A print friendly PDF version is available from this Communicable Diseases Intelligence issue's table of contents.

This paper presents the work of the Australian Institute of Health and Welfare (AIHW) and its role in communicable diseases information. The AIHW has a number of datasets that can support investigations and research of communicable disease epidemiology. These datasets are managed under Commonwealth legislation and are accessible to external researchers under privacy guidelines. This paper sets out more detail about these issues.

The Australian Institute of Health and Welfare

The Australian Institute of Health and Welfare was established as the Australian Institute of Health by an Act of Parliament in 1987, to report to the nation on the state of its health. In 1992, the Australian Institute of Health was expanded to embrace community service statistics becoming the Australian Institute of Health and Welfare. The AIHW origins can be traced back to the School of Public Health and Tropical Medicine set up by the Commonwealth Department of Health at the University of Sydney in 1930. As an independent agency under the portfolio of Health and Ageing, the AIHW works with many government and non-government bodies across the nation to generate reliable, regular and current facts and figures on the health and welfare of Australians.

The AIHW's work is guided by a mission

To improve the health and well-being of Australians, we inform community discussion and decision-making through national leadership in developing and providing health and welfare statistics and information.

The AIHW's values of objectivity, independence, quality, respect, accessibility, client focus and people are reflected in all its work. These values, combined with an adherence to strict privacy and confidentiality standards, are enshrined in The Australian Institute of Health and Welfare Act 1987 and have positioned the organisation as a leader in the field of health and welfare statistics and information.

The scope of AIHW work can be summarised as:

• to identify and meet the information needs of governments and the community to enable them to make informed decisions to improve the health and welfare of all Australians;
• to provide authoritative and timely information and analysis to the Commonwealth, State and Territory governments and non-government clients through the collection, analysis and dissemination of national health, housing assistance and community services data; and
• to develop, maintain and promote, in conjunction with stakeholders, information standards for health, housing assistance and community services.

The AIHW's work is underpinned by expertise in all aspects of information technology, including database management, software development, information standards, data linkage and IT security.

The AIHW has both the skill and capacity to bring together the major interested parties to develop and promote standardised data definitions and collection methods, new national collections, the linking of separate national collections, and presentation of key summary statistics (or indicators). These skills give the AIHW the capacity to develop innovative approaches to information processing, information management, and data and information access within the varying limitations of the collaborating agencies. All major AIHW publications are available free of charge from its website (http://www.aihw.gov.au).

In summary, the AIHW role is to provide statistics and information on the nation's health and welfare to government and community bodies for use in policy development, discussions and decision making. However, the AIHW does not directly formulate health or welfare policy.

Top of page

The AIHW's role in communicable disease reporting

The AIHW has four key functions which are relevant to communicable disease surveillance in Australia;

• Australia's Health and Australia's Welfare: flagship publications of the Institute;
• national data sets;
• national information standards and agreements; and
• protecting information.

Australia's health and Australia's welfare: flagship publications of the Institute

The AIHW has a legislative requirement to produce reports on the nation's health and welfare services each two years. Australia's Health 2002 was the eighth biennial health report of the AIHW. It is the nation's authoritative source of statistics and information on patterns of health and illness, determinants of health, the supply and use of health services, and health service costs and performance. The sections on communicable disease provide information on acute respiratory infections; bloodborne diseases such as viral hepatitis and HIV/AIDS; non-HIV sexually transmitted infections; vaccine preventable diseases; and on topical problems such as meningococcal disease and Creutzfeldt-Jakob disease. The report can be found on the AIHW website at: http://www.aihw.gov.au/publications/aus/ah02/index.html.

Australia's Welfare 2001 was the fifth biennial report on welfare services by the AIHW. The publication draws together information in the fields of welfare services including expenditure, housing assistance, children's services, aged care services, and disability services.

National data sets

Hospital morbidity

The AIHW compiles the National Hospital Morbidity Database (NHMD) from data supplied by State and Territory health authorities. It is a collection of electronic, confidential summary records for admitted patients separated from public and private hospitals in Australia in the years 1993-94 to 1999-00 (ongoing). The NHMD uses the National Health Data Dictionary definitions, which ensures a high standard of data comparability.

The AIHW presents a summary of this collection in the annual report Australian Hospital Statistics. The report presents detailed information on the characteristics and hospital care of the six million people admitted to public and private hospitals each year, including their age, sex, diagnoses and the procedures they underwent. The report can be found at: http://www.aihw.gov.au/publications/hse/ahs00-01/index.html

Interactive cubes of data

Included on the AIHW website are interactive cubes of data from the National Hospital Morbidity Database, which allow users to specify tables and graphs. Each cube includes information on the number of separations (same day and overnight), patient days and average length of stay, by age group and sex and year of separation, for each diagnosis. The datacubes can be found at: http://www.aihw.gov.au/hospitals/datacubes/index.cfm

Top of page

AIHW mortality database and the National Death Index

Mortality data are stored in several ways at the AIHW:

1. Long-term spreadsheets containing data on many specific causes of death by age and sex going back to 1907 (Available from the Mortality portal at: www.aihw.gov.au);
2. The AIHW National Mortality Database (unit record data from 1964 to 2000); and
3. National Death Index (unit record data from 1980 to 2002).

Information for the AIHW National Mortality Database is provided to the AIHW by the Registrars of Births, Deaths and Marriages and coded nationally by the Australian Bureau of Statistics (ABS). The database holds all registered deaths in Australia since 1964 (latest year is 2000). The information includes the disease or condition leading directly to death and the other contributing diseases or conditions, as well as demographic and administrative information.

The Registrars also provide the data for the National Death Index database. This database contains identified unit record data from 1980 to 2002 and can be used for up-to-date fact and cause of death case findings.

National information standards and agreements

Australia has an established structure to develop information for both the health and public health portfolio. The AIHW understands and appreciates the information capture and management needs of its stakeholders. The National Health Information Agreement continues as a vital element in the development of national health information.

National Health Information Agreement

The National Health Information Agreement operates under the auspice of Australian Health Ministers' Advisory Council; its signatories are the Commonwealth, State and Territory health authorities, the ABS and the AIHW. It operates through the National Health Information Management Group that comprises representatives of all the signatories.

National Health Information Management Group

The AIHW participates in the national health structure on the National Health Information Management Group and its National Health Data Committee. The AIHW produces the National Health Data Dictionary, which contains all national data definitions developed through the committee. The goal is national consistency and it is designed to improve the comparability of data across the health arena.

National Public Health Partnership

The National Public Health Partnership (NPHP) provides a formal structure for the Commonwealth, State and Territory Governments to come together to develop a joint Australian intergovernmental agenda for public health. The AIHW is a member of the NPHP, and its sub-committee, the National Public Health Information Working Group.

National Public Health Information Working Group

The National Public Health Information Working Group manages the information development portfolio of the of the NPHP. It publishes the National Public Health Information Development Plan which represents a comprehensive strategy for the development of public health information in Australia.

Protecting identified information

The Australian Institute of Health and Welfare Act 1987 prescribes strict conditions to ensure the security of the data it manages. It provides for strict penalties (including imprisonment) for breaches of confidentiality. In particular, the Act prohibits the release of personal information to the police and courts. The AIHW has produced a suite of documents that provide guidelines for staff and researchers regarding the collection, storage, use and release of data collected under the AIHW Act.

Ethics

The Act provides for oversight of the AIHW data collections by the AIHW Ethics Committee. The AIHW is obliged to protect the confidentiality of the information it receives, to respect the privacy and sensitivity of those to whom it relates, to maintain high-level data security procedures and, where appropriate, to incorporate the requirements of its information providers in those procedures. Section 29 of the AIHW Act specifies confidentiality provisions. The Section allows for the release of identifiable information to specified third parties with the written permission of the information provider or with the formal approval of the AIHW Health and Welfare Ethics Committee.

Top of page

Summary

This overview has described the AIHW role in Australia's communicable disease surveillance. The AIHW provides statistics and information on the nation's health and welfare within local, state, national and international settings. It has established an expertise in the collection, standards and dissemination of information. Given these qualities, the AIHW has a wealth of expertise and welcomes the use of its publications and data sources. Details of the Institute's work can be found on its website (http://www.aihw.gov.au).


This article was published in Communicable Diseases Intelligence Volume 26, No 4, December 2002