QUARTERLY REPORT - Healthdirect · quarterly report for the period January to March 2013. This...

QUARTERLY REPORT

Quarter 1January - March 2013

All registered nurses and general practitioners (GPs) providing our services hold unconditional registration with the Australian Health Practitioner Registration Authority (AHPRA). All GPs have unconditional registration with the Medical Board of Australia. All registered nurses and GPs have a minimum of three years experience.

Healthdirect Australia was established, and is jointly funded, by the Australian Government and the governments of the Australian Capital Territory, New South Wales, the Northern Territory, South Australia, Tasmania and Western Australia. It is a public company limited by shares and is responsible for delivering health information websites and health advice lines by contracting with service providers and managing ongoing operations.

2 Healthdirect Australia Quarterly Report Q1 2013

Foreword

Healthdirect Australia Quarterly Report Q1 2013 3

I am pleased to present the Healthdirect Australia quarterly report for the period January to March 2013.

This report contains data for the following services:

1. healthdirect Australia

Staffed by registered nurses, healthdirect Australia provides 24 hour telephone health advice to people calling from the ACT, NSW, the NT, SA, TAS and WA. Callers can speak to a registered nurse about a health concern or query, and may be assisted to care for their condition at home, referred to a local face-to-face primary health service or in an emergency transferred to Triple Zero (000).

2. after hours GP helpline

The after hours GP helpline is intended as an addition to existing after hours medical services. Callers in the after hours period to the nurse triage services provided by healthdirect Australia, NURSE-ON-CALL in Victoria and 13 HEALTH in Queensland, have their condition assessed by a registered nurse and if appropriate, the nurse transfers their call to a telephone-based GP. The GP will assess the caller’s condition and provide medical advice. If a caller needs to see a health professional immediately, they will be referred to the most appropriate local face-to-face after hours service. If the call is an emergency, it will be transferred to Triple Zero (000). All Australians have access to telephonic health advice from registered and accredited GPs in the after hours period (Tasmanian callers have access via the GP Assist service).

3. Pregnancy, Birth and Baby

Pregnancy, Birth and Baby is a phone and online service for all Australians, providing information, advice and counselling about pregnancy, childbirth and a baby’s first year. Quality information is provided on topics such as maternal nutrition, breastfeeding, a baby’s development and sleeping habits.

Women and their families who are facing other challenges such as emotional distress, perinatal issues, and questions about pregnancy options can call the helpline and be transferred to a qualified counsellor.

4. mindhealthconnect

mindhealthconnect is part of the Australian Government’s National e-Mental Health Strategy. This website provides all Australians with access to a range of trusted, high quality programs, services and information to support a healthy mind. mindhealthconnect covers three key mental health concerns – stress, anxiety and depression – and will expand over the next 18 months to include additional mental health issues. Visitors to the website can access a range of online programs as well as videos, fact sheets and online support groups. They can also choose to use a guided search tool, which will then filter the most relevant information for their concern.

Colin SeeryCEOHealthdirect Australia

1. healthdirect Australia 6

1.1 Number of calls 6

1.1.1 Calls handled 6

1.1.2 Call type 6

1.2 Time of calls 6

1.2.1 Time of day 6

1.2.2 Day of week 7

1.3 Patient age and gender 7

1.4 Caller relationship to patient 8

1.5 Location 8

1.6 Aboriginal and Torres Strait Islander patients 8

1.7 Interpreter and hearing services 8

1.8 Clinical issues 9

1.9 Advice 9

2. after hours GP helpline 10


2.2 Time of calls 11

2.2.1 Time of day 11

2.2.2 Day of week 11

2.3 Patient age and gender 12

2.4 Caller relationship to patient 12

2.5 Location 12

2.6 Aboriginal and Torres Strait Islander patients 12


2.8 Clinical issues 13

2.9 Advice 13

Contents

3. Pregnancy, Birth and Baby 14


3.2 Time of calls 14



3.3 Age and gender of callers 15

3.4 Caller relationships 15

3.5 Location of callers 15

3.6 Aboriginal and Torres Strait Islander callers 16


3.8 Types of information requested by callers 16

3.9 Advice given to callers 18

3.10 Number of website visits 18

3.11 Time of website visits 18



3.12 Website visitor location 18

4. mindhealthconnect 19

4.1 Number of website visits 19

4.2 Time of website visits 19



4.3 Website visitor location 19

The following statistics pertain to calls handled by the telephone nurse triage service, healthdirect Australia for the period January - March 2013 (Q1 2013). healthdirect Australia operates in the ACT, NSW, the NT, SA, TAS and WA.

1.1 Number of calls1.1.1 Calls handled

healthdirect Australia handled 208,313 calls in Q1 2013 (Fig 1).

0

10

20

30

40

50

60

70

80

Mar-13Feb-13Jan-13

69,65662,619

76,038

Figure 1: Calls per month (healthdirect Australia)

In Q1 2013, there was a 3.2% decrease in calls from the previous quarter (Q4 2012 – 215,251) and an 1.3% increase in calls from the same period in 2012 (Q1 2012 – 205,721) (Fig 2).

Q1 2012

Q4 2012

Q1 2013 208,313

215,251

205,721

Figure 2: Calls per quarter (healthdirect Australia)

1.1.2 Call type

In Q1 2013, the majority of calls were triaged (82.1%), followed by a request for health information (10.6%), a quick call (4.3%) and a provider referral (3%). Quick calls include feedback, wrong numbers and media enquiries (Fig 3).

82.1% Triage

4.3% Quick call

3.0% Provider referral

Figure 3: Call type (healthdirect Australia)

1.2 Time of calls1.2.1 Time of day

In Q1 2013, the most frequent call time was 8.00pm while the least frequent call time was 5.00am (times are AEST / AEDST). The period 6.00pm – 11.00pm had the heaviest call traffic (35%) (Fig 4).

0

5

10

15

20

11 PM10 PM

9 PM8 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM12 PM

11 AM

10 AM9 AM

8 AM7 AM

6 AM5 AM

4 AM3 AM

2 AM1 AM

12 AM

Figure 4: Calls per hour (healthdirect Australia)

1. healthdirect Australia Nurse triage


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s

‘000

s

‘000s

1.2.2 Day of week

In Q1 2013, Sunday was the busiest day (16.7% calls), followed by Saturday (15.9%) and Monday (14%). Thursday had the lowest volume of calls (13%).

1.3 Patient age and genderCallers and patients are not necessarily the same person, for example a mother might call on behalf of a child. The information in this section pertains to the patient.

In Q1 2013, 61% of patients were female and 39% male. 26.5% of calls were made on behalf of a child aged 0-4 years, representing a significantly higher proportion of patients than any other age group for both females and males (Fig 5).

0

5

10

15

20

25

30

>80

75 - 79

70 - 74

65 - 69

60 - 64

55 - 59

50 - 54

45 - 49

40 - 44

35 - 39

30 - 34

25 - 29

20 - 24

15 - 19

10 - 14

5 - 90 - 4

Figure 5: Patients by age and gender (healthdirect Australia)


“ There was a 1.3% increase in calls to healthdirect Australia compared to the same period in 2012 “

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1. healthdirect Australia Nurse triage (continued)

1.4 Caller relationship to patientOf the callers who identified their relationship to the patient, the majority of calls were made for concerns about personal health (60.9%) (Table 1).

Relationship of caller to patient %

Self 60.9

Parent 32.1

Wife / partner 1.6

Child 1.4

Table 1: Top four caller-to-patient relationships (healthdirect Australia)

1.5 LocationIn Q1 2013, the highest number of patients originated from NSW (94,698), followed by WA (47,962) and SA (26,898). 79% of patients were from metropolitan areas (Fig 6).

N/A represents location data that was not available or collected.

Metro

Rural

Remote

N/A

8,291

94,698

2,671

26,898

5,352

47,962

21,636

0

20

40

60

80

100

N/AWATASSANTNSWACT

Figure 6: Patients by location (healthdirect Australia)

1.6 Aboriginal and Torres StraitIslander patientsIn Q1 2013, 3.6% of patients identified themselves as being Aboriginal or Torres Strait Islander (Table 2).

Cultural background %

Aboriginal or Torres Strait Islander 3.6

Not Aboriginal or Torres Strait Islander 83.8

Declined 12.6

Table 2: Cultural background (healthdirect Australia)

1.7 Interpreter and hearing servicesIn Q1 2013, 13 people required the services of an interpreter and two used the National Relay Service.

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1.8 Clinical issuesWhere appropriate, clinical issues are categorised as adult or paediatric (child).

In Q1 2013, the most common clinical issues addressed by a triage nurse were medication queries, abdominal pain and vomiting by a child (Table 3).

(P) represents paediatric conditions.

Clinical issue

1 Medication query

2 Abdominal pain

3 Vomiting (P)

4 Chest pain

5 Fever (P)

6 Head trauma (P)

7 Diarrhoea (P)

8 Pregnancy concerns

9 Bites and stings

10 Cold symptoms (P)

11 Rash (P)

12 Postoperative problems

13 Headache

14 Nausea / vomiting

15 Back symptoms

16 Tooth, gum and jaw symptoms

17 Dizziness / vertigo

18 Cough (P)

19 Neurological symptoms

20 Poisoning (P)

Table 3: 20 most common clinical issues (healthdirect Australia)

1.9 AdviceIn Q1 2013, the most frequent types of advice given by triage nurses were ‘Self care at home’ (20.4%), ‘Refer to after hours GP helpline’ (17.4%) and ‘See a Doctor / health provider within 24 hours’ (15.4%). 14.1% of callers were advised that the patient should ‘Attend an Emergency Department immediately,’ while 5.4% of calls were transferred to Triple Zero (000) (Table 4).

Recommendation / advice %

Self care at home 20.4

Refer to after hours GP helpline 17.4

See Doctor / health provider within 24 hours 15.4

Attend Emergency Department immediately 14.1


See Doctor / health provider immediately 8.8

Activate Triple Zero (000) 5.4


See Doctor / health provider within 2 weeks 1.7

Call Poisons Information Centre immediately 1.3

See mental health provider immediately 0.2

Table 4: Recommendation / advice (healthdirect Australia)


The after hours GP helpline is available in all states and territories of Australia with the exception of Tasmania, (who have access to accredited GPs via GP assist service). The service operates during the following hours:

• 6.00pm – 8.00am Monday to Saturday,• 12.00pm Saturday – 8.00am Monday, and• 24 hours a day on public holidays.

Callers to the telephone-based nurse triage services healthdirect Australia, NURSE-ON-CALL in Victoria and 13 HEALTH in Queensland during after hours GP helpline operating hours may be transferred to a GP when a triage nurse determines it is clinically appropriate.

In Q1 2013, approximately 25,000 patients were provided with self care advice by telephone GPs, assisting in the prevention of unnecessary visits to emergency departments and after hours services. Approximately 13,000 patients were specifically redirected from requiring and seeking urgent after hours face-to-face treatment by speaking with a GP via the telephone.

2. after hours GP helpline Calls transferred by triage nurses


“ There was a 11.4% increase in calls to the after hours GP helpline from the same period in 2012 (Q1 2012 - 36,550) “

2.1 Number of callsThe after hours GP helpline handled 40,717 calls in Q1 2013 (Fig 7).

0

5

10

15

20

Mar-13Feb-13Jan-13

12,614 12,345

15,758

Figure 7: Calls per month (after hours GP helpline)

In Q1 2013, there was a 0.4% decrease in calls from the previous quarter (Q4 2012 – 40,877) but a 11.4% increase in calls from the same period in 2012 (Q1 2012 - 36,550) (Fig 8).

Q1 2012

Q4 2012

Q1 2013 40,717

40,877

36,550

Figure 8: Calls per quarter (after hours GP helpline)


In Q1 2013, the most frequent call time was 9.00pm while the least frequent call time was 8.00am (times are AEST/ AEDST). The period 6.00pm – 1.00am had the heaviest call traffic (59%) (Fig 9). Note that calls between 8.00am and 6.00pm reflect calls that were received on weekends and public holidays.

0

1

2

3

4

5

11 PM10 PM

9 PM8 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM12 PM

11 AM

10 AM9 AM

8 AM7 AM

6 AM5 AM

4 AM3 AM

2 AM1 AM

12 AM

Figure 9: Calls per hour (after hours GP helpline)

2.2.2 Day of week

In Q1 2013, Sunday was the busiest day (23.7% calls), followed by Saturday (18.2%) and Monday (13.1%). Thursday had the lowest volume of calls (10.7%).

‘000

s

‘000

s

‘000s


2.5 LocationIn Q1 2013, the highest number of patients originated from NSW (14,405), followed by VIC (12,221) and WA (7661). 78% of patients were from metropolitan areas (Fig 11).

Metro

Rural

Remote

1,302

14,405

417 883

4,422

12,221

7,661

0

3

6

9

12

15

WAVICSAQLDNTNSWACT

Figure 11: Patients by location (after hours GP helpline)

2.6 Aboriginal and Torres Strait Islander patientsIn Q1 2013, 3.8% of patients identified themselves as being Aboriginal or Torres Strait Islander (Table 6).




Declined 4.5

Table 6: Cultural background (after hours GP helpline)

Note: this table excludes triage calls transferred from the NURSE-ON-CALL, as these calls do not provide information on the cultural background of the caller.

2. after hours GP helpline Calls transferred by triage nurses (continued)

2.3 Patient age and genderCallers and patients are not necessarily the same person; for example a mother might call on behalf of a child. The information in this section pertains to the patient. In Q1 2013, 63% of patients were female and 37% male. 24% of calls were made on behalf of a child aged 0-4 years, representing for both females and males a significantly higher proportion of patients than any other age group (Fig 10).

0

1

2

3

4

5

6

>80

75 - 79

70 - 74

65 - 69

60 - 64

55 - 59

50 - 54

45 - 49

40 - 44

35 - 39

30 - 34

25 - 29

20 - 24

15 - 19

10 - 14

5 - 90 - 4

Figure 10: Patients by age and gender (after hours GP helpline)

2.4 Caller relationship to patientOf the callers who identified their relationship to the patient, the majority of calls were made for concerns about personal health (58.4%) (Table 5).

Relationship of caller to patient %Self 58.4

Parent 33.6

Wife / partner 2.3

Child 1.9

Husband / partner 1.3

Table 5: Top five caller-to-patient relationships (after hours GP helpline)


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2.7 Interpreter and hearing services25 callers required the services of an interpreter and three callers used the National Relay Service.

2.8 Clinical issuesWhere clinically appropriate, specific conditions are categorised as adult or paediatric (child).

In Q1 2013, the most common clinical issues addressed by the after hours GP helpline were diarrhoea and vomiting (Table 7).

(P) represents paediatric conditions.

Clinical issue

1 Diarrhoea

2 Vomiting

3 Rash

4 Dizziness / vertigo

5 Headache

6 Gastrointestinal bleeding

7 Vomiting (P)

8 Postoperative problems

9 Cough (P)

10 Urinary symptoms: female

11 Bloody urine

12 Pregnancy problems

13 Flank pain

14 Chest pain

15 Diarrhoea (P)

16 Diabetes symptoms

17 Sore throat

18 Back symptoms

19 Crying baby <3 months

20 Premenopausal symptoms

Table 7: 20 most common clinical issues (after hours GP helpline)

2.9 AdviceIn Q1 2013, the most frequent types of advice given by GPs on the after hours GP helpline were ‘Self care and see a doctor / health provider within normal operating hours’ (50.3%), ‘See a GP immediately’ (27.2%) and ‘Self care at home’ (9.3%). 0.8% of calls were transferred to Triple Zero (000) (Table 8).


Self care advice and see a doctor / health provider within normal operating hours

50.3

See a GP immediately 27.2

Self care at home 9.3

Emergency Department immediately 8.1

Table 8: Recommendation / advice (after hours GP helpline)


The following statistics pertain to Pregnancy, Birth and Baby for the period January - March 2013 (Q1 2013). This report incorporates the Pregnancy, Birth and Baby website, which launched on 14 January 2013.

3.1 Number of callsPregnancy, Birth and Baby handled 8,893 calls in Q1 2013 (Fig 12).

0

500

1000

1500

2000

2500

3000

3500

Mar-13Feb-13Jan-13

3,026

2,603

3,264

Figure 12: Calls per month (Pregnancy, Birth and Baby)

Q1 2013 showed a 2.5% increase than the previous quarter (Q4 2012 – 8,676) (Fig 13).

Q1 2012

Q4 2012

Q1 2013 8,893

8,676

10,974

Figure 13: Calls per quarter (Pregnancy, Birth and Baby)

3. Pregnancy, Birth and Baby Advice and counselling

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In Q1 2013, the most popular call time was 7.00pm while the least popular was 5.00am (times are AEST/AEDST) (Fig 14).

0

100

200

300

400

500

600

700

11 PM10 PM

9 PM8 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM12 PM

11 AM

10 AM9 AM

8 AM7 AM

6 AM5 AM

4 AM3 AM

2 AM1 AM

12 AM

Figure 14: Calls per hour (Pregnancy, Birth and Baby)

3.2.2 Day of week

In Q1 2013, Monday was the busiest day (15.2% calls), followed by Wednesday (14.8%) then Tuesday (14.5%) and Friday (14.5%). Saturday had the lowest volume of calls (13.2%).


3.3 Age and gender of callersCallers and patients are not necessarily the same person; for example a mother might call on behalf of a child. The information in this section pertains to the caller.

In Q1 2013, 75.3% of callers were female and 12.7% male. 12% of callers elected not to disclose their gender. The most common age groups for female callers were 30-34 (27.8%), 25-29 (23.2%) and 35-39 (13.7%).

The most common age groups for male callers were 30-34 (4.9%), 25-29 (3.1%) and 35-39 (3%) (Fig 15).

>80

75 - 79

70 - 74

65 - 69

60 - 64

55 - 59

50 - 54

45 - 49

40 - 44

35 - 39

30 - 34

25 -29

20 - 24

15 - 19

<150

500

1000

1500

2000Male callers

Female callers

Figure 15: Caller age and gender (Pregnancy, Birth and Baby helpline)

3.4 Caller relationshipsOf the callers who identified their relationship to the patient, the majority of calls were made for concerns about personal health (67.3%) (Table 9).

Relationship of caller to subject %

Self 67.3

Mother 23.2

Father 5.0

Husband / male partner 2.6

Table 9: Top four caller-to-subject relationships(Pregnancy, Birth and Baby)

3.5 Location of callersIn Q1 2013, the highest number of calls originated from NSW (2,882) followed by SA (1,551) and WA (1,187) (Fig 16).

Metro

Rural

Remote

N/A

0

500

1000

1500

2000

2500

3000

N/AWAVICTASSAQLDNTNSWACT

151

2,882

71

897

1,551

103

1,164 1,187

887

Figure 16: Callers by location (Pregnancy, Birth and Baby)


3.6 Aboriginal and Torres Strait Islander callersIn Q1 2013, 1.3% of callers identified themselves as being Aboriginal or Torres Strait Islander (Table 10).




Declined 19.9

Table 10: Cultural background (Pregnancy, Birth and Baby)

3.7 Interpreter and hearing servicesFive callers required the services of an interpreter and no callers required hearing assistance services.

3. Pregnancy, Birth and Baby Advice and counselling (continued)


3.8 Types of information requested by callersIn Q1 2013, the most common types of information requested via the helpline were regarding the topics of maternal and child health, constipation and bottle feeding (Table 11).

Type of information requested

1 Maternal and child health

2 Constipation

3 Bottle feeding

4 Crying baby

5 Drugs and alcohol

6 Breastfeeding

7 Child health: poos, wees and nappies

8 General counselling

9 Feeding: solids

10 Sleep: 0 - 3 months

11 Sleep: 3 - 6 months

12 Sleep: 6 months +

13 Babies and hot weather

14 Pregnancy: eating well

15 Child health - about babies

16 Sexual health services

17 Sudden Infant Death Syndrome (SIDS)

18 Family welfare / crisis invervention

19 Foods to avoid during pregnancy

20 Development - teeth

Table 11: Top 20 types of information requested (Pregnancy, Birth and Baby)


“ 48,995 people in Q1 have visited the Pregnancy, Birth and Baby website since it was launched in January 2013 “

3. Pregnancy, Birth and Baby Advice and counselling (continued)

3.11 Time of website visits3.11.1 Time of day

In Q1 2013, 51.7% of visits occurred between 10.00am and 5.00pm (Fig 18).

0

1000

2000

3000

4000

5000

11 PM10 PM

9 PM8 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM12 PM

11 AM

10 AM9 AM

8 AM7 AM

6 AM5 AM

4 AM3 AM

2 AM1 AM

12 AM

Figure 18: Time of visits (Pregnancy, Birth and Baby)

3.11.2 Day of week

Visitor numbers were very steady throughout the week in Q1 2013. Saturday had the lowest number of visits (11.5%).

3.12 Website visitor locationIn Q1 2013, the highest number of visits originated from NSW (36.2%), followed by VIC (25.1%) and QLD (14.1%) (Fig 19).

17,713

12,297

6,903

4,236

2,2883,576

1,215 5632040

5

10

15

20


Figure 19: Visitor location (Pregnancy, Birth and Baby)


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3.9 Advice given to callersIn Q1 2013, the most common types of advice or recommendations given were ‘Referral to a nurse’ (67.8%), ‘Supply of pregnancy and perinatal fact sheets’ (13.4%) and ‘General counselling’ (6.3%) (Table 12).


Referral to a nurse 67.8

Supply of pregnancy and perinatal fact sheets 13.4

General counselling 6.3

Health provider contact details 5.9

Referred back to a treating medical professional 2.5

Referral to a pregnancy / perinatal support agency

1.4

Pregnancy counselling 1.3

Table 12: Recommendation / advice (Pregnancy, Birth and Baby)

3.10 Number of website visits48,995 people visited the Pregnancy, Birth and Baby website in Q1 2013 (Fig 17).

14/01/13

14/02/13

14/03/13

31/03/130

200

400

600

800

1000

1200

Figure 17: Total visits (Pregnancy, Birth and Baby)

The following statistics pertain to the website www.mindhealthconnect.org.au for the period January - March 2013 (Q1 2013).

4.1 Number of website visits151,153 people visited the mindhealthconnect website in Q1 2013 (Fig 20).

500

1000

1500

2000

2500

3000

3500

4000

01/01/13

01/02/13

01/03/13

31/03/13

Figure 20: Total visits (mindhealthconnect)

4.2 Time of website visits4.2.1 Time of day

In Q1 2013, 45% of visits occurred between 10.00am and 5.00pm (Fig 21).

11 PM10 PM

9 PM8 PM

7 PM6 PM

5 PM4 PM

3 PM2 PM

1 PM12 PM

11 AM

10 AM9 AM

8 AM7 AM

6 AM5 AM

4 AM3 AM

2 AM1 AM

12 AM0

2,000

4,000

6,000

8,000

10,000

12,000

Figure 21: Time of visits (mindhealthconnect)

4.2.2 Day of week

The busiest day of the week in Q1 2013 was Thursday (15.3% of visits), followed by Wednesday (14.7%) and Friday (14.5%). Monday had the lowest number of visits (13.5%).

4.3 Website visitor locationIn Q1 2013, the highest number of visits originated from NSW (33.6%), followed by VIC (28.2%) and QLD (15.3%) (Fig 22).

50,786

42,591

23,159

13,899

4,408

11,261

3,167 1,6442380

10

20

30

40

50

60


Figure 22: Visitor location (mindhealthconnect)


4. mindhealthconnect A gateway to trusted mental health services

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Level 19 133 Castlereagh StreetSydney NSW 2000(02) 9263 [email protected]

ABN 28 118 291 044

QUARTERLY REPORT - Healthdirect · quarterly report for the period January to March 2013. This...

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