 2010 2011 2012 2013
No.
of p
atie
nts
23
Mortality In WA, nervous system disease accounted for 8.8% of all deaths between 2007 and 2011.11 During the five year period, the male and female rates of mortality from nervous system diseases did not change significantly.11 The average number of deaths due to nervous system diseases in WA between 2007-11 was 1107 per year.11
Table 7: Total death rates for WA metropolitan and country residents by condition 2007–11
Condition Metro 26 Country 27 Total 11
Systemic atrophies primarily affecting the central nervous system
Metro
298 Countr y
74 Total
372
Parkinson’s disease Number of attendances
403 Countr y
95 Total
498
Dementia (including Alzheimer’s disease) Number of attendances
3311 Countr y
688 Total
3999
Episodic and paroxysmal disorders Number of attendances
91 Countr y
44 Total
135
Other disorders of the nervous system Number of attendances
401 Countr y
108 Total
509
All nervous system diseases Number of attendances
4505 Countr y
1009 Total
5514
1Systemic atrophies primarily affecting the central nervous system includes Huntington’s disease; hereditary ataxia; spinal muscular atrophy and related syndromes (including motor neurone disease), systemic atrophies primarily affecting central nervous system in diseases classified elsewhere and postpolio syndrome. 2Episodic and paroxysmal disorders includes epilepsy, status epilepticus, migraine, other headache syndromes, transient cerebral ischaemic attacks and related syndromes, vascular syndromes of brain in cerebrovascular diseases and sleep disorders. 3Other disorders of the nervous system include disorders of autonomic nervous system, hydrocephalus, toxic encephalopathy, other disorders of brain, other disorders of brain in diseases classified elsewhere, other diseases of spinal cord, other disorders of central nervous system, postprocedural disorders of nervous system, not elsewhere classified, other disorders of nervous system, not elsewhere classified and other disorders of nervous system in diseases classified elsewhere.
#N.B.: The mortality data is based on underlying cause of death as determined by the Australian Bureau of Statistics and doesn’t include additional causes of death.
24
A separate analysis of mortality data for more prevalent neurological conditions was undertaken. The following table identifies the numbers of deaths by neurological condition.
Table 8: Number of deaths in WA in 2011 by neurolog ical condition 3
Condition Number of deaths
Cerebral palsy Number of deaths
18
Dementia Number of deaths
1223
Epilepsy Number of deaths
99
Huntington’s disease Number of deaths
5
Hydrocephalus Number of deaths
24
Motor neurone disease Number of deaths
84
Multiple sclerosis Number of deaths
23
Muscular dystrophy Number of deaths
10
Parkinson’s disease Number of deaths
214
Stroke Number of deaths
1210
Transient ischemic attack Number of deaths
97
Traumatic brain injury Number of deaths
55
Further mortality trend data is provided in Appendix 2.
#N.B.: The data included above used both principal diagnosis plus additional diagnosis for each condition of interest.
25
Community services and supports It is estimated that there are more than 600 recognised neurological conditions which vary in the type of symptoms experienced and the acute, chronic, remissive or degenerative nature of the condition.28 There are over 130 different neurological conditions currently supported in WA. A list of these conditions has been provided in Appendix 1.
Table 9: Estimated membership numbers and prevalenc e in community based organisations in WA in 2014 6
Organisation Members/ clients supported
Prevalence estimate reported by the organisation
Data source
Alzheimer’s Australia WA
3500 members
Prevalence esti mate
30 700 living with dementia in WA
Data source
Australian Institute of Health and Welfare/ Australian Bureau of Statistics
Centre for Cerebral Palsy
Supporting 1720 people
Prevalence esti mate
2.4 per 1000 have cerebral palsy in WA
Data source
Cerebral Palsy Registry on 14/10/2014
Epilepsy Action 350 members 280 with Epilepsy 70 family/ carer
Prevalence esti mate
Australian figure: 230 000 Data source
Sydney Epilepsy Incidence Study. George’s Institute for Medical Research
Epilepsy Association
350 members Prevalence estimate unknown
Data source
N/A
Headwest 250 clients supported per year
Prevalence estimate unknown
Data source
N/A
Huntington’s WA 425 members 63 children 157 family
Prevalence esti mate
12-16 per 100 000 in WA 20% clustered in South West of WA
Data source
Estimate from WA Neurosciences Unit
Learning and Attention Disorders
400 members Prevalence estimate unknown
Data source
N/A
Myalgic Encephalomyelitis /Chronic Fatigue
80 members Prevalence esti mate
0.2–0.7% in Australia Data source
2004 Royal Australasian College of Physicians
Motor Neurone Disease
240 members 140 patients
Prevalence esti mate
1 in 13 000 in Australia Data source
Macquarie University Study
Multiple Sclerosis 2500 members 250 patients
Prevalence esti mate
71 per 100 000 in Australia Data source
MS Society national data
Muscular Dystrophy
100 members 400 people serviced
Prevalence estimate unknown
Data source
N/A
26
Organisation Members/ clients supported
Prevalence estimate reported by the organisation
Data source
Neurodegenerative Conditions Coordinated Care Program (NCCCP)
50 clients supported
Prevalence estimate unknown
Data source
N/A
Neurological Council of WA
1742 clients supported 2013-14
Prevalence estimate unknown
Data source
N/A
Neurosciences Unit
250-300 new clients supported per annum
Prevalence estimate unknown
Data source
N/A
Parkinson’s WA 3000 members 1800 patients
Prevalence esti mate
8000 in WA Data source
Pharmaceutical Benefits Scheme
Silver Chain 3129 clients supported with neurological condition
Prevalence estimate unknown
Data source
N/A
Trigeminal Neuralgia Support Group
100 members Prevalence esti mate
1 in 20 000 Internationally Data source
Mayo Clinic USA – Dr Zakrzewska
Spina Bifida and Hydrocephalus
151 members (54 sufferers)
Prevalence estimate unknown
Data source
N/A
State Head Injury Unit
Servicing 600–700 per year (ABI <2 years)
Prevalence estimate unknown
Data source
N/A
Stroke Foundation 500 members Prevalence esti mate
4652 suffering stroke 41 173 stroke survivors 999 Stroke deaths
Data source
National Stroke Foundation 2014 data
Using the data from the above table it can be estimated that there are over 19 800 people who are members of WA based community neurological organisations and/or receive services and supports from these agencies. Services provided may be of a clinical or non-clinical nature.6
#N.B.: The data from Table 9 is based on best estimates provided by community organisations. It is acknowledged that organisations use a number of different data systems to collect data on their client contacts and member numbers, therefore the figures should only be used as an indication of potential numbers. Future data collection could consider the numbers of members and clients serviced in regional and remote areas. There are also opportunities to improve data collection and linkages using data registries for specific conditions.
27
Home and community care A number of the community organisations providing in home services to people with a neurological condition are partially or fully funded by the Home and Community Care Program (HACC). All providers are required to provide data on the services they provided as required under the minimum data set and a report is produced annually based on this data. The minimum data set includes:
• characteristics of care recipients (for example sex, date of birth, Aboriginal status, functional status items)
• the circumstances of care recipients (i.e. where they live, whether they have a carer) • the characteristics of carers (for example, date of birth, sex, Aboriginal status) • information about the service episode (for example source of referral, data of entry, date
of last update) • the assistance received by recipients and carers from the HACC program (for example
amounts and types of assistance received)7
Unfortunately, the minimum data set does not include information on the health issues causing their need for services so without data linkage systems there is limited ability to determine how many HACC services are provided to people with a neurological condition. Some HACC funded organisations do collect this information separately however it is not linked to the HACC minimum data set.
The HACC client characteristic data for 2012-13 showed that the number of female HACC care recipients outnumbered male HACC care recipients across all regions in WA and in fact there were almost twice as many female care recipients (65.7% female vs 34.3% male).7
The leading number of service types provided under the HACC Program were:
1. assessment 2. domestic assistance 3. transport 4. home maintenance 5. social support 6. centre based day care 7. client care coordination7
The 2012–13 HACC report noted that the assessment volumes increased 17.9% over the previous year, despite a 9.4% decrease in the number of new clients.7 In terms of age of recipients, the highest number of care recipients in every service type falls in the 75-89 age group.7
Silver Chain Group, which receives HACC funding, collects additional data outside of the minimum dataset. In 2014, Silver Chain provided services for 3129 clients in WA with at least one of 36 different neurological conditions including Alzheimer's disease, cerebral palsy, Parkinson disease and multiple sclerosis.6 These clients have 3449 diagnosed neurological conditions between them and are receiving one of at least 44 services from Silver Chain including continence management and advice, home help, nursing and allied health.6
#N.B.: The HACC minimum dataset could be a useful and complementary source of data if it included information on the medical cause for a recipient’s access to services or if a data linkage system was developed.
28
Disability Services Commission There is also a minimum data set collected by the Disability Services Commission. Within the data fields the service user’s primary and other disability groups are identified. Table 10 identifies that there were 15 948 people with acquired brain injury and 39 140 people with neurological conditions who accessed disability services in 2012-13.8
Table 10: Disability service users in WA, by primar y or other significant disability group 2012–138
Primary disability group
Other disability group
Total disability group
Disability group Primar y disability group
Number Primar y disability group
% Other disability group
Number Other disability group
% Total disability group
Number Total disability group
% Disabil it y g roup
Intellectual/learning All Int ellectual /learning Pr imary disabil it y g roup nu mb er
134 005 All Int ellectual /learning Pr imary disabil it y g roup %
45.3 All Int ellectual /learning Oth er disabil it y group numb er
40 687 All Int ellectual /learning Oth er disabil it y group %
13.0 All Int ellectual /learning Total disabilit y g roup nu mber
174 692 All Int ellectual /learning Total disabilit y g roup %
55.9 Intellec tual/ l earning disability group
Intellectual Intellec tual Primar y disability group number
84 082 Intellec tual Primar y disability group %
28.4 Intellec tual Other disability group number
16 980 Intellec tual Other disability group %
5.4 Total Intellec tual disability group number
101 062 Total Intellec tual disability group %
32.3 Intellec tual/ l earning disability group
Specific learning/ADD Specific l earni ng/ADD Pri mar y disability group number
12 808 Specific l earni ng/ADD Pri mar y disability group %
4.3 Specific l earni ng/ADD Other disability group number
11 463 Specific l earni ng/ADD Other disability group %
3.7 Total Specific l ear ning/ADD disability gr oup number
24 271 Total Specific l ear ning/ADD disability gr oup %
7.8 Intellec tual/ l earning disability group
Autism Autism Pri mary disability group number
26 347 Autism Pri mary disability group %
8.9 Autism Other disability group number
10 288 Autism Other disability group %
3.3 Total Autism disability group number
36 635 Total Autism disability group %
11.7 Intellec tual/ l earning disability group
Development delay Devel opment delay Pri mar y disability group number
10 768 Devel opment delay Pri mar y disability group %
3.6 Devel opment delay Other disability group number
1956 Devel opment delay Other disability group %
0.6 Total Devel opment delay disability group number
12 724 Total Devel opment delay disability group %
4.1 Disabil it y g roup
Physical/diverse All ph ysical /diverse Primary disab ilit y grou p number
78 935 All ph ysical /diverse Primary disab ilit y grou p %
26.7 All ph ysical /diverse Other disab ilit y group nu mber
70 044 All ph ysical /diverse Other disab ilit y group
%22.4 All ph ysical /diverse Tot al d isabi lit y group numb er
148 979 All ph ysical /diverse Tot al d isabi lit y group %
47.7 Physical/di verse disability group
Physical Physical Primar y disability group number
49 655 Physical Primar y disability group %
16.8 Physical Other disability group number
44 236 Physical Other disability group %
14.2 Total Physical disability gr oup number
93 981 Total Physical disability gr oup %
30.0 Physical/di verse disability group
Acquired brain injury Acquired brai n i njur y Primar y disability group number
11 340 Acquired brai n i njur y Primar y disability group %
3.8 Acquired brai n i njur y Other disability group number
4608 Acquired brai n i njur y Other disability group %
1.5 Total Acquired brai n inj ur y disability group number
15 948 Total Acquired brai n inj ur y disability group %
5.1 Physical/di verse disability group
Neurological Neur ological Pri mar y disability group number
17 940 Neur ological Pri mar y disability group %
6.1 Neur ological Other disability group number
21 200 Neur ological Other disability group %
6.8 Total Neur ological disability group number
39 140 Total Neur ological disability group %
12.5 Disabil it y g roup
Sensory/speech All sen sory/sp eech Primary disab ilit y group nu mber
26 341 All sen sory/sp eech Primary disab ilit y group %
8.9 All sen sory/sp eech Other disabil it y g roup nu mb er
39 630 All sen sory/sp eech Other disabil it y g roup %
12.7 All sen sory/sp eech Tot al disab ilit y grou p number
65 971 All sen sory/sp eech Tot al disab ilit y grou p %
21.1 Sensor y/speech disability group
Deaf-blind Deaf-blind Primar y disability group number
748 Deaf-blind Primar y disability group %
0.3 Deaf-blind Other disability group number
1281 Deaf-blind Other disability group %
0.4 Total Deaf- blind disability group number
2029 Total Deaf- blind disability group %
0.6 Sensor y/speech disability group
Vision Vision Primar y disability group number
12 721 Vision Primar y disability group %
4.3 Vision Other disability group number
11 385 Vision Other disability group %
3.6 Total Visi on di sability group number
24 106 Total Visi on di sability group %
7.7 Sensor y/speech disability group
Hearing Heari ng Pri mar y disability group number
8900 Heari ng Pri mar y disability group %
3.0 Heari ng Other disability group number
7897 Heari ng Other disability group %
2.5 Total Hearing disability group number
16 797 Total Hearing disability group %
5.4 Sensor y/speech disability group
Speech Speech Pri mar y disability group number
3972 Speech Pri mar y disability group %
1.3 Speech Other disability group number
19 067 Speech Other disability group %
6.1 Total Speech disability group number
23 039 Total Speech disability group %
7.4 Disabil it y g roup
Psychiatric All p sychiatric Primary disab ilit y group nu mber
56 391 All p sychiatric Primary disab ilit y group %
19.1 All p sychiatric Other disabil it y g roup nu mb er
27 994 All p sychiatric Other disabil it y g roup %
9.0 All p sychiatric Tot al disab ilit y grou p number
84 385 All p sychiatric Tot al disab ilit y grou p %
27.0
Psychiatric Psychiatric Pri mar y disability group number
56 391 Psychiatric Pri mar y disability group %
19.1 Psychiatric Other disability group number
27 994 Psychiatric Other disability group %
9.0 Total Psychiatric disability group number
84 385 Total Psychiatric disability group %
27.0 Disability group
Totalª Primar y disability group total Total all Pri mar y disability group number
295 672 Primar y disability group total Total all Pri mar y disability group %
100.0 Other disability group total Total all Other disability group number
312 539 Other disability group total Total all Other disability group %
100.0 Total disability group total Total all disability group number
312 539 Total disability group total Total disability group %
100.0
ª Primary disability group was ‘not stated/not collected’ for 16 867 service users (which includes service users who used only recreation/holiday programs (service type 3.02) and who did not provide a response). The total for ‘primary disability group’ excludes these records, while the total for ‘total disability group’ includes these records.
29
Notes
1. Service user data are estimates after use of a statistical linkage key to account for individuals who received services from more than one service type outlet during the 12 month period.
2. Service user data were not collected for all NDA service types. Refer to the appendix to this bulletin, separately published as Disability support services: Appendix 2012-13 (AIHW 2014).
3. Totals for ‘other significant disability’ and ‘total disability’ are not the sum of components because individuals may report multiple types of disability.
# N.B.: A linkage process was used by the Australian Institute of Health and Welfare to identify the extent of joint use of disability services and the HACC program29. The data could be further considered with additional breakdown by type of neurological condition.
30
Impact of rare diseases study Exploring the impact of rare diseases on the Wester n Australian health system The Office of Population Health Genomics (OPHG) is leading an international collaborative study investigating the impact of rare diseases on the WA health system. Rare diseases are those which occur in Australia in less than 1 in 2000 people. At present, there is limited data on the number of people affected by, and the burden of rare diseases on the WA health system. Collating data on rare diseases is significantly hampered by the inadequate coding specific for each disease within the ICD coding system. Orphanet is an international consortium that has developed a comprehensive coding system for rare diseases called Orpha number (www.orpha.net). Orphanet, in collaboration with the World Health Organisation, have expanded the ICD coding system such that the new release of ICD-11 will more adequately code rare diseases.
This epidemiological cohort study aims to measure the impact of rare diseases on the WA health system over a ten year period using linked data from the Hospital Morbidity Data Set (HMDS), the Western Australian Register of Developmental Anomalies (WARDA) which receives mandatory data of developmental anomalies (birth defects and cerebral palsy) for children aged 0-6 years, and death records supplied from the Registry of Births, Deaths and Marriages within the WA Department of the Attorney General. In addition, linked data from Emergency, Cancer Registry and Mental Health data sets will assist in identifying comorbidities of rare disease. Neurological diseases contribute to approximately 13% of the rare diseases coded in this study. This study is a collaborative study led by OPHG in partnership with the WA Health Data Linkage Branch. Expert advice is contributed by the WA Department of Health Directorates of Data Integrity, Health System Economic Modelling and Epidemiology Branch; Genetic Services WA, Telethon Kids Institute and Orphanet France. Information from this study will inform the state and national planning for improved management of rare diseases in Australia.
31
Conclusion This report has been able to demonstrate the range of data that is available to identify the significance of neurological conditions in WA. It has provided estimates of the number of people accessing public hospital and non-admitted outpatient services and/or community services, although often the figures under estimate the true rates. Future efforts should concentrate on the establishment of a reliable and valid linked dataset for neurological conditions.
This type of dataset could be used to identify:
• number of people with neurological conditions across WA • prevalence and/or incidence of different types of neurological conditions • prevalence and/or incidence trends over time to enable planning for future service needs • percentage of people that are currently being serviced and the type of services they
access • whether current levels of service provision are adequate and best utilised • impact of new initiatives which aim to reduce the severity of conditions and level of care
required.
It is important to continue to gain a better understanding of the epidemiological profile of neurological conditions to ensure that services in WA meet the need of the community both now and into the future.
32
Appendix 1: List of conditions serviced in WA
Acquired brain injury
Adem [acute disseminated encephalomyelitis]
Alexander disease
Angelman syndrome
Ankylosng spondylitis
Alzheimer's disease
Anaplastic astrocytoma
Autism
Ataxic disorder
Arteriovenous malformation
Brain aneurysm
Brain tumour
Blepharos spasm
Cadasil
Canavan disease
Cauda equine syndrome
Cerebellar ataxia
Cerebral palsy
Charcot-Marie-Tooth disease
Chiari malformation
Chorea
Cognitive dysfunction
Complex regional pain syndrome
Chronic fatigue syndrome
Chronic demyelinating inflammatory Polyneuropathy
Dementias
Down's syndrome
Diabetic neuropathy
Duchene muscular dystrophy
Dysautonomias
Dystonias
Encephalitis
Epilepsy
Essential tremor
Extrapyramidal syndrome
Fibromyagia
Focal cerebral palsy
Fragile x syndrome
Friedreich's ataxia
Frontotemporal dementia
Global development delay
Guillain barre' syndrome
Hashimoto encephalopathy
Hallervorden-spatz syndrome
Headache and migraine
Hemifacial spasm
Hereditary motor and sensory neuropathy
Hereditary spastic paraparesis
Holopresencepaly
Huntington’s disease
Hydrocephalus
Hypertrophic olivary degeneration
Hypoxic-ischaemic encephalopathy
Inclusion body myositis
Idiopathic intracranial hypertension
Intellectual disability
Intracranial bleed
Kennedy's disease
Lambert-eaton myasthenic syndrome
Lateral medullary syndrome
Labrynitis
Lewy body disease
Lissen cephaly
Limbic encephalitis
Locked-in syndrome
Lyme disease
Meniere's disease
Meningitis
Melas
Microcephaly
33
Motor neuron disease
Moya moya disease
Myalgic encephalomyelitis
Myasthenia gravis
Myelitis
Myelodysplasia
Myeloradiculopathy
Myopathy
Multisystem atrophy
Multiple sclerosis
Narcolepsy
Neuropathy, ataxia and retinitis pigmentosa [narp]
Neurofibromatosis
Neuromyelitis opticus
Normal pressure hydrocephalus
Oligodenroglioma
Oliviopontocerebellar degeneration
Paraplegia
Parkinsonism
Parkinson's disease
Peripheral neuropathies
Poem syndrome
Poliomyelitis
Post traumatic distress syndrome
Posterior fossa meningioma
Prader-willi syndrome
Progressive supranuclear palsy
Quadriplegia
Radiation myolitus
Rett syndrome
Restless leg syndrome
Schaltenbrand syndrome
Scoliosis
Seizure disorders
Smart syndrome
Soto syndrome
Spinal atrophy
Spinocerebllar degeneration
Spinocerebellar ataxia
Spina bifida
Spinal arachnoiditis
Spinal cord compression
Spinal cord injury
Spinal cord tumour
Spinal muscular atrophy
Spinal stenosis
Spontaneous cerebellar haemorrhage
Stereotypies
Stiffman syndrome
Stroke
Subacute sclerosing panencephalitis
Subarachnoid haemorrhage
Systemic lupus
Temporal arteritis
Tourette syndrome
Traumatic brain injury
Transient ischemic attack
Trigeminal neuralgia
Tuberous sclerosis
Vanishing white matter disease
Vascular dementia
Vertigo
West syndrome
William syndrome
34
Appendix 2: Data summary for major conditions Data summaries have been provided for the following conditions:
• cerebral palsy • dementia • epilepsy • Huntington’s disease • hydrocephalus • migraine • motor neurone disease • multiple sclerosis • muscular dystrophy • Parkinson’s disease • spina bifida • stroke • transient ischemic attack • traumatic brain injury
Considerations when interpreting the following data:
• The data on hospitalisations does not consider admissions from private hospitals. • Hospitalisation rates, length of stay and costs within the report, only considered
occasions where a neurological condition was the principal diagnosis. • Changes in hospitalisation rates across years is calculated using age standardised rates. • The ED data also included additional ICD codes listed in Appendix 3.
35
Cerebral palsy In 2012, cerebral palsy patients had an average length of stay in hospital of 3.97 days, an occupancy of 5065 beddays at a total cost of $ 7,586,833.3 Additionally in 2011 there were 18 deaths recorded in WA from cerebral palsy.3
The total combined number of hospital separations for cerebral palsy in WA between 2008-12 was 6021.3 For WA, the rate of cerebral palsy hospitalisations decreased between 2008-12, but it was not significant.3 The average annual percentage change in the rate was -0.97%.3
In 2012, there were a total of 1277 hospitalisations in WA for cerebral palsy; from this 55% were males and 45% females.3
Figure 7: Annual number of hospitalisations for cer ebral palsy in WA by gender for 2008–12.3
The above figure shows the WA annual hospital separations by gender for the years 2008–12 for cerebral palsy. During the five year period, both the male and female rate of hospitalisations decreased, but neither were significant.3
693 665 681 676707
496
539511
483
570
400
500
600
700
800
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
36
Figure 8: Total number of hospitalisations for cere bral palsy in WA by Aboriginality and gender for 2008–12. 3
The above figure shows the total number hospitalisations for cerebral palsy in WA by aboriginality and gender between 2008–12. Over the five year period, Aboriginal people accounted for 13% of hospitalisations for cerebral palsy in WA.3 This is significant as 3.1% of the population in WA are Aboriginal.30
Table 11: Number of hospitalisations for cerebral p alsy by key age groups and gender for 2008–12 in WA. 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
600 Male 5–14 years (N)
1759 Male 15–24 years (N)
499 Male 25–44 years (N)
304 Male 45–64 years (N)
180 Male 65+ years (N)
80 Gender
Female Femal e 0–4 years (N)
471 Femal e 5–14 years (N)
1368 Femal e 15–24 years (N)
342 Femal e 25–44 years (N)
219 Femal e 45–64 years (N)
152 Femal e 65+ years (N)
47
All All 0–4 years (N)
1071 All 5–14 years (N)
3127 All 15–24 years (N)
841 All 25–44 years (N)
523 All 45–64 years (N)
332 All 65+ years (N)
127
The age group most hospitalised for cerebral palsy is the 5-14 year olds and accounted for 52% of the hospital admissions between 2008-12.3
0
500
1000
1500
2000
2500
3000
3500
4000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
37
Figure 9: Annual cerebral palsy hospitalisations in WA metropolitan and regional health service areas for 2003–13. 3
The above figure displays the number of annual hospitalisations for cerebral palsy in WA metropolitan and regional health service areas between 2003-13. On average, metropolitan health service areas recorded 911 hospitalisations annually for cerebral palsy, compared to regional service areas with an average of 263 hospitalisations annually.3
Figure 10: Annual cerebral palsy attendances in WA emergency departments for 2008–14.4
The above figure shows the number of ED attendances for cerebral palsy in WA have remained reasonably consistent between 2008–14.4
701774
918972 939 898 932 940 899
1032 1018
263 262 261 256 274 288 270 252 257 237 275
0
200
400
600
800
1000
1200
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
11 11
9
12
109
12
0
5
10
15
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
WA Health Services
38
Figure 11: Annual cerebral palsy mortality rate for all WA Department of Health services between 2001–11. 4
The above figure displays the annual cerebral palsy mortality rate for WA metropolitan and regional health service areas between 2001-11. On average, there is 13 deaths from cerebral palsy each year in WA.4
Table 12: Cerebral palsy ICD codes used
Cerebral palsy ICD codes
G80.00 Spastic cerebral palsy, unspecified
G80.01 Spastic diplegic cerebral palsy
G80.02 Spastic hemiplegic cerebral palsy
G80.03 Spastic quadriplegic cerebral palsy
G80.09 Other spastic cerebral palsy
G80.3 Dyskinetic cerebral palsy
G80.4 Ataxic cerebral palsy
G80.8 Other cerebral palsy
G80.9 Cerebral palsy, unspecified
1112 12
13
8
16
6
19
15
8
18
0
5
10
15
20
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearAll WA Health Services
39
Dementia In 2012, dementia patients had an average length of stay in WA hospitals of 15.6 days, an occupancy of 124 133 beddays at a total cost of $ 85,225,176.3 Additionally, in 2011 there were 1223 deaths from dementia in WA.3
The total combined number of hospital separations for dementia in WA over the past five years from 2008-12 was 39 146, from this 45% were males and 55% females.3 In 2012, there were a total of 7955 hospitalisations for dementia.3
Dementia (including Alzheimer’s disease) hospitalisations accounted for 0.1% of all hospitalisations by principal diagnosis between 2008-12.3
For WA, the rate of dementia hospitalisations in WA between 2008–12 decreased and was significant (P<0.001). The average annual percentage change in the rate was -6.42%.3
Figure 12: Annual number of hospitalisations for de mentia in WA by gender for 2008–12. 3
The above figure shows the annual number of dementia hospital separations by gender in WA between 2008-12. During the five year period, both the male and female rates of dementia hospitalisation decreased, and was significant (P<0.001).3 The average annual percentage change in the rate for males was -4.99% and -7.55% for females.3
3629
33683190
3360
3592
4900
4577
4224
3943
4363
3000
3500
4000
4500
5000
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
40
Figure 13: Total number of hospitalisations for dem entia in WA by Aboriginality and gender for 2008–12. 3
The above figure shows the total number of dementia hospitalisations in WA by aboriginality and gender between 2008-12. Over the five year period, Aboriginal people accounted for 2% of hospitalisations for dementia.3
Table 13: Number of dementia hospitalisations by ke y age groups and gender 2008–12 in WA3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
0 Male 5–14 years (N)
0 Male 15–24 years (N)
80 Male 25–44 years (N)
130 Male 45–64 years (N)
896 Male 65+ years (N)
16 105 Gender
Female Femal e 0–4 years (N)
0 Femal e 5–14 years (N)
0 Femal e 15–24 years (N)
5 Femal e 25–44 years (N)
49 Femal e 45–64 years (N)
601 Femal e 65+ years (N)
21 352
All All 0–4 years (N)
0 All 5–14 years (N)
0 All 15–24 years (N)
13 All 25–44 years (N)
179 All 45–64 years (N)
1497 All 65+ years (N)
37 457
The age group most hospitalised for dementia is the 65+ year olds and accounted for 96% of the hospital admissions between 2008-12 in WA.3
16670
21619
469
388
0
5000
10000
15000
20000
25000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
41
Figure 14: Annual dementia hospitalisations for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the annual number of dementia hospitalisations for WA metropolitan and regional health service areas between 2003-13. On average, metropolitan health service areas recorded 6789 hospitalisations annually for dementia compared to regional service areas with an average of 1554 hospitalisations annually.3
Figure 15: Annual dementia attendances in WA metrop olitan and regional emergency departments for 2008–14. 4
6995 6957 7236 7507 7357 69406511
6049 59946460 6670
1634 1683 1642 1623 1714 1557 1421 1353 1283 1477 1709
0
1000
2000
3000
4000
5000
6000
7000
8000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
9541059 1065
12731370
1487 1505
47 32 54 64 89 76 84
0
200
400
600
800
1000
1200
1400
1600
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
42
Figure 15 shows the number of ED attendances for dementia in WA have nearly doubled in country areas between 2008-14.4 There has also been a 37% increase in the number of ED admissions in the metropolitan areas between 2008-14.4
Figure 16: Annual dementia mortality rate for WA me tropolitan and regional health service areas between 2001–11. 3
The above figure displays the annual dementia mortality rate for WA metropolitan and regional health service areas between 2001–11. On average, metropolitan health service areas recorded 873 deaths annually compared with 180 deaths reported for regional service areas.3
472 501
765820
891 917 936
1081 1093 10971033
104 91166 159 177 173
224 213254 232
190
0
200
400
600
800
1000
1200
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
43
Table 14: Dementia ICD codes used for the above dat a
Dementia ICD Codes
F00.0 Dementia in Alzheimer's disease with early onset (G30.0+)
F00.1 Dementia in Alzheimer's disease with late onset (G30.1+)
F00.2 Dementia in Alzheimer's disease, atypical or mixed type (G30.8+)
F00.9 Dementia in Alzheimer's disease, unspecified (G30.9+)
F01.0 Vascular dementia of acute onset
F01.1 Multi-infarct dementia
F01.2 Subcortical vascular dementia
F01.3 Mixed cortical and subcortical vascular dementia
F01.8 Other vascular dementia
F01.9 Vascular dementia, unspecified
F02.0 Dementia in Pick's disease (G31.0+)
F02.1 Dementia in Creutzfeldt-Jakob disease (A81.0+)
F02.2 Dementia in Huntington's disease (G10+)
F02.3 Dementia in Parkinson's disease (G20+)
F02.4 Dementia in human immunodeficiency virus [HIV] disease (B22.0+)
F02.8 Dementia in other specified diseases classified elsewhere
F03. Unspecified dementia
F05.1 Delirium superimposed on dementia
F10.7 Mental and behavioural disorders due to use of alcohol, residual and late-onset psychotic disorder
F11.7 Mental and behavioural disorders due to use of opioids, residual and late-onset psychotic disorder
F12.7 Mental and behavioural disorders due to use of cannabinoids, residual and late-onset psychotic disorder
F13.70 Mental and behavioural disorders due to use of sedatives or hypnotics, residual and late-onset psychotic disorder – unspecified agent
F13.71 Mental and behavioural disorders due to use of sedatives or hypnotics, residual and late-onset psychotic disorder– gammahydroxybutyrate
F13.79 Mental and behavioural disorders due to use of sedatives or hypnotics, residual and late-onset psychotic disorder – other specified agent
F14.7 Mental and behavioural disorders due to use of cocaine, residual and late-onset psychotic disorder
F15.70 Mental and behavioural disorders due to use of other stimulants, including caffeine, residual and late-onset psychotic disorder, unspecified stimulants
F15.71 Mental and behavioural disorders due to use of other stimulants, including caffeine, residual and late-onset psychotic disorder, methylamphetamine
Mental and behavioural disorders due to use of other stimulants, including caffeine,
44
Dementia ICD Codes residual and late-onset psychotic disorder, mdma/ecstasy
F15.79 Mental and behavioural disorders due to use of other stimulants, including caffeine, residual and late-onset psychotic disorder, other specified stimulants
F16.70 Mental and behavioural disorders due to use of hallucinogens, residual and late-onset psychotic disorder – unspecified hallucinogen
F16.71 Mental and behavioural disorders due to use of hallucinogens, residual and late-onset psychotic disorder – ketamine
F16.79 Mental and behavioural disorders due to use of hallucinogens, residual and late-onset psychotic disorder – other specified hallucinogen
F17.7 Mental and behavioural disorders due to use of tobacco, residual and late-onset psychotic disorder
F18.7 Mental and behavioural disorders due to use of volatile solvents, residual and late-onset psychotic disorder
F19.7 Mental and behavioural disorders due to multiple drug use and use of psychoactive substances, residual and late-onset psychotic disorder
45
Epilepsy In 2012, epilepsy patients had an average length of stay in hospital of 10.49 days, an occupancy of 29 224 beddays at total cost of $20,106,254.3 Additionally, in 2011 there were 99 deaths from epilepsy in WA.3
The total combined number of hospital separation for epilepsy in WA over the past five years between 2008-12 was 13 426, from this 57% were males and 43% females.3 In 2012, there were a total of 2787 hospitalisations for epilepsy.3
For WA, the rate of epilepsy hospitalisation decreased over the five year period between 2008-12 and it was significant (P<0.001).3 The average annual percentage change in the rate was -2.28%.3
Figure 17: Annual number of hospitalisations for ep ilepsy in WA by gender for 2008–12. 3
The above figure shows the total number of epilepsy separations annually by gender for WA between 2008–12. During the five year period, the male rate of epilepsy hospitalisation decreased, but it was not significant (P<0.52).3 For females the rate of epilepsy hospitalisation also decreased, and it was significant (P<0.001). The average annual percentage change in the rate was -3.77%.3
1457 14591432
1495
1575
12501175
1229
1142
1212
1000
1100
1200
1300
1400
1500
1600
1700
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
46
Figure 18: Total number of hospitalisations for epi lepsy in WA by Aboriginality and gender for 2008–12. 3
The above figure shows the total number of epilepsy hospitalisations in WA by Aboriginality and gender from 2008–12. Over the five year period, Aboriginal people accounted for 22% of the hospitalisations for epilepsy. This is significant as Aboriginal people make up 3.1% of the population of WA.30
Table 15: Number of epilepsy hospitalisations by ke y age groups and gender 2008–12 in WA3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
543 Male 5–14 years (N)
706 Male 15–24 years (N)
836 Male 25–44 years (N)
2266 Male 45–64 years (N)
2027 Male 65+ years (N)
1040 Gender
Female Femal e 0–4 years (N)
566 Femal e 5–14 years (N)
693 Femal e 15–24 years (N)
939 Femal e 25–44 years (N)
1652 Femal e 45–64 years (N)
1188 Femal e 65+ years (N)
970
All All 0–4 years (N)
1109 All 5–14 years (N)
1399 All 15–24 years (N)
1775 All 25–44 years (N)
3918 All 45–64 years (N)
3215 All 65+ years (N)
2010
Between 2008–12 the aged groups most hospitalised for epilepsy were; 24–44 year olds accounting for 29% of hospital admissions and 45-64 year olds accounting for 24% of the hospital admissions.3
5423 4994
1995
1014
0
2000
4000
6000
8000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
47
Figure 19: Annual epilepsy hospitalisations for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the number of annual epilepsy hospitalisations for WA metropolitan and regional health service areas between 2003–13. For both health service areas there has been a steady decline in the number of hospitalisations for epilepsy.3
Figure 20: Annual epilepsy attendances in WA metrop olitan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for epilepsy in WA have nearly doubled in regional areas between 2008-14.4 There has also been a 18% increase in the number of ED admissions in the metropolitan areas between 2008-14.4
22232009 1965 2010 1930
1731 1682 1771 17421894 1855
13421177 1185
1087 1027 945 924 864 843 856 786
0
500
1000
1500
2000
2500
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
2321 2428 2495 25242732 2717 2817
119 118 127 122 161 130 216
0
500
1000
1500
2000
2500
3000
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
48
Figure 21: Annual epilepsy mortality rate for metro politan and regional health service areas between 2001–11. 3
The above figure displays the annual epilepsy mortality rate for WA metropolitan and regional health service areas between 2001–11. On average, metropolitan health service areas had an annual mortality rate of 73 deaths with 20 deaths reported for regional service areas.3
6674
6469
80 77 7368
56
91
75
15 1520 20
11
2227
17 1625 24
0
25
50
75
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
49
Table 16: Epilepsy ICD codes used for the above dat a
Epilepsy ICD Codes
G40.00 Localisation-related (focal)(partial) idiopathic epilepsy and epileptic syndromes with seizures of localised onset, without mention of intractable epilepsy
G40.01 Localisation-related (focal)(partial) idiopathic epilepsy and epileptic syndromes with seizures of localised onset, with intractable epilepsy
G40.10 Localisation-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, without mention of intractable epilepsy
G40.11 Localisation-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, with intractable epilepsy
G40.20 Localisation-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, without mention of intractable epilepsy
G40.21 Localisation-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, with intractable epilepsy
G40.30 Generalised idiopathic epilepsy and epileptic syndromes, without mention of intractable epilepsy
G40.31 Generalised idiopathic epilepsy and epileptic syndromes, with intractable epilepsy
G40.40 Other generalised epilepsy and epileptic syndromes, without mention of intractable epilepsy
G40.41 Other generalised epilepsy and epileptic syndromes, with intractable epilepsy
G40.50 Special epileptic syndromes, without mention of intractable epilepsy
G40.51 Special epileptic syndromes, with intractable epilepsy
G40.60 Grand mal seizures, unspecified (with or without petit mal), without mention of intractable epilepsy
G40.61 Grand mal seizures, unspecified (with or without petit mal), with intractable epilepsy
G40.70 Petit mal, unspecified, without grand mal seizures, without mention of intractable epilepsy
G40.71 Petit mal, unspecified, without grand mal seizures, with intractable epilepsy
G40.80 Other epilepsy, without mention of intractable epilepsy
G40.81 Other epilepsy, with intractable epilepsy
G40.90 Epilepsy, unspecified, without mention of intractable epilepsy
G40.91 Epilepsy, unspecified, with intractable epilepsy
G41.0 Grand mal status epilepticus
G41.1 Petit mal status epilepticus
G41.2 Complex partial status epilepticus
G41.8 Other status epilepticus
G41.9 Status epilepticus, unspecified
50
Huntington’s disease In 2012, Huntington’s disease patients had an average length of stay in hospital of 17.4 days, an occupancy of 609 beddays at a total cost of $ 291,409.3
The total combined number of hospital separations for Huntington’s disease in WA over the past five years from 2008-12 was 227, from this 51% were males and 49% females.3 In 2012, there were a total of 35 hospitalisations for Huntington’s disease; from this 51% were males and 49% females.3
For WA, the rate of Huntington’s disease hospitalisations decreased over the past five years and it was significant (P<0.001). The average annual percentage change in the rate was -24.58%.3
Figure 22: Annual number of hospitalisations in WA for Huntington’s disease by gender from 2008–12. 3
The above figure displays the annual number of hospitalisations for Huntington’s disease in WA by gender from 2008-12. Since 2008, the number of hospitalisations for males has significantly decreased while hospitalisations for females has remained relatively stable. The average annual percentage change in the rate for males was -34.04% and -9.14% for females.3
The number of Aboriginal people hospitalised in WA for Huntington’s disease between 2008-12 was five.3
60
26
19
10
18
15
29
20
1317
0
10
20
30
40
50
60
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
51
Table 17: Number of Huntington’s disease hospitalis ations by key age groups and gender 2008–12 in WA 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
0 Male 5–14 years (N)
0 Male 15–24 years (N)
0 Male 25–44 years (N)
65 Male 45–64 years (N)
37 Male 65+ years (N)
31 Gender
Female Femal e 0–4 years (N)
0 Femal e 5–14 years (N)
0 Femal e 15–24 years (N)
0 Femal e 25–44 years (N)
40 Femal e 45–64 years (N)
36 Femal e 65+ years (N)
18
All All 0–4 years (N)
0 All 5–14 years (N)
0 All 15–24 years (N)
0 All 25–44 years (N)
105 All 45–64 years (N)
73 All 65+ years (N)
49
The age group most hospitalised for Huntington’s disease was males aged 25-44 years and accounted for 46% of the total number of hospitalisations in WA between 2008-12.3
Figure 23: Annual Huntington’s disease hospitalisat ions for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the annual number of hospitalisations for Huntington’s disease in WA metropolitan and regional health service areas between 2003-13. The number of hospitalisations for Huntington’s disease has fluctuated for both metropolitan and regional health service areas during the past ten years. In 2008-09, hospitalisations at both health service areas were the highest with 48 at metropolitan and 44 at regional health service areas.3 Since that time, the number of hospitalisations has decreased and in 2013 there were 27 hospitalisations recorded at metropolitan and 11 at regional health service areas.3
The Huntington’s disease mortality rates and ED presentations for metropolitan and regional health service areas for WA have not been graphed as the numbers are too small. It is estimated that there were less than 78 deaths across the ten years.3
Table 18: Huntington’s disease ICD codes used for t he above data
Huntington’s disease ICD codes
G10. Huntington’s disease
4345
41
34
26
31
48
30
17
28 27
75
12
6 7
44
79
6 5
11
0
5
10
15
20
25
30
35
40
45
50
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
sopi
talis
atio
ns
YearMetropolitan Regional
52
Hydrocephalus In 2012, hydrocephalus patients had an average length of stay in hospital of 14.9 days, an occupancy of 6181 beddays at a total cost of $11,735,562.3
The total combined number of hospital separations for hydrocephalus in WA over the past five years from 2008-12 was 2086, from this 54% were males and 46% females.3 In 2012, there were a total of 416 hospitalisations for hydrocephalus.3
For WA, the rate of hydrocephalus hospitalisations decreased over the past five years and it was significant (P<0.001). The average annual percentage change in the rate was -5.48%.3
During the 5 year period, the male rate of hydrocephalus hospitalisation decreased, and it was significant (P<0.001). The average annual percentage change in the rate was -6.49%.3
Figure 24: Annual number of hospitalisations for hy drocephalus in WA by gender for 2008-12.3
The above figure displays the annual number of hospitalisations for hydrocephalus in WA by gender from 2008-12. The total number of hospitalisations for hydrocephalus has decreased since 2008.3 Since 2008, the number of hospitalisations for males has decreased and this was significant (P<0.001).3 The rate of hospitalisations for females also decreased however it was not significant (P<0.06). 3 Each year, on average 224 males are hospitalised for hydrocephalus compared to 194 females.3
218
265
220
201214
200192
208
166
202
150
200
250
300
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
53
Figure 25: Total number of hospitalisations for hyd rocephalus in WA by Aboriginality and gender for 2008-12. 3
The above figure shows the total number hospitalisations for hydrocephalus in WA by aboriginality and gender from 2008-12. In contrast to non-aboriginal people, higher numbers of Aboriginal females were hospitalised for hydrocephalus than males.3 Over the five year period, Aboriginal people accounted for 7% of the total hospitalisations for hydrocephalus in WA.3
Table 19: Number of hydrocephalus hospitalisations by key age groups and gender 2008–12 in WA 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
104 Male 5–14 years (N)
61 Male 15–24 years (N)
63 Male 25–44 years (N)
152 Male 45–64 years (N)
280 Male 65+ years (N)
458 Gender
Female Femal e 0–4 years (N)
133 Femal e 5–14 years (N)
54 Femal e 15–24 years (N)
53 Femal e 25–44 years (N)
126 Femal e 45–64 years (N)
252 Femal e 65+ years (N)
350
All All 0–4 years (N)
237 All 5–14 years (N)
115 All 15–24 years (N)
116 All 25–44 years (N)
278 All 45–64 years (N)
532 All 65+ years (N)
808
The age group most hospitalised for hydrocephalus is the 65+ year olds who accounted for 39% of the hospital admissions between 2008-12.3
1053897
65
71
0
200
400
600
800
1000
1200
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
54
Figure 26: Annual number of hospitalisations for hy drocephalus for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the number of annual hydrocephalus hospitalisations for WA metropolitan and regional health service areas between 2003–13. Since 2003, hospitalisations in both metropolitan and regional health service areas have decreased.3 Since 2001, WA metropolitan health service areas account for, on average, 78% of the total hospitalisations for hydrocephalus each year.3
Figure 27: Annual hydrocephalus attendances in WA E Ds between 2008–14. 4
The above figure shows the number of ED attendances for hydrocephalus have remained relatively consistent between 2008–14.4
392371
328
394459
319358
324
260306 302
13997
76 78 85 96 95 99 97 104 108
0
100
200
300
400
500
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
3235
30
23 22
3732
0
10
20
30
40
50
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
WA Health Services
55
Figure 28: Annual hydrocephalus mortality rate for all WA Department of Health services between 2001–11. 3
The above figure displays the annual number of deaths resulting from hydrocephalus in WA between 2001–11. Each year in WA, on average, 17 people die from hydrocephalus.3
16
11
1820
14
9
30
9
1820
24
0
10
20
30
40
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearAll WA Health…
56
Table 20: Hydrocephalus ICD codes used for the abov e data
Hydrocephalus ICD codes
Congenital hydrocephalus
Q03.0 Malformations of aqueduct of Sylvius*
Q03.1 Atresia of foramina of Magendie and Luschka
Q03.8 Other congenital hydrocephalus**
Q03.9 Congenital hydrocephalus, unspecified
Acquired or unspecified hydrocephalus
G91.0 Communicating hydrocephalus
G91.1 Obstructive hydrocephalus
G91.2 Normal-pressure hydrocephalus
G91.3 Post-traumatic hydrocephalus, unspecified
G91.8 Other hydrocephalus
G91.9 Hydrocephalus, unspecified
G94.0 Hydrocephalus in infectious and parasitic diseases classified elsewhere (A00-B99+)
G94.1 Hydrocephalus in neoplastic disease (C00-D48+)
G94.2 Hydrocephalus in other diseases classified elsewhere
*Increased granularity from 1 July 2010 onwards
*Q03.01 Congenital stenosis and obstruction of aqueduct of sylvius
Q03.09 Other congenital malformations of aqueduct of sylvius
*Q03.81 Congenital communicating hydrocephalus
Q03.89 Other congenital hydrocephalus
57
Migraine In 2012, migraine patients had an average length of stay in hospitals in WA of 3.46 days, an occupancy of 6022 beddays at a total cost of $6,942,465.3
The total combined number of hospital separations for migraine in WA over the past five years from 2008-12 was 6698, from this 22% were males and 78% females.3 In 2012, there were a total of 1742 hospitalisations for migraine, from this 22% were males and 78% females.3
For WA, the rate of migraine hospitalisations in WA increased over the last five years, and it was significant (P<0.001). The average annual percentage change in the rate was 12.59%.3
Figure 29: Annual number of hospitalisations for mi graine in WA by gender for 2008–12. 3
The above figure displays the annual number of hospitalisations in WA for migraine by gender from 2008–12. Overall, hospitalisations for migraine are far greater in females than males with 1052 females hospitalised on average per year compared to 288 hospitalisations for males.3
203 228 269349 391
810 862975
1260 1351
0
200
400
600
800
1000
1200
1400
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
58
Figure 30: Total number of hospitalisations for mig raine in WA by Aboriginality and gender for 2008–12. 3
The above figure shows the total number hospitalisations for migraine in WA by aboriginality and gender from 2008-12. Over the five year period, Aboriginal people accounted for 3% of the hospitalisations for migraine.3
Table 21: Number of migraine hospitalisations by ke y age groups and gender 2008–12 in WA
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
6 Male 5–14 years (N)
142 Male 15–24 years (N)
199 Male 25–44 years (N)
536 Male 45–64 years (N)
414 Male 65+ years (N)
143 Gender
Female Femal e 0–4 years (N)
<5 Femal e 5–14 years (N)
193 Femal e 15–24 years (N)
571 Femal e 25–44 years (N)
2148 Femal e 45–64 years (N)
1812 Femal e 65+ years (N)
530
All All 0–4 years (N)
10 All 5–14 years (N)
335 All 15–24 years (N)
770 All 25–44 years (N)
2684 All 45–64 years (N)
2226 All 65+ years (N)
673
Between 2008-12 the aged groups most hospitalised for migraine were; 24-44 year olds accounting for 40% of hospital admissions and 45-64 year olds accounting for 33% of the hospital admissions.3
1380
5089
60
169
0
1000
2000
3000
4000
5000
6000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
59
Figure 31: Annual number of hospitalisations for mi graine for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the number of annual migraine hospitalisations for WA metropolitan and regional health service areas between 2003–13. Since 2003, hospitalisations in the metropolitan area have increased and regional health service areas have seen a slight decline.3 In 2013, WA metropolitan health service areas represented 78% of the total hospitalisations for migraine in WA with1280 hospitalisations.3
Figure 32: Annual migraine attendances in WA metrop olitan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances in regional areas for migraine have increased from 159 attendances in 2008 to 188 attendances in 2014.4 There has also been a 28% increase in the number of ED admissions in the metropolitan areas between 2008–14.4
522599
741 698 722 692814
924
12441382 1280
471 474375 376 359
307 264 307 327 325 365
0
200
400
600
800
1000
1200
1400
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
15541709 1650
2011 2082 20082147
159 161 153 187 206 170 188
0
500
1000
1500
2000
2500
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
60
The migraine mortality rates for WA metropolitan and regional health service areas between 2001–11 have not been graphed as the numbers are too small. It is estimated that there were less than 50 deaths related to migraine across the ten years.3
Table 22: Migraine ICD codes used for the above dat a
Migraine ICD codes
G43.0 Migraine without aura [common migraine]
G43.1 Migraine with aura [classical migraine]
G43.2 Status migrainosus
G43.3 Complicated migraine
G43.8 Other migraine
G43.9 Migraine, unspecified
61
Motor neurone disease In 2012, motor neurone disease patients had an average length of stay in hospital of 10.7 days, an occupancy of 2185 beddays at a total cost of $2,088,975.3 Additionally in 2011, there were 84 deaths from motor neurone disease in WA.3
The total combined number of hospital separation of motor neurone disease in WA over the past five years from 2008-12 was 1367, from this 53.5% were males and 46.5% females.3 In 2012 there were a total of 217 hospitalisations for motor neurone disease.3
For WA between 2008–12, the rate of motor neurone disease hospitalisations in WA decreased, and it was significant (P<0.001). The average annual percentage change in the rate was -12.15%.3
Figure 33: Annual number of hospitalisations for mo tor neurone disease in WA by gender for 2008–12. 3
The above figure displays the annual number of hospitalisations for motor neurone disease by gender from 2008–12 in WA. Over the five year period, hospitalisations for both genders have declined. The average annual percentage change in the rate was -15.04%.3 For females the average annual percentage change in the rate was -7.12% and -15.04% for males.3 In 2012, there were 116 hospitalisations for males and 101 hospitalisations for females.3
190
225
171160
116120
90105
89 101
0
50
100
150
200
250
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
62
Figure 34: Total number of hospitalisations for mot or neurone disease in WA by Aboriginality and gender for 2008–12. 3
The above figure shows the total number of hospitalisations for motor neurone disease in WA by aboriginality and gender from 2008–12. Hospitalisations for Aboriginal people account for less than 2% of the total number of hospitalisations for motor neurone disease in WA.3 Hospitalisations for males was nearly double females, with 848 hospitalisations for males compared to 493 for females between 2008–12.3
Table 23: Number of motor neurone disease hospitali sations by key age groups and gender 2008–12 in WA. 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
<5 Male 5–14 years (N)
<5 Male 15–24 years (N)
<5 Male 25–44 years (N)
78 Male 45–64 years (N)
277 Male 65+ years (N)
798 Gender
Female Femal e 0–4 years (N)
<5 Femal e 5–14 years (N)
<5 Femal e 15–24 years (N)
<5 Femal e 25–44 years (N)
9 Femal e 45–64 years (N)
154 Femal e 65+ years (N)
339
All All 0–4 years (N)
<5 All 5–14 years (N)
<5 All 15–24 years (N)
<5 All 25–44 years (N)
87 All 45–64 years (N)
431 All 65+ years (N)
837
The age group most hospitalised for motor neurone disease was the 65+ year olds and accounted for over 60% of the total number of the hospital admissions in WA between 2008–12.3
848
493
14
12
0
250
500
750
1000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
63
Figure 35: Annual hospitalisations for motor neuron e disease at WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the annual number of hospitalisations for motor neurone disease at WA metropolitan and regional health service areas between 2003–13. Over the past ten years the number of hospitalisations has fluctuated at both metropolitan and regional health service areas, with the total number of hospitalisations in 2013 declining since 2003.3
Figure 36: Annual motor neurone disease attendances in WA emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for motor neurone disease across WA have decreased from 17 to 12 attendances between 2008–14.4
211186
204
249 253 254
214 221
189
153168
7153 59
36
125
54
101
55 59 62 65
0
100
200
300
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
GenderMetropolitan Regional
17
13
16 16
13
16
12
0
5
10
15
20
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
WA Health Services
64
Figure 37: Annual motor neurone disease mortality r ate for WA metropolitan and regional health service areas between 2001–11. 3
The above figure shows the number of deaths recorded annually for motor neurone disease at WA metropolitan and regional health service areas. Despite fluctuations, the total number of deaths has increased since 2001–13 mortality rates showing a 39% increase for metropolitan areas and just under 90% increase for regional health service areas.3
Table 24: Motor neurone disease ICD codes used for the above data
Motor neurone disease ICD codes*
G12.2 Motor neurone disease
4149
70
58
42
5559 62 64 63
67
9 11 1115 14
9 10
2012 13
17
0
10
20
30
40
50
60
70
80
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
65
Multiple sclerosis In 2012, multiple sclerosis patients had an average length of stay in hospital of 2.27 days, an occupancy of 9175 beddays at a total cost of $12,189,179.3 Additionally, in 2011 there were 23 deaths from multiple sclerosis in WA.3
The total combined number of hospital separations for multiple sclerosis in WA over the past five years from 2008-12 was 14 006; from this 29% were males and 71% females.3 In 2012, there were a total of 4037 hospitalisations for multiple sclerosis.3
For WA, the rate of multiple sclerosis hospitalisation increased over the five year period, and it was significant (P<0.001).3 The average annual percentage change in the rate was 22.54%.3
Figure 38: Annual number of hospitalisations in WA for multiple sclerosis by gender from 2008–12.3
The above figure displays the annual number of hospitalisations in WA for multiple sclerosis by gender from 2008–12. Over the five year period, the number of multiple sclerosis hospitalisations in WA has significantly increased for both males and females. During the five year period, the average percentage change annually was 18.87% for males and 24.15% for females.3 In 2012, 2868 females and 1169 males were hospitalised for multiple sclerosis.3
472693
810 9311169
1039
1464
1994
2566 2868
0
500
1000
1500
2000
2500
3000
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
66
Figure 39: Total number of hospitalisations in WA f or multiple sclerosis by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of hospitalisations for multiple sclerosis in WA by aboriginality and gender from 2008–12. Over the five year period, Aboriginal people accounted for 0.3% of the hospitalisations for multiple sclerosis.3
Table 25: Number of multiple sclerosis hospitalisat ions by key age groups and gender 2008–12 in WA 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
0 Male 5–14 years (N)
10 Male 15–24 years (N)
249 Male 25–44 years (N)
1914 Male 45–64 years (N)
1612 Male 65+ years (N)
290 Gender
Female Femal e 0–4 years (N)
0 Femal e 5–14 years (N)
21 Femal e 15–24 years (N)
440 Femal e 25–44 years (N)
4964 Femal e 45–64 years (N)
3945 Femal e 65+ years (N)
561
All All 0–4 years (N)
0 All 5–14 years (N)
31 All 15–24 years (N)
689 All 25–44 years (N)
6097 All 45–64 years (N)
5557 All 65+ years (N)
851
Between 2008-12 the aged groups most hospitalised for multiple sclerosis were; 24–44 year olds accounting for 49% of hospital admissions and 45-64 year olds accounting for 50% of the hospital admissions in WA.3
Non-Aboriginal, 4065
Non-Aboriginal, 9898Aboriginal, 10
Aboriginal, 33
0
2500
5000
7500
10000
Males Females
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
67
Figure 40: Annual multiple sclerosis hospitalisatio ns for WA metropolitan and regional health service areas between 2003–13. 3
The above figure displays the annual number of hospitalisations for multiple sclerosis at WA metropolitan and regional health service areas between 2003–13. Since 2007, hospitalisations at both health service areas have increased, although regional health service areas have seen a slight decline since 2012. In 2013, WA metropolitan health service areas represented 86% of the total hospitalisations in WA with 3543 hospitalisations.3
Figure 41: Annual multiple sclerosis attendances in WA metropolitan and regional EDs between 2008–14. 4
The above figure shows the number of ED attendances for motor neurone disease across WA have remained relatively consistent between 2008–14.4
683 702 669 647 701
1243
1730
2257
2831
3438 3543
134 125 96 137 166 264 414 541 664 587 585
0
1000
2000
3000
4000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
7684 80 77 79
73 77
6 9 7 7 10 8 6
0
25
50
75
100
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
68
The multiple sclerosis mortality rate for metropolitan and regional health service areas between 2001–11 for WA have not been graphed as the numbers are too small. It is estimated that there were approximately 243 deaths from multiple sclerosis across the ten years.3
Table 26: Multiple sclerosis ICD codes used for the above data
Multiple sclerosis ICD codes
G35. Multiple sclerosis
69
Muscular dystrophy In 2012 there were a total of 108 hospitalisations for muscular dystrophy in WA; from this 61% were males and 39% females.3 Additionally, in 2011 there were ten deaths from muscular dystrophy in WA.3
The total combined number of hospital separations for muscular dystrophy in WA over the five years from 2008–12 was 612; from this 67% were males and 33% females.3 In 2012 there were 108 separations for stroke compared to 136 in 2008.3
For WA, the total rate of muscular dystrophy hospitalisations decreased over the five year period and was significant (P<0.01).3 The average annual percentage change in the rate was -6.68%.3
Figure 42: Annual number of hospitalisations in WA for muscular dystrophy by gender from 2008–12. 3
The above figure shows the WA annual muscular dystrophy separations by gender for the years 2008–12. During the five year period, both the male and female rate of hospitalisations decreased, but neither were significant.3
92
73
85 91
66
44 4641
3242
0
25
50
75
100
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMales Females
70
Figure 43: Total number of hospitalisations for mus cular dystrophy by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of hospitalisations for muscular dystrophy in WA by aboriginality and gender from 2008-12. Hospitalisations for Aboriginal people account for less than 2% of the total number of hospitalisations for muscular dystrophy in WA.3 Hospitalisations for males nearly double female with 407 hospitalisations for males compared to 205 for females between 2008-12.3 As there were less than five cases, data for Aboriginal females is not displayed in the above figure.
Table 27: Number of muscular dystrophy hospitalisat ions by key age groups and gender 2008–12 in WA 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
24 Male 5–14 years (N)
74 Male 15–24 years (N)
81 Male 25–44 years (N)
52 Male 45–64 years (N)
145 Male 65+ years (N)
31 Gender
Female Femal e 0–4 years (N)
32 Femal e 5–14 years (N)
40 Femal e 15–24 years (N)
22 Femal e 25–44 years (N)
52 Femal e 45–64 years (N)
47 Femal e 65+ years (N)
12
All All 0–4 years (N)
56 All 5–14 years (N)
114 All 15–24 years (N)
103 All 25–44 years (N)
104 All 45–64 years (N)
192 All 65+ years (N)
43
Table 27 shows the number of hospitalisations by key age groups and gender in WA. The age group most hospitalised was the 45–64 year old age group who accounted for 31% of all hospitalisations between 2008-12.3
Non-Aboriginal, 396
Non-Aboriginal, 204
Aboriginal, 11
0
50
100
150
200
250
300
350
400
450
Males Females
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
71
Figure 44: Annual hospitalisations for muscular dys trophy at WA metropolitan and regional health service areas between 2003–13. 3
The above figure shows the number of hospitalisations annually for muscular dystrophy at both WA metropolitan and regional health service areas. The number of hospitalisations for muscular dystrophy has decreased since 2003 with the annual total for 2013 recorded at 65 for metropolitan and 24 for regional health service areas.3
Figure 45: Annual muscular dystrophy mortality rate for all WA Department of Health service areas between 2001–11. 3
The above figure displays the annual mortality rate for muscular dystrophy across all WA Department of Health service areas between 2001–11. Due to low numbers, no split can be provided for metropolitan and regional health service areas. During the ten year period, the mortality rate has remained relatively unchanged due to the small numbers.
95 94 9890
115 11297
103 103
82
65
40
2416 20
3123 22 21 20
26 24
0
20
40
60
80
100
120
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
9
65
6
11
5
12
10
6
8
10
0
2
4
6
8
10
12
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearAll Health Services
72
Table 28: Muscular dystrophy ICD codes used
Muscular dystrophy ICD codes*
G71.0 Muscular dystrophy
G71.1 Myotonic disorders (myotonic congenital muscular dystrophy)
G71.2 Congenital myopathies (congenital muscular dystrophy, not otherwise specified)
73
Parkinson’s disease In 2012, Parkinson’s disease patients had an average length of stay in hospital of 19.76 days, an occupancy of 36 943 at a total cost of $21,245,8983. Additionally in 2011 there were 214 deaths from Parkinson’s disease in WA.3
The total combined number of hospital separation for Parkinson’s disease over the past five years from 2008-12 was 8631; from this 60% were males and 40% were females.3 In 2012 there were 1870 separations for Parkinson’s disease compared to 1773 in 2008.3 For WA, the total rate of Parkinson’s disease hospitalisations decreased over the five year period and was significant (P<0.01).3 The average annual percentage change in the rate was -1.92%.3
Figure 46: Annual number of hospitalisations in WA for Parkinson’s disease by gender from 2008–12. 3
The above figure displays the annual number of hospitalisations for Parkinson’s disease in WA by gender for 2008–12. Over the five year period, hospitalisations for males are higher than females.3 Each year on average, males accounted for 1063 hospitalisations compared to 663 hospitalisations for females.3
10961030 1016 1049
1126
677
549
659 685744
400
600
800
1000
1200
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
74
Figure 47: Total number of hospitalisations in WA f or Parkinson’s disease by Aboriginality and gender for 2008–12. 3
The above figure shows the total number of hospitalisations for Parkinson’s disease in WA by aboriginality and gender from 2008–12. Aboriginal people accounted for less than 2% of the hospitalisations for Parkinson’s’ disease.3
Table 29: Number of Parkinson’s disease hospitalisa tions by key age groups and gender 2008–12 in WA. 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
0 Male 5–14 years (N)
<5 Male 15–24 years (N)
22 Male 25–44 years (N)
77 Male 45–64 years (N)
571 Male 65+ years (N)
4646 Gender
Female Femal e 0–4 years (N)
0 Femal e 5–14 years (N)
0 Femal e 15–24 years (N)
15 Femal e 25–44 years (N)
62 Femal e 45–64 years (N)
332 Femal e 65+ years (N)
2905
All All 0–4 years (N)
0 All 5–14 years (N)
<5 All 15–24 years (N)
37 All 25–44 years (N)
139 All 45–64 years (N)
903 All 65+ years (N)
7551
The age group most hospitalised for Parkinson’s disease between 2008–12, was the 65+ year olds and they accounted for 87% of the total number of hospitalisations in WA.3
5272
3258
45
56
0
1000
2000
3000
4000
5000
6000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
75
Figure 48: Annual hospitalisations for Parkinson’s disease at WA metropolitan and regional health service areas in WA between 2003–13 .3
The above figure displays the annual number of Parkinson’s disease hospitalisations for WA metropolitan and regional health service areas between 2003–13. On average, metropolitan health service areas recorded 1479 hospitalisations annually and regional service areas an average of 353 hospitalisations annually.3
Figure 49: Annual Parkinson’s disease attendances i n WA metropolitan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for Parkinson’s disease in the metropolitan area saw an increase in 2012 from 79 attendances to 133 attendances in 2014.4
14601596 1592 1675 1601
14221271
1373 1425 14481647
346 353 369 359 439 345 302 297 304414
498
0
200
400
600
800
1000
1200
1400
1600
1800
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
88 89 88100
79
117
133
6 0 010 9 11
00
25
50
75
100
125
150
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
76
Figure 50: Annual Parkinson’s disease mortality rat e for metropolitan and regional health service areas in WA between 2001–11. 3
The above figure displays the annual Parkinson’s disease mortality rate for WA metropolitan and regional health service areas between 2001–11. On average, metropolitan health service areas record an average of 171 deaths per year for Parkinson’s disease compared to 36 deaths for regional service areas.3
Table 30: Parkinson’s disease ICD codes used for th e above data
Parkinson’s disease ICD codes*
G20. Parkinson's disease
G21.0 Malignant neuroleptic syndrome
G21.1 Other drug-induced secondary parkinsonism
G21.2 Secondary parkinsonism due to other external agents
G21.3 Postencephalitic parkinsonism
G21.4 Vascular parkinsonism
G21.8 Other secondary parkinsonism
G21.9 Secondary parkinsonism, unspecified
G22. Parkinsonism in diseases classified elsewhere
158 148 153 153170 175
188204
187165
185
34 2838 38 34 25
4837
4937
29
0
50
100
150
200
250
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
77
Spina bifida In 2012, spina bifida patients had an average length of stay in hospital of 15.16 days, an occupancy of 2168 beddays at a total cost of $2,089,701.3
The total combined number of hospital separation of spina bifida in WA over the past five years from 2008-12 was 750, from this 46% were males and 54% females.3 In 2012, there were 143 separations for spina bifida compared to 179 in 2008.3
For WA total, the rate of spinal bifida hospitalisation decreased, and it was significant (P<0.001). The average annual percentage change in the rate was -8.36%.3
Figure 51: Annual spina bifida hospitalisations in WA by gender from 2008–12. 3
The above figure shows the WA annual spina bifida separation by gender for the years 2008–12. During the five year period, the male rate of spina bifida hospitalisation decreased, and it was significant (P<0.001).3 The average annual percentage change in the rate was -20.72%.3 For females the rate of spina bifida hospitalisation increased, but it was not significant (P<0.50).3 The average annual percentage change in the rate was 3.57%.3
Male, 105
Male, 71
Male, 80
Male, 43 Male, 49
Female, 74
Female, 81
Female, 63
Female, 90 Female, 94
0
25
50
75
100
125
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
78
Figure 52: Total number of spina bifida hospitalisa tions in WA by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of hospitalisations for spina bifida in WA by aboriginality and gender from 2008–12. In WA, Aboriginal people accounted for 11.5% of the hospitalisations for spina bifida. This is significant as Aboriginal people make up 3.1% of the population of WA.30 Hospitalisations for females were greater than males in both Aboriginal and Non-Aboriginal people.3
Table 31: Number of spina bifida hospitalisations b y key age groups and gender 2008–12 in WA 3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
63 Male 5–14 years (N)
48 Male 15–24 years (N)
76 Male 25–44 years (N)
104 Male 45–64 years (N)
40 Male 65+ years (N)
17 Gender
Female Femal e 0–4 years (N)
76 Femal e 5–14 years (N)
74 Femal e 15–24 years (N)
103 Femal e 25–44 years (N)
117 Femal e 45–64 years (N)
30 Femal e 65+ years (N)
<5
All All 0–4 years (N)
139 All 5–14 years (N)
122 All 15–24 years (N)
179 All 25–44 years (N)
221 All 45–64 years (N)
70 All 65+ years (N)
19
Between 2008–12 the aged groups most hospitalised for spina bifida were; 24-44 year olds accounting for 29% of hospital admissions and 15-24 year olds accounting for 24% of the hospital admissions in WA.3
314 350
34
52
0
100
200
300
400
500
Male FemaleNo.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
79
Figure 53: Annual hospitalisations for spina bifida at WA metropolitan and regional health service areas in WA between 2003–13. 3
The above figure displays the annual number of spina bifida hospitalisations for WA metropolitan and regional health service areas between 2003–13. Since 2003, hospitalisations in both metropolitan and regional health service areas have decreased.3
The spina bifida mortality rates for metropolitan and regional health service areas for WA have not been graphed as the numbers are too small. It is estimated that there were less than 30 deaths related to spina bifida across the ten years.3
129
149164
134 136122
108 11093 100 106
38 4055
67 61 5743
33 39 4232
0
25
50
75
100
125
150
175
200
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
80
Table 32: Spina bifida disease ICD codes used for t he above data
Spina Bifida ICD Codes
Q05.00 Cervical spina bifida with hydrocephalus, unspecified whether lesion is open or closed
Q05.01 Cervical spina bifida with hydrocephalus, open, aperta, not covered with skin or membrane
Q05.02 Cervical spina bifida with hydrocephalus, closed, cystica, covered with skin or membrane
Q05.10 Thoracic spina bifida with hydrocephalus, unspecified whether lesion is open or closed
Q05.11 Thoracic spina bifida with hydrocephalus, open, aperta, not covered with skin or membrane
Q05.12 Thoracic spina bifida with hydrocephalus, closed, cystica, covered with skin or membrane
Q05.20 Lumbar spina bifida with hydrocephalus, unspecified whether lesion is open or closed
Q05.21 Lumbar spina bifida with hydrocephalus, open, aperta, not covered with skin or membrane
Q05.22 Lumbar spina bifida with hydrocephalus, closed, cystica, covered with skin or membrane
Q05.30 Sacral spina bifida with hydrocephalus, unspecified whether lesion is open or closed
Q05.31 Sacral spina bifida with hydrocephalus, open, aperta, not covered with skin or membrane
Q05.32 Sacral spina bifida with hydrocephalus, closed, cystica, covered with skin or membrane
Q05.40 Unspecified spina bifida with hydrocephalus, unspecified whether lesion is open or closed
Q05.41 Unspecified spina bifida with hydrocephalus, open, aperta, not covered with skin or membrane
Q05.42 Unspecified spina bifida with hydrocephalus, closed, cystica, covered with skin or membrane
Q05.50 Cervical spina bifida without hydrocephalus, unspecified whether lesion is open or closed
Q05.51 Cervical spina bifida without hydrocephalus, open, aperta, not covered with skin or membrane
Q05.52 Cervical spina bifida without hydrocephalus, closed, cystica, covered with skin or membrane
Q05.60 Thoracic spina bifida without hydrocephalus, unspecified whether lesion is open or closed
Q05.61 Thoracic spina bifida without hydrocephalus, open, aperta, not covered with skin or membrane
81
Spina Bifida ICD Codes
Q05.62 Thoracic spina bifida without hydrocephalus, closed, cystica, covered with skin or membrane
Q05.70 Lumbar spina bifida without hydrocephalus, unspecified whether lesion is open or closed
Q05.71 Lumbar spina bifida without hydrocephalus, open, aperta, not covered with skin or membrane
Q05.72 Lumbar spina bifida without hydrocephalus, closed, cystica, covered with skin or membrane
Q05.80 Sacral spina bifida without hydrocephalus, unspecified whether lesion is open or closed
Q05.81 Sacral spina bifida, open, aperta, not covered with skin or membrane
Q05.82 Sacral spina bifida, closed, cystica, covered with skin or membrane
Q05.90 Spina bifida, unspecified, unspecified whether lesion is open or closed
Q05.91 Spina bifida, unspecified, open, aperta, not covered with skin or membrane
Q05.92 Spina bifida, unspecified, closed, cystica, covered with skin or membrane
Q76.0 Spinalbifida occulta
82
Stroke In 2012, stroke patients had an average length of stay in hospital of 14.75 days, an occupancy of 80 820 beddays at a total cost of $78,107,937.3 Additionally in 2011, there were 1210 deaths from stroke in WA.3
The total combined number of hospital separations for strokes in WA over the five years from 2008-12 was 24 774; from this 54% were males and 46% females.3 In 2012 there were 5479 separations for stroke compared to 4813 in 2008.3 For WA, the total rate of stroke hospitalisations decreased over the five years period, however it was not significant (P<0.584). The average annual percentage change in the rate was -0.36%.3
Figure 54: Annual stroke hospitalisations in WA by gender from 2008–12. 3
The above figure shows the WA annual stroke separation by gender for the years 2008–12. During the five year period, both the male and female rate of hospitalisations decreased, but neither were significant.3
25612497
2671 26892958
22522139 2083
24032521
1500
2000
2500
3000
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
83
Figure 55: Total number of stroke hospitalisations in WA by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of stroke hospitalisations in WA by aboriginality and gender from 2008–12. Over the five year period, Aboriginal people accounted for 4% of the hospitalisations for stroke.3
Table 33: Number of stroke hospitalisations by key age groups and gender 2008–12 in WA3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
44 Male 5–14 years (N)
22 Male 15–24 years (N)
78 Male 25–44 years (N)
754 Male 45–64 years (N)
3679 Male 65+ years (N)
8799 Gender
Female Femal e 0–4 years (N)
24 Femal e 5–14 years (N)
23 Femal e 15–24 years (N)
63 Femal e 25–44 years (N)
659 Femal e 45–64 years (N)
2120 Femal e 65+ years (N)
8509
All All 0–4 years (N)
68 All 5–14 years (N)
45 All 15–24 years (N)
141 All 25–44 years (N)
1413 All 45–64 years (N)
5799 All 65+ years (N)
17 308
The age group most hospitalised for stroke was the 65+ year olds and they accounted for 70% of the total number of strokes in WA between 2008–12.3
1279710923
579
475
0
2000
4000
6000
8000
10000
12000
14000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
84
Figure 56: Annual stroke hospitalisations for WA me tropolitan and regional health service areas between 2003–13. 3
The above figure displays the number of annual stroke hospitalisations for WA metropolitan and regional health service areas between 2003–13. On average, metropolitan health service areas recorded 3679 stroke hospitalisations annually and regional service areas had an average of 1028 stroke hospitalisations annually.3
Figure 57: Annual stroke attendances in WA metropol itan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for stroke increased by 13% in the metropolitan areas and have remained reasonable consistent in country areas between 2008–14.4
3145 32413498 3630 3789 3723 3594 3639
39034189 4119
852 926 1037 984 991 1022 975 1033 1112 1170 1210
0
1000
2000
3000
4000
5000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
537 527565
597568
539
616
35 18 17 17 26 26 32
0
100
200
300
400
500
600
700
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
85
Figure 58: Annual stroke mortality rate for WA metr opolitan and regional health service areas between 2001–11. 3
The above figure displays the annual stroke mortality rate for WA metropolitan and regional health service areas between 2001–11. On average, metropolitan health service areas had an annual mortality rate for stroke of 1065 deaths with 273 deaths reported for regional service areas.3
1002 10261111 1137
10091081 1033
11541098 1108
959
261 276 274 281 260 263 282 266318 272 251
0
200
400
600
800
1000
1200
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
86
Table 34: Stroke ICD codes used for the above data
Stroke ICD Codes*
I60.0 Subarachnoid haemorrhage from carotid siphon and bifurcation
I60.1 Subarachnoid haemorrhage from middle cerebral artery
I60.2 Subarachnoid haemorrhage from anterior communicating artery
I60.3 Subarachnoid haemorrhage from posterior communicating artery
I60.4 Subarachnoid haemorrhage from basilar artery
I60.5 Subarachnoid haemorrhage from vertebral artery
I60.6 Subarachnoid haemorrhage from other intracranial arteries
I60.7 Subarachnoid haemorrhage from intracranial artery, unspecified
I60.8 Other subarachnoid haemorrhage
I60.9 Subarachnoid haemorrhage, unspecified
I61.0 Intracerebral haemorrhage in hemisphere, subcortical
I61.1 Intracerebral haemorrhage in hemisphere, cortical
I61.2 Intracerebral haemorrhage in hemisphere, unspecified
I61.3 Intracerebral haemorrhage in brain stem
I61.4 Intracerebral haemorrhage in cerebellum
I61.5 Intracerebral haemorrhage, intraventricular
I61.6 Intracerebral haemorrhage, multiple localised
I61.8 Other intracerebral haemorrhage
I61.9 Intracerebral haemorrhage, unspecified
I62.0 Subdural haemorrhage (acute)(nontraumatic)
I62.1 Nontraumatic extradural haemorrhage
I62.9 Intracranial haemorrhage (nontraumatic), unspecified
I63.0 Cerebral infarction due to thrombosis of precerebral arteries
I63.1 Cerebral infarction due to embolism of precerebral arteries
I63.2 Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
I63.3 Cerebral infarction due to thrombosis of cerebral arteries
I63.4 Cerebral infarction due to embolism of cerebral arteries
I63.5 Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.8 Other cerebral infarction
I63.9 Cerebral infarction, unspecified
I64. Stroke, not specified as haemorrhage or infarction *Excludes: late effects of old stroke; cerebrovascular disease without infection or haemorrhage; TIA
87
Transient ischaemic attack In 2012, transient ischaemic attack (TIA) patients had an average length of stay in hospital in WA of 5.19 days, an occupancy of 8012 beddays at a total cost of $9,669,957.03.3
The total combined number of TIA hospital separation in WA over the past five years from 2008-12 was 7480; from this 49% were males and 51% females.3 In 2012 there were 1545 separations for TIA compared to 1370 in 2008.3
For WA total, the rate of TIA hospitalisation decreased, but it was not significant (P<0.50). The average annual percentage change in the rate was -0.66%.3
Figure 59: Annual transient ischaemic attack hospit alisations in WA by gender from 2008–12.3
The above figure displays the annual number of hospitalisations in WA for TIA by gender from 2008–12. Using age standardised rates for comparison, over the five year period, the number of TIA hospitalisations in WA has decreased in both males and females. Since 2008, TIA hospitalisations has decreased each year on average by -1.21% for males and -0.14% for females.3 However, the decreases for both genders were not significant.3
681
714
747
810
746
689
720
793781 799
650
700
750
800
850
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
88
Figure 60: Total number of transient ischaemic atta ck hospitalisations in WA by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of hospitalisations for TIA in WA by aboriginality and gender from 2008–12. Over the five year period, Aboriginal people accounted for 2.6% of the hospitalisations for TIA.3
Table 35: Number of hospitalisations for transient ischaemic attack by key age groups and gender 2008–12 in WA3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
<5 Male 5–14 years (N)
<5 Male 15–24 years (N)
<10 Male 25–44 years (N)
166 Male 45–64 years (N)
980 Male 65+ years (N)
2543 Gender
Female Femal e 0–4 years (N)
<5 Femal e 5–14 years (N)
<5 Femal e 15–24 years (N)
<10 Femal e 25–44 years (N)
172 Femal e 45–64 years (N)
758 Femal e 65+ years (N)
2848
All All 0–4 years (N)
<5 All 5–14 years (N)
<5 All 15–24 years (N)
<10 All 25–44 years (N)
338 All 45–64 years (N)
1738 All 65+ years (N)
5397
The age group most hospitalised for TIA was the 65+ year olds and accounted for 72% of the total number of hospitalisations for TIA in WA between 2008–12.3
3617 3664
81 118
0
500
1000
1500
2000
2500
3000
3500
4000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
89
Figure 61: Annual number of hospitalisations for tr ansient ischaemic attack at WA metropolitan and regional health service areas betw een 2003–13.3
The above figure displays the annual number of TIA hospitalisations at WA metropolitan and regional health service areas between 2003–13. There has been a gradual increase in the number of hospitalisations from 825 in 2003 to 1220 in 2013.
Figure 62: Annual transient ischaemic attack attend ances in WA metropolitan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for TIAs increased by 17% in the metropolitan areas and 28% in regional areas between 2008–14.4
825 790860
807 838
983 10321120
12191166
1220
386 347 371 335 362 370 383 393 352 348406
0
250
500
750
1000
1250
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
1331 1363 1370 1415 14181491
1604
88 108 118 104 147 115 123
0
200
400
600
800
1000
1200
1400
1600
1800
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
90
Figure 63: Annual transient ischaemic attack mortal ity rate for metropolitan and regional health service areas in WA between 2001–11. 3
The above figure displays the annual TIA mortality rate for WA metropolitan and regional health service areas between 2001–11. The number of TIA deaths has increased over the ten year period across WA.3
26
39 4151
5965
70 7277
88
71
11 8 7 16 11 15 17 16 1524 26
0
25
50
75
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearMetropolitan Regional
91
Table 36: Transient ischaemic attack ICD codes used for the above data
Transient ischaemic attack IDC codes
G45.0 Vertebro-basilar artery syndrome
G45.1 Carotid artery syndrome (hemispheric)
G45.2 Multiple and bilateral precerebral artery syndromes
G45.3 Amaurosis fugax
G45.4 Transient global amnesia
G45.8 Other transient cerebral ischaemic attacks and related syndromes
G45.9 Transient cerebral ischaemic attack, unspecified
92
Traumatic acquired brain injury In 2012, traumatic acquired brain injury patients had an average length of stay in hospital of 6.97 days, an occupancy of 29 237 beddays at a total cost of $48,476,877.06.3
The total combined number of hospital separation of traumatic acquired brain injury in WA over the past five years from 2008-12 was 18 416; from this 67% were males and 33% females.3 In 2012 there were 4,193 separations for traumatic acquired brain injury compared to 3213 in 2008.3
For WA total, the rate of traumatic acquired brain injury hospitalisation increased, and it was significant (P<0.001). The average annual percentage change in the rate was 3.64%.3
Figure 64: Annual traumatic acquired brain injury h ospitalisations in WA by gender from 2008–12.3
The above figure displays the annual number of hospitalisations in WA for traumatic acquired brain injury by gender from 2008-12. Over the five year period, the number of traumatic acquired brain injury hospitalisations in WA has increased in both males and females. 3 Since 2008, each year traumatic acquired brain injury hospitalisations has increased on average by 2.72% for males and 5.55% for females.3
21972326
24472626 2754
1016 10941220 1297
1439
500
1000
1500
2000
2500
3000
2008 2009 2010 2011 2012
No.
of h
ospi
talis
atio
ns
YearMale Female
93
Figure 65: Total number of traumatic acquired brain injury hospitalisations in WA by Aboriginality and gender from 2008–12. 3
The above figure shows the total number of hospitalisations for traumatic acquired brain injury in WA by aboriginality and gender from 2008–12. Over the five year period, Aboriginal people accounted for 10% of the hospitalisations for traumatic acquired brain injury in WA.3 This is significant as Aboriginal people make up 3.1% of the population of WA.30
Table 37: Number of hospitalisations for traumatic acquired brain injury by key age groups and gender 2008–12 in WA3
Gender 0–4 years
(N) 5–14 years
(N) 15–24 years
(N) 25–44 years
(N) 45–64 years
(N) 65+ years
(N) Gender
Male Male 0–4 years (N)
354 Male 5–14 years (N)
1089 Male 15–24 years (N)
2890 Male 25–44 years (N)
3459 Male 45–64 years (N)
2067 Male 65+ years (N)
2491 Gender
Female Femal e 0–4 years (N)
291 Femal e 5–14 years (N)
390 Femal e 15–24 years (N)
277 Femal e 25–44 years (N)
1206 Femal e 45–64 years (N)
970 Femal e 65+ years (N)
2332
All All 0–4 years (N)
645 All 5–14 years (N)
1479 All 15–24 years (N)
3767 All 25–44 years (N)
4665 All 45–64 years (N)
3037 All 65+ years (N)
4823
The age group most hospitalised for traumatic acquired brain injury between 2008–12, was the 65+ year olds and accounted for 26% of the total number of hospitalisations in WA.3
11250
5341
1100
725
0
2000
4000
6000
8000
10000
12000
14000
Male Female
No.
of h
ospi
talis
atio
ns
GenderNon-Aboriginal Aboriginal
94
Figure 66: Annual number of hospitalisations for tr aumatic acquired brain injury at WA metropolitan and regional health service areas betw een 2003–13.3
The above figure displays the annual number of traumatic acquired brain injury hospitalisations at WA metropolitan and regional health service areas between 2003–13. Since 2008, the number of hospitalisations for traumatic acquired brain injury has been increasing on average by 3.64%.3
Figure 67: Annual traumatic acquired brain injury a ttendances in WA metropolitan and regional emergency departments between 2008–14. 4
The above figure shows the number of ED attendances for traumatic acquired brain injury increased by 26% in the metropolitan areas and 42% in regional areas between 2008–14.4
13401500
1683 1701 1792
2085
23322519
28062950 2986
1079 1110908 991 959 1042 996 1007 988
1087 1094
500
1000
1500
2000
2500
3000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
No.
of h
ospi
talis
atio
ns
YearMetropolitan Regional
23022465 2341
2670 26302950
3119
178 189 170 207 193 246 305
0
500
1000
1500
2000
2500
3000
3500
2008 2009 2010 2011 2012 2013 2014
No.
of E
D a
ttend
ence
s
Metropolitan Regional
95
Figure 68: Annual mortality rate for traumatic acqu ired brain injury at metropolitan and regional health service areas in WA between 2001–11 .3
The above figure displays the annual mortality rate for traumatic acquired brain injury at WA metropolitan and regional health service areas between 2001–11. Due to low numbers for regional areas, the mortality rate is shown for all WA health services. Over the ten period, on average, 53 deaths are recorded as a result of traumatic acquired brain injury.3
34
61
4035
44
55 51 49
85
71
55
0
25
50
75
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
No.
of d
eath
s
YearAll WA Health Services
96
Table 38: Traumatic acquired brain injury ICD codes used for the above data
Traumatic acquired brain injury ICD codes
S06.00 Diag Concussion
S06.01 Diag Loss of consciousness of unspecified duration
S06.02 Diag Loss of consciousness of brief duration [less than 30 minutes]
S06.03 Diag Loss of consciousness of moderate duration [30 minutes to 24 hours]
S06.04 Diag Loss of consciousness of prolonged duration [more than 24 hours] with return to pre-existing conscious level
S06.05 Diag Loss of consciousness of prolonged duration [more than 24 hours] without return to pre-existing conscious level
S06.1 Diag Traumatic cerebral oedema
S06.20 Diag Diffuse cerebral and cerebellar brain injury, unspecified
S06.21 Diag Diffuse cerebral contusions
S06.22 Diag Diffuse cerebellar contusions
S06.23 Diag Multiple intracerebral and cerebellar haematomas
S06.28 Diag Other diffuse cerebral and cerebellar injury
S06.30 Diag Focal cerebral and cerebellar injury, unspecified
S06.31 Diag Focal cerebral contusion
S06.32 Diag Focal cerebellar contusion
S06.33 Diag Focal cerebral haematoma
S06.34 Diag Focal cerebellar haematoma
S06.38 Diag Other focal cerebral and cerebellar injury
S06.4 Diag Epidural haemorrhage
S06.5 Diag Traumatic subdural haemorrhage
S06.6 Diag Traumatic subarachnoid haemorrhage
S06.8 Diag Other intracranial injuries
S06.9 Diag Intracranial injury, unspecified
T06.0 Diag injuries of brain and cranial nerves with injuries of nerves and spinal cord and neck level
97
Appendix 3: Additional emergency department codes Table 39: Additional code included in emergency dep artment attendances 4
Additional code included in emergency department at tendances
F05.0 Delirium not superimposed on dementia, so described
F05.9 Delirium, unspecified
F050 Delirium not superimposed on dementia, so described
F07.0 Organic personality disorder
F07.1 Postencephalitic syndrome
F07.8 Postconcussional syndrome
F07.9 Other organic personality and behavioural disorders due to brain disease, damage and dysfunction
G45 Vertebro-basilar artery syndrome
G93.0 Cerebral cysts
G93.2 Benign intracranial hypertension
G93.3 Postviral fatigue syndrome
G93.4 Encephalopathy, unspecified
G93.5 Compression of brain
G93.6 Cerebral oedema
G93.7 Reye's syndrome
G93.9 Disorder of brain, unspecified
98
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