Cross border hospital use: analysis using data linkage across four Australian states

Area of Science:

• Health Services Research
• Public Health
• Data Linkage

Background:

• Assessing national data linkage capacity is crucial for understanding healthcare access and outcomes.
• Cross-border patient movement impacts health service planning and resource allocation.
• Hospital use and mortality patterns among mobile populations require investigation.

Purpose of the Study:

• To evaluate the quality and effectiveness of national data linkage capabilities.
• To investigate patterns of cross-border hospital utilization and associated mortality.
• To identify geographical areas with high cross-border hospital use and deaths.

Main Methods:

• Analysis of linked person-level hospital separation and death registration data.
• Inclusion of 7.7 million hospital patients across New South Wales, Queensland, Western Australia, and South Australia (public hospitals only).
• Data spanning from July 1, 2004, to June 30, 2009.

Main Results:

• Approximately 3.0% of patients (223,262) utilized hospitals across state borders.
• Significant interstate patient movement was observed, particularly related to mining and tourism.
• 1.3% of cross-border hospital patients (2,800) died in the receiving jurisdiction, with an additional 496 deaths within 30 days of interstate hospital separation.

Conclusions:

• Person-level data linkage across jurisdictions effectively identified geographical 'hot spots' of cross-border hospital use and deaths.
• Findings have significant implications for strategic health service delivery planning.
• The study supports the utility of linked data for longitudinal studies, especially concerning mobile populations.