Hearing health outreach services to Indigenous children and young people in the Northern Territory 2012–13 and 2013–14

Presents analyses on hearing health outreach services provided to Indigenous children and young people in the Northern Territory. Summary This report presents information on ear and hearing outreach services funded by the Department of Health and delivered by the Northern Territory Department of Health between July 2012 and June 2014. The main funding sources for these services are the National Partnership Agreement on Stronger Futures in the Northern Territory and the Healthy Ears—Better Hearing, Better Listening program. The report also includes information on hearing health and middle ear conditions among service recipients. Service delivery In 2013–14, 2,122 outreach audiology services were delivered to 1,764 Indigenous children and young people. In total, from July 2012 to June 2014, 4,054 audiology services were delivered to 2,889 children and young people. Child Hearing Health Coordinators (CHHCs) conducted 697 visits to 675 children in 2013–14—slightly below the target of 700 children set by the Australian and Northern Territory governments. In total, 1,140 children were seen at 1,208 CHHC visits from July 2012 to June 2014. A total of 860 ear, nose and throat (ENT) teleotology services were provided to 766 children and young people in 2013–14. From July 2012 to June 2014, 1,684 ENT teleology services were provided to 1,283 children and young people. Hearing health status among children and young people who received services Hearing loss was present in 55% of children and young people who received outreach audiology services at their latest service in 2013–14. Hearing health status improved for a large proportion of the children and young people who received 2 or more outreach audiology services. Of the 498 children and young people who had hearing loss at their first audiology service, 41% experienced functional improvements in their hearing (with 26% regaining normal hearing capability at their last check, and 15% having their hearing loss status improve from bilateral to unilateral). Among 102 children and young people with hearing impairment at their first audiology check, the severity of impairment improved for 50% at their last check, remained at the same level for 40%, and deteriorated for 10%. Middle ear conditions among children and young people who received services In 2013–14, of the 1,791 children and young people who received an audiology or ENT service, 67% were diagnosed with at least 1 type of middle ear condition (an increase from 61% in 2012–13)—most commonly otitis media with effusion (24%). Of the 781 children and young people who received 2 or more ENT or audiology services from July 2012 to June 2014, the proportion diagnosed with at least 1 middle ear condition between the first and last service decreased, from 79% to 76%. Improvements were seen for those who received 3 or more services since August 2007: the proportion of children and young people diagnosed with at least 1 middle ear condition decreased, from 81% at the first service to 55% at the last service. Among those diagnosed with chronic suppurative otitis media with discharge or dry perforation at an initial service, overall, the results suggest poor progress, with the majority of these children and young people still experiencing the same condition or developing another type of ear disease over the course of their treatment

Disability support services: services provided under the National Disability Agreement 2013–14

In 2013–14, an estimated 321,531 people used disability support services under the National Disability Agreement, including 4,200 who transitioned to the National Disability Insurance Scheme during the year. Summary In 2013-14, an estimated 321,531 people used disability support services under the National Disability Agreement (NDA)-a 9% increase since 2009-10, and a 3% increase since 2012-13. Of those who used NDA services in 2013-14: 44% used community support services, 41% used employment services, 18% used community access services, 14% used accommodation  support services, and 12% used respite services around three-quarters  (74%) were aged under 50, with an average age of 34 most (59%) were male majority (87%) were Australian-born 6% were Aboriginal and Torres Strait Islander people more than half (55%) had an intellectual or learning disability (44% as their primary disability) many needed at least some assistance with activities of daily living (68%), activities of independent living (82%), and activities of work, education and community living (86%) more than half (54%) lived with their families close to one-third (32%) of those aged 15 and over were not in the labour force 70% of those aged 15 and over who were in the labour force were unemployed an estimated 4,200 transitioned to the National Disability Insurance Scheme during the year

Alcohol and other drug treatment services in Australia 2013–14

Alcohol and other drug treatment services across Australia provide a broad range of treatment services and support to people using drugs and to their families and friends. This report presents the information for 2013–14 about publicly funded alcohol and other drug treatment service agencies, the people they treat and the treatment provided. Summary Around 119,000 clients received over 180,000 treatment episodes from 795 publicly funded alcohol and other drug treatment agencies across Australia An estimated 118,741 clients received treatment in 2013–14. This equates to a rate of 509 clients per 100,000 people, or about 1 in 200 people in the general population. About 2 in 3 clients were male (67%) and 1 in 2 were aged 20–39 (54%). Despite only comprising 2.7% of the population, 1 in 7 (14%) clients were Aboriginal and Torres Strait Islander. Treatment agencies provided a total of 180,713 treatment episodes—an average of 1.5 episodes per client—and 4 in 5 (79%) episodes ended within 3 months. There has been a steady increase in the number of treatment episodes provided over the last 5 years (from 145,630 to 180,713), an increase of 24%. Between 2012–13 and 2013–14, the estimated number of clients who received treatment increased by 8%. Of those clients who received treatment in 2013–14, 22% also received treatment in 2012–13. The age profile of people receiving treatment suggests there is an ageing cohort of clients Over the 5 years to 2013–14, the proportion of treatment episodes for clients who were aged 20–29 fell from 29% to 27%, while the proportion for those aged 40 and over rose from 30% to 33%. Alcohol continues to be the most common drug leading clients to seek treatment but treatment for use of amphetamines is increasing Alcohol, cannabis, amphetamines and heroin  have remained the most common principal drugs of concern for clients since 2003–04. Nationally, alcohol was the most common principal drug of concern in 2013–14, accounting for 40% of episodes. For clients aged 30 and over, alcohol was the most common principal drug of concern, while for clients aged 10–29, cannabis was the most common. Since 2009–10, the proportion of episodes where alcohol was the most common principal drug of concern has decreased (from 48% to 40%), while the proportion of episodes for amphetamines have increased (from 7% to 17%). The number of episodes for clients injecting and smoking/inhaling amphetamines has also increased, with more than 6 times as many clients smoking/inhaling in 2013–14 as in 2009–10. Most clients have more than 1 drug of concern In more than half (54%) of treatment episodes, the client also reported additional drugs of concern. Just under a third (29%) had 1 additional drug of concern and 13% had 2 drugs. Nicotine and cannabis were the most common additional drugs of concern. Counselling continues to be the most common type of treatment Since 2003–04, the proportion of episodes for each main treatment type has remained fairly stable, with counselling, withdrawal management and assessment only being the most common types of treatment. Counselling continues to be the most common main treatment type provided for clients (2 in 5 episodes since 2003–04). &nbsp

Youth justice in Australia 2013–14

Presents information on all young people who were under youth justice supervision in Australia during 2013–14, both in the community and in detention. It also explores key aspects of their supervision, and recent trends. Introduction The youth justice system is the set of processes and practices for managing children and young people who have committed, or allegedly committed, an offence. While each state and territory in Australia has its own youth justice legislation, policies and practices, the general processes by which young people are charged and sentenced, and the types of legal orders available to the courts, are similar. Separate justice systems exist for young people and adults. Young people can be charged with a criminal offence if they are aged 10 and older. The upper age limit for treatment as a young person is 17 in all states and territories except Queensland, where the limit is 16. However, some young people aged 18 and older are also involved in the youth justice system. This may be due to the offence being committed when the young person was aged 17 or younger; the continuation of supervision once they turn 18; or their vulnerability or immaturity. Also, in Victoria, some young people aged 18–20 may be sentenced to detention in a youth facility under a ‘dual track’ sentencing system, which is intended to prevent vulnerable young people from entering the adult prison system at an early age.   A young person first enters the youth justice system when they are investigated by police for allegedly committing a crime. Legal action taken by police may include court actions (the laying of charges to be answered in court) and non-court actions (such as cautions, conferencing, counselling or infringement notices). A court may decide to dismiss the charge, divert the young person from further involvement in the system (for example by referral to mainstream services), or transfer them to specialist courts or programs. If the matter proceeds and the charge is proven, the court may hand down any of a number of orders, either supervised or unsupervised. &nbsp

Using the Juvenile Justice National Minimum Data Set to measure returns to sentenced youth justice supervision: stage 2

This is the second of 2 reports presenting measures of returns to sentenced youth justice supervision using data from the Juvenile Justice National Minimum Data Set. Summary In Australia, youth justice departments are responsible for providing services to young people sentenced to community-based supervision or detention. These services aim to reduce the frequency and seriousness of youth offending. When considered with other outcome indicators, the rate of return to sentenced supervision is one possible indicator of the performance of a youth justice department (although there are factors beyond the control of youth justice departments that will impact on the level of reoffending). This is the second report that examines measures of returns to sentenced youth justice supervision using data from the Juvenile Justice National Minimum Data Set (JJ NMDS). The first report (AIHW 2013) explored the feasibility of using this longitudinal person-based data set, which contains information on young people under supervision, and found that it was possible to fulfil many of the principles developed by Richards (2011). This second report further examines timeframes for measuring returns and explores the potential for using JJ NMDS data to measure the seriousness of reoffending. Timeframes for measuring returns to sentenced supervision Returns to sentenced supervision can be measured over a number of timeframes. While longer timeframes will capture more returns, the nature of youth justice supervision means that the cohort used for analysis must be age restricted. Shorter timeframes allow for more recent data to be used, but will be affected by the length of time required for administrative procedures such as court proceedings. Based on a comparison of 5 timeframes (returns within 3 months, 6 months, 1 year, 2 years and at any time during possible youth justice supervision), it is recommended that timeframes of 6 months and 1 year be used. It is also recommended that analyses be contextualised by the impact of prior supervised sentences to account for the effect of offending history on the type of sentence received. Measuring the seriousness of reoffending Measuring whether the seriousness of offending has escalated could also provide valuable information on performance. The JJ NMDS contains offence data for 3 states and preliminary analyses of the escalation of reoffending are provided in this report. However, it is unlikely that offence data for the remaining states and territories will be available in the foreseeable future. One possible alternative that uses available JJ NMDS data is the severity of supervised sentences received for reoffending. A preliminary analysis found that an increase in sentence severity was more likely to correspond with an increase in offence seriousness than with a decrease or no change in offence seriousness. This indicates that an increase in sentence severity can be used as a proxy indicator of an escalation of offending behaviour in the absence of offence data, although sentence severity is also influenced by other factors. It is recommended that this measure be used until offence data for all states and territories are available. Future work Recommendations for future work include agreeing on measures to be reported annually and exploring the feasibility of using other data sources in addition to the JJ NMDS to enable a more comprehensive analysis on youth recidivism

Osteoarthritis: musculoskeletal fact sheet

This fact sheet summarises information from the AIHW\u27s online musculoskeletal compendium. Summary Osteoarthritis is a degenerative condition mostly affecting the joints such as hips, knees and ankles. The main symptoms include pain, stiffness and limited joint movement which get worse over time. Normally, healthy cartilage allows bones to glide over one another. In people with osteoarthritis, the cartilage covering the bone ends in the joints breaks down and wears away, causing the bones to rub together, creating pain, swelling and loss of motion. Based on self-reported data from the most recent Australian Bureau of Statistics National Health Survey (2011–12), 1.8 million Australians (8%) reported having osteoarthritis. It is more common in women (10.2%) than men (5.6%). The prevalence of osteoarthritis rises with age. While relatively few younger people have this condition, the prevalence rises sharply from age 45

Incidence of type 1 diabetes in Australia 2000–2013

Presents the latest available national data on new cases of type 1 diabetes from Australia’s National (insulin-treated) Diabetes Register. In 2013, there were 2,323 new cases of type 1 diabetes in Australia, equating to 11 cases per 100,000 population. This rate has remained relatively stable between 2000 and 2013, fluctuating between 10 and 13 cases per 100,000 population each year. Summary Type 1 diabetes is a lifelong autoimmune  disease requiring management  with insulin to ensure blood glucose levels remain within a safe range. If left untreated, or improperly managed, type 1 diabetes can lead to many health complications. This report uses the latest available data from the National (insulin-treated) Diabetes Register to examine the incidence-that is, the number of new cases-of type 1 diabetes in Australia. From 2000 to 2013 there were 31,895 new cases of type 1 diabetes in Australia, with 2,323 of these in 2013. The rate of type 1 diabetes has remained stable for more than a decade, at around 10 to 13 cases per 100,000 population each year. The incidence of type 1 diabetes was higher for males than for females-12 per 100,000 compared with 9 per 100,000, respectively, in 2013. More than half of all new cases of type 1 diabetes were in people aged under 18 years. Rates were 3 times as high among 0-14 years olds (24 per 100,000 population) compared with those aged 15 and over (8 per 100,000 population). The rate of type 1 diabetes was lowest in the Northern Territory, at 6 per 100,000 population, compared with other states and territories, which ranged  from 11 to 13 per 100,000 population between 2000 and 2013. From 2001-2013, the rate of type 1 diabetes was lower in remote and very remote areas compared with other areas of Australia-7 cases per 100,000 population compared with 11-13 per 100,000, respectively. Aboriginal and Torres Strait Islander people had a lower incidence of type 1 diabetes than non-Indigenous  Australians: 7 per 1000,000 population and 10 per 100,000, respectively, in 2005-2013

National opioid pharmacotherapy statistics 2014

Summary Dependence on opioid drugs is associated with a range of health and social problems that affect individual drug users, their family and friends, and the wider public. This bulletin presents information on the clients receiving opioid pharmacotherapy treatment, the doctors prescribing opioid pharmacotherapy drugs, and the dosing points that clients attend to receive their medication. Over 48,000 Australians received pharmacotherapy treatment for their opioid dependence on a snapshot day in June 2014 The number of people receiving opioid pharmacotherapy treatment almost doubled between 1998 (from around 25,000) and 2014, but growth in client numbers slowed in recent years (growing by 0.5-2% a year between 2011 and 2014). Heroin is the most common opioid drug leading people to pharmacotherapy treatment Clients were nearly twice as likely to report heroin as an opioid drug of dependence as they were for all opioid pharmaceuticals combined, however this varied by jurisdiction. Methadone continued to be the drug most commonly prescribed; the form in which buprenorphine is prescribed is changing Around two-thirds  (67%) of clients received methadone in 2014, and this has been relatively stable since 2006. The remaining third (33%) received 1 of 2 forms of buprenorphine. Of these, the proportion receiving buprenorphine only has fallen (from 24% to 13%) while the proportion receiving buprenorphine combined with naloxone has risen (from 5% to 20%) over the same period. Naloxone is added to buprenorphine to deter its injection. Opioid pharmacotherapy clients are getting older on average In 2014, around two-thirds  (69%) of clients were aged 30-49, and this has been fairly consistent since 2006. However, from 2006 to 2014 the proportion of clients aged less than 30 more than halved (from 28% to 10%), and the proportion of clients aged 50 and over more than doubled (from 8% to 21%). These trends indicate an ageing population of clients in pharmacotherapy treatment. Males and Indigenous Australians are over-represented in pharmacotherapy treatment Around two-thirds (65%) of clients receiving pharmacotherapy in June 2014 were male. Where reported, 1 in 10 (10%) clients identified as Indigenous and Indigenous Australians were around 3 times as likely to have received pharmacotherapy treatment as non-Indigenous Australians. Prescriber numbers have increased, and most work in the private sector The number of prescribers of opioid pharmacotherapy rose by 31% since 2012 (from 1,768 to 2,319). In 2014, most prescribers treated 1-5 clients (39%), worked in the private sector (82%) and were authorised to prescribe more than 1 type of pharmacotherapy drug (74%). Most dosing points were located in pharmacies Most clients need to attend a dosing point regularly to take their opioid pharmacotherapy drug under supervision. In 2013-14 there were 2,432 dosing point sites in Australia, and 9 in 10 (89%) were located in pharmacies

Access to health services by Australians with disability 2012

This bulletin examines the level of access to a range of health services by Australians with disability living in the community (excluding people living in institutions), and the experiences these people face in accessing health services. Abstract In 2012, 17% of people with disability who needed to see a GP delayed or did not go because of the cost; 20% who needed to see a medical specialist did not go mainly due to the cost; and 67% who needed to see a dentist delayed seeing or did not go because of the cost. Compared with people with disability living in Major cities, people with disability living in Outer regional and Remote areas had lower use rates of services provided by GPs, medical specialists and dentists as well as coordinated care provided by different types of health professionals. They were more likely to visit a hospital emergency department for health issues that could potentially be dealt with by non-hospital services, and to face barriers to accessing health services

Healthy Futures—Aboriginal Community Controlled Health Services: report card

During 2012-13, Aboriginal Community Controlled Health Services saw just over 250,000 Indigenous clients. This report shows increases in the proportion of clients receiving appropriate processes of care for ten of the 16 primary health care indicators. Summary This report on Aboriginal Community Controlled Health Services (ACCHS) presents information sourced from a variety of data sets, but mostly from two main data collections: the Online Services Report (OSR) collection for 2012-13, which provides information on staffing, clients and episodes of care provided at primary health services funded to provide care to Indigenous Australians the National Key Performance Indicators (nKPIs) for Aboriginal and Torres Strait Islander primary health care collection, covering the period December 2012 to December  2013. Indicator-related information is collected on chronic disease prevention and management, and maternal and child health. The nKPIs aim to improve the delivery of primary health care services by supporting continuous quality improvement activity among service providers. In 2012-13, 141 ACCHS participated in OSR data collection processes. During the year, these ACCHS: provided  services  to over 316,000 clients, about 252,000 of whom were Indigenous provided over 2.4 million episodes  of care nationally, with around 2.1 million of these being for Indigenous Australians. An episode  of care is a visit to the health service, and may include contacts with multiple health workers made  3.7 million client contacts, including contacts with health staff and drivers who facilitate access to primary care, and referrals to other health services where ACCHS provided transport services. In December  2013, ACCHS saw an estimated 212,679 Indigenous regular clients. ACCHS providing nKPI data saw more regular clients in December 2013 than they did one year before. There were 124 ACCHS that provided valid data on the number of Indigenous regular clients in December 2012, June 2013 and December 2013. At these ACCHS, the number of clients increased by 6%, over the period from 183,435 in December 2012 to 194,521 in December 2013. The Aboriginal and Torres Strait Islander primary health care nKPIs are aimed at improving the delivery of primary health care services by supporting continuous quality improvement activity among service providers. The nKPIs include 16 indicators that measure \u27processes of care\u27 performed  for clients (such as tests, procedures  or Medicare- claimable services), and 5 outcome measures. \u27Processes of care\u27 are largely under the control of health services, and indicate good practice in primary health care. In the December 2013 period, the proportion of clients who received processes of care rose for 10 indicators out of 16, covering: antenatal visits prior to 13 weeks of pregnancy; birthweight recorded; those aged 0-4 and 25 and over with a Medicare Benefits Schedule (MBS) health assessment; those with type 2 diabetes or Chronic Obstructive Pulmonary Disease (COPD) who were immunised against influenza; smoking status or alcohol consumption recorded; and those with type 2 diabetes who received a General Practice Management  Plan or Team Care Arrangement. For the remaining six indicators, the number of Indigenous regular clients who received processes of care rose, but the number of eligible clients also rose. As a result, the proportion of clients who received the care did not increase. ACCHS showed improvement for 2 of the 5 outcome indicators: the proportion of clients with BMI recorded who were not overweight or obese the proportion of clients with type 2 diabetes whose HbA1c result was less than or equal to 7%. The proportion remained stable for the remaining three outcome indicators: babies with normal birthweight, clients who have never smoked, and clients with type 2 diabetes with blood pressure less than or equal to 130/80 mmHg. Health outcomes are influenced by the work of primary health care; however, they are also influenced by a range of other factors such as education, employment, income and housing