Service Profile for Atherton and Mareeba Hospitals€¦ · Atherton Hospital is a primary hub service located 81 kilometres south-west of the District’s major referral hospital

“PRINTED COPIES ARE UNCONTROLLED” Endorsed by IPPEC—does not represent Queensland Health policy at this time.

Part B (1)

Service Profile for Atherton and Mareeba

Hospitals

Infrastructure Renewal Planning Project for Rural and Remote Areas

July 2010

Infrastructure Renewal Planning Project for Rural and Remote Areas Service Profile for Atherton & Mareeba Hospitals Paper 2 July 2010


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Contents

1 Executive summary ........................................................................................................ 3

2 Service Profile for Atherton and Mareeba Hospitals................................................... 5 2.1 Geographic profile.........................................................................................................5 2.2 Demographic profile......................................................................................................6

2.2.1 Catchment population .....................................................................................6 • Atherton .............................................................................................................6 • Mareeba ............................................................................................................6

2.3 Atherton and Mareeba Hospitals ..................................................................................8 2.3.1 Atherton Hospital.............................................................................................8 2.3.2 Mareeba Hospital ............................................................................................9 2.3.3 Atherton Hospital inpatient activity ................................................................11

• Current activity.................................................................................................11 • Projected activity..............................................................................................12 • Projected activity for Atherton Hospital ............................................................13

2.3.4 Mareeba Hospital inpatient activity................................................................13 • Current Activity ................................................................................................13 • Projected activity for Mareeba Hospital ...........................................................15

2.4 Core services ..............................................................................................................16 • Surgical and procedural...................................................................................16 • Medical ............................................................................................................16 • Maternity..........................................................................................................17 • Paediatrics.......................................................................................................19 • Emergency Department...................................................................................20

2.4.1 Non-admitted general medical services ........................................................21 2.4.2 Non-admitted occasions of services..............................................................21

• Visiting specialist services ...............................................................................22 2.4.3 Current support services for Atherton and Mareeba .....................................23

• Pathology.........................................................................................................23 • Medical imaging...............................................................................................23 • Pharmacy ........................................................................................................23 • Dental/oral health services ..............................................................................24

2.5 Primary health care and community health services ..................................................25 2.5.1 Primary health care .......................................................................................25 2.5.2 Integrated mental health services .................................................................25 2.5.3 Allied health services.....................................................................................25

3 Current and future bed requirements ......................................................................... 26 3.1 Summary of projected bed requirements....................................................................26

4 References..................................................................................................................... 28

5 List of figures and tables ............................................................................................. 29



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1 Executive summary The Infrastructure Renewal Planning Project for Rural and Remote Areas has been identified by the Deputy Premier as a priority project aimed at providing a comprehensive and prioritised health infrastructure program for rural Queensland. The need to address health inequities and access to hospitals in remote areas has also been identified by the Commonwealth Government’s National Health and Hospital Network Agreement 2010.

This Service Profile for Atherton and Mareeba Hospitals combines two of the 12 profiles developed for each of the Queensland prioritised rural sites. Atherton Hospital is a primary hub service located 81 kilometres south-west of the District’s major referral hospital Cairns Base Hospital. Mareeba Hospital is located 34 kilometres west of Atherton Hospital and 64 kilometres from Cairns Base Hospital. It is a small community-based hospital that largely provides services for residents of Mareeba. Given the close proximity of the two services it is important the two services provide complementary rather than competing services. Whilst this approach will be challenging to implement, complementary health services will assist in attracting and retaining an appropriate workforce.

The profile identifies the current level (draft CSCF v3.0 Level 2 and 3) and mix of clinical services provided at each site with a focus on the core services of surgical and procedural, maternity, general medical and Emergency Department. Table 1 and Table 2 detail current beds and future bed requirements for Atherton and Mareeba Hospitals respectively.

Atherton Hospital was built in the early 1900’s, and being over 100 years old, requires significant infrastructure improvement to ensure it can provide the core services of surgical and procedural, maternity, general medical and Emergency Department in a safe and efficient way. The Emergency Department will require an increased number of treatment spaces and significant reorganisation to ensure functionality. The Operating Theatre Suite is also in poor condition. In order to provide the level of surgical services proposed as a rural primary hub facility, the Operating Suite will require significant refurbishment ensuring day and overnight surgery can be provided safely. The Maternity Department is also in a poor condition and has a dysfunctional layout.

Mareeba Hospital was built in the early 1980’s and although the buildings are in reasonable condition, refurbishment and expansion of some areas will be required. The Emergency Department will require expansion and refurbishment to meet growing demand in presentations. A separate Outpatient Department is also proposed to support the needs of a range of health services including visiting specialists and primary medical services. Mareeba Hospital currently has limited day surgical services. Should day surgery activity be expanded and provided on a regular basis Stage 2 recovery chairs will be required.

Rural hospitals rely on visiting clinicians to provide a range of specialist services. Dysfunctional layouts and insufficient treatment spaces make it difficult to attract specialists to the hospital to provide these services. Without the services provided by visiting specialists rural communities will continue to experience health inequities.

Rural hospitals typically have difficulty recruiting staff, and the age and condition of accommodation provided is a major barrier to attracting and retaining a skilled workforce. If staff cannot be recruited and retained patient’s access to safe and sustainable services will be compromised.



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Table 1: Summary of current and future bed requirements for Atherton Hospital

Bed and treatment spaces Current number Number required by 2021/22

Overnight beds 57 65

Same day beds 0 8

Bed alternatives 12 10

Emergency Department treatment spaces

10 16

Multipurpose consultation rooms (for outpatients)

0 11 multipurpose +

3 maternity

Table 2: Summary of current and future bed requirements for Mareeba Hospital

Bed and treatment spaces Current number Number required by 2021/22

Overnight beds 46 45

Same day beds 0 4

Bed alternatives 0 0

Emergency Department treatment spaces

8 18

Multipurpose consultation rooms (for outpatients)

0 9 multipurpose



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2 Service Profile for Atherton and Mareeba Hospitals

2.1 Geographic profile

The Atherton and Mareeba Hospitals are located within the hinterland region of the Cairns and Hinterland Health Service District (the District). The District covers an area of 275,000 square kilometres from Mossman in the north to Cardwell in the south and west beyond Croydon (Figure 1). In the District the Statistical Local Areas of Atherton, Croydon, Eacham, Herberton and Mareeba comprise the area know as the Tablelands.

Figure 1: Map of Cairns and Hinterland Health Service District

Source: Queensland Health 2010

The District provides a broad range of hospital services located at:

•••• Cairns

•••• Yarrabah

•••• Gordonvale

•••• Innisfail

•••• Atherton

•••• Mareeba

•••• Herberton

•••• Tully

•••• Babinda

•••• Mossman (Multipurpose Health Centre).

Atherton Hospital is a primary hub service located 81 kilometres south-west of the District’s major referral hospital Cairns Base Hospital. Mareeba Hospital is located 34 kilometres west of Atherton Hospital and 64 kilometres from Cairns Base Hospital. It is a small community-based hospital that largely provides services for residents of Mareeba.



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According to the Australian Statistical and Geographical Categories, the areas serviced by Atherton and Mareeba Hospitals are classified as ‘outer regional’ (RA3) to ‘very remote’ (RA5). Mareeba and Atherton are both classified RA3, with towns in their catchment areas such as Croydon classified RA5.1

2.2 Demographic profile

2.2.1 Catchment population

Atherton

The primary catchment for Atherton Hospital includes the Statistical Local Areas of Atherton, Croydon, Eacham and Herberton, and is part of the Tablelands.

In 2008, the estimated resident population for the Atherton Hospital catchment was 25,233 (Table 3), equating to 10.6 per cent of the total resident population of the District. The age groups which made up the greatest proportion of the catchment population were the 45–69 years (35% of total) and the 15–44 years (33% of total). Between 2008 and 2026, it is projected that the greatest population increase will be in the 70+ years (132%).

Table 3: Estimated resident population projections by age range for Atherton Hospital catchment 2006–2026

Age Group in Years 2008 2011 2016 2021 2026

% Age Distribution

2008 % Growth 2008–2026

0–14 5,184 5,053 5,118 5,359 5,655 21 9

15–44 8,291 8,348 8,504 8,737 9,245 33 12

45–69 8,950 9,699 10,316 10,474 10,356 35 16

70+ 2,808 3,306 4,280 5,387 6,512 11 132

Total 25,233 26,406 28,218 29,957 31,768 26

% Growth 5 7 6 6

Note: Catchment incorporates Atherton Croydon Eacham and Herberton SLAs Source: Estimated Resident Population by SLA Sex and Age 2006 Census (2008 Edition) Population Projections Qld 2008 Edition Medium Series by SLA Sex five year age group. Produced by Department of Infrastructure and Planning (PIFU)

In 2006 the number of people who identified as Aboriginal and Torres Strait Islander in the Tablelands area was 3715, or nine per cent of the total population. Of that 3715, 1585 were from the Atherton, Croydon, Eacham and Herberton Statistical Local Areas.

Mareeba

The primary catchment area for Mareeba Hospital is the Mareeba Statistical Local Area, which includes Mareeba Town. In 2009, Mareeba Town had the largest urban population of the Tablelands at 7772 people, or 20.5 per cent of the Tablelands’ total population.

In 2008, the estimated resident population for the Mareeba Hospital catchment was 20,340, equating to 8.5 per cent of the total resident population of the District (Table 4). The age groups which made up the greatest proportion of the catchment population were those 15–44 years (36% of total) and those 45–69 years (34% of total). Between 2008 and 2026, it is projected that the greatest population increase will be in the 70+ years (118%) and that the number of children will decline (13%).



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Table 4: Estimated resident population and projections by age range Mareeba SLA 2006–2021

Age Group in Years 2008 2011 2016 2021 2026

% Age Distribution

2008 % Growth 2008–2026

0–14 4,030 3,718 3,511 3,496 3,488 20 -13

15–44 7,410 7,301 7,096 6,879 6,923 36 -7

45–69 6,981 7,186 7,421 7,499 7,449 34 7

70+ 1,919 2,252 2,930 3,578 4,189 9 118

Total 20,340 20,457 20,958 21,452 22,049 8

% Growth 1 2 2 3

Note: Catchment is for Mareeba SLA only Source: Estimated Resident Population by SLA Sex and Age 2006 Census (2008 Edition) Population Projections Qld 2008 Edition Medium Series by SLA Sex five year age group Produced by Department of Infrastructure and Planning (PIFU)

In 2006, the number of people who identified as Aboriginal and Torres Strait Islander in the Mareeba Statistical Local Area was 2130, or 11.7 per cent, of the total resident population.

In 2006, 77 per cent of Tablelands’ Statistical Local Areas included residents reported to be Australian born, and 16.7 per cent reported to be born overseas. Seven per cent of residents spoke a language other than English at home, compared to 6.3 per cent of Queensland residents. This includes traditional Aboriginal and Torres Strait Islander languages, with English often being the second language.



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2.3 Atherton and Mareeba Hospitals

2.3.1 Atherton Hospital

Atherton Hospital is a 57 bed facility and the primary hub for the Cairns and Hinterland Health Service District. Atherton Hospital provides services at a draft CSCF v3.0 Level 3 or lower. The hospital provides a range of services, including:

•••• accident and emergency

•••• aged care

•••• low risk maternity (including 24 hour operative obstetrics)

•••• paediatrics

•••• cardiac stress testing

•••• chemotherapy (day only)

•••• obstetrics and gynaecology

•••• oral health

•••• physician

•••• gastrointestinal endoscopy

•••• radiology

•••• general surgical:

− two Operating Theatres one of which operates as an endoscopy suite

− general medical acute inpatient care

− limited orthopaedic

•••• renal dialysis (operating as a satellite site to Cairns Base Hospital)

•••• diabetic educator

•••• pharmacy

•••• allied health:

− dietetics and nutrition

− occupational therapy

− physiotherapy

− social work

− speech therapy.

The minimum suite of core services aims to ensure that procedural services, maternity services, emergency services, and general medical services are able to be provided. The basis for identifying gaps in service capability against the core service profile is to secure and consolidate services provided at Atherton Hospital. This may involve enhancing existing service roles and staffing levels to support its role as a hub service for the Cairns Hinterland region.

The current service capability at Atherton Hospital is outlined in Table 5.

Table 5: Draft CSCF v3.0 service gap analysis for Atherton Hospital

Core services

Draft CSCF v3.0

Level Current services

Current CSCF Level Gaps

Emergency services 3 Emergency services 3 • No administrative support out of hours or on weekends

• No designated triage

Medical services 3 Medical services 3 No physiotherapist on call

Surgical services 3 Surgical services 3 Elective surgery only

Peri-operative services 3 Peri-operative Services 3 Elective only

Anaesthetics services 3 Anaesthetics services 3

Maternity services 3 Maternity services 3 • Credentialed MO not always available on call

• No sonographer



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Core services

Draft CSCF v3.0



Neonatal services 3 Neonatal services 3

Mental health Services 2 Mental health services 2

Rehabilitation services 3 Rehabilitation services 3

Palliative care services 2 Palliative care services 2

Pathology services 3 Pathology services 3

Medical imaging services

3 Medical imaging services

3 No ultrasonographer on site – only a visiting service

Pharmacy services 3 Pharmacy services 3

Source: Queensland Health February 2010

2.3.2 Mareeba Hospital

Mareeba Hospital is a 46 bed community-based hospital and is a hub service for Cairns and Hinterland Health Service District. Mareeba Hospital provides services at a draft CSCF v3.0 Level 3 or lower. The hospital provides a range of services, including:

•••• general medical/surgical acute inpatient care

•••• obstetrics and gynaecology (midwife-led maternity service)

•••• 24 hour emergency care

•••• one Operating Theatre

•••• specialist outpatient clinics, including medical surgical obstetrics and gynaecology, diabetes education, mental health, aged care and memory, and paediatrics including child safety

•••• community health services located within the hospital (Table 6)

•••• primary paediatric care

•••• sub-acute care, palliative care and rehabilitation

•••• speech pathology, physiotherapy, occupational therapy, social work, dietetics and nutrition

•••• support services including pharmacy diagnostic imaging and pathology.

The current service capability at Mareeba Hospital is outlined in Table 6.



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Table 6: Draft CSCF v3.0 service gap analysis for Mareeba Hospital

Core services

Draft CSCF v3.0



Emergency services 3 Emergency services 3

Medical services 3 Medical services 3

Surgical services 3 Surgical services 3 Emergency surgical/anaesthetic services not available 24/7- transfer to Cairns

Peri-operative services 3 Peri-operative Services

3 Emergency surgical/anaesthetic services not available 24/7- transfer to Cairns

Anaesthetics services 3 Anaesthetics services 3 Emergency surgical/anaesthetic services not available 24/7- transfer to Cairns

Maternity services 3 Maternity services 2 Low risk midwifery only- close links to Cairns maternity service

Neonatal services 3 Neonatal services 3

Mental health services 2 Mental health services

2

Rehabilitation services 3 Rehabilitation services

3

Palliative care services 2 Palliative care services

2

Pathology services 3 Pathology services 2 Transfers all specimens to Cairns

Medical imaging services

3 Medical imaging services

3 No ultrasonographer on site – only a visiting service

Pharmacy services 3 Pharmacy services 3 No pharmacist on call but on site during business hours

Source: Queensland Health February 2010



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2.3.3 Atherton Hospital inpatient activity

Current activity

A summary of inpatient activity average occupancy and average length of stay (ALOS) for Atherton Hospital is detailed in Table 7 and Table 8. In 2008/09, residents of the District (all ages) accounted for 98.8 per cent of all overnight beddays and 96.6 per cent of same day separations (seps). There were no other significant inflows from any other district or region. The average annual occupancy rate for 2008/09 was 78.4 percent, based on both overnight and same day activity.

Table 7: Summary of inpatient activity at Atherton Hospital 2004/05–2008/09

Year Separations Beddays ALOS Bed Numbers *% Occupancy

2004/05 5075 14,115 2.8 57 67.8

2005/06 5210 13,820 2.7 57 66.4

2006/07 5576 15,146 2.7 57 72.8

2007/08 5420 15,785 2.9 57 75.9

2008/09 5669 16,308 2.9 57 78.4

Source: Queensland Health Admitted Patient Data Collection April 2010 * occupancy rates based on both same day and over night activity

Table 8: Separations (all age) by district of residence Atherton Hospital 2008/09

Same Day Overnight

Health Service District of Residence Separations

% of Total Seps Seps Beddays

% of Total Beddays

Cairns and Hinterland 2678 96.6 2814 13,370 98.8

Cape York 7 0.3 11 37 0.3

Central Queensland 3 0.1 4 10 0.1

Central West 2 0.1 1 1 0.0

Darling Downs–West Moreton 8 0.3 3 11 0.1

Gold Coast 0.0 2 2 0.0

Mackay 4 0.1 1 2 0.0

Metro North 5 0.2 6 13 0.1

Metro South 4 0.1 1 3 0.0

Mt Isa 7 0.3 8 10 0.1

Other States and Overseas 24 0.9 31 51 0.4

Sunshine Coast-Wide Bay 8 0.3 2 2 0.0

Torres Strait-Northern Peninsula 3 0.1 4 8 0.1

Townsville 19 0.7 9 16 0.1

Total 2772 2897 13,536

Source: Queensland Health Admitted Patient Data Collection April 2010

In 2008/09, the top three reasons for overnight separation at Atherton Hospital were cardiology obstetrics and non-subspecialty surgery (Table 9).

Non-acute respiratory medicine and cardiology accounted for the highest number of beddays for the same period. The most common reasons for separation were non-subspecialty surgery, diagnostic gastrointestinal endoscopy and non-subspecialty medicine.



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Table 9: Top 10 all age Service Related Groups (SRGs) by separations at Atherton Hospital 2008/09

Top 10 SRGs Same day Seps Top 10 SRGs Overnight Seps Beddays

Non-subspecialty Surgery 428 Non-acute 199 4382

Diagnostic GI Endoscopy 350 Respiratory Medicine 242 1061

Non-subspecialty Medicine 330 Cardiology 376 1036

Orthopaedics 260 Non-Subspecialty Medicine 268 983

Chemotherapy and Radiotherapy 156 Obstetrics 298 820

Cardiology 156 Orthopaedics 170 815

Gastroenterology 135 Neurology 171 721

Ophthalmology 106 Non-subspecialty Surgery 281 651

Plastic and Reconstructive Surgery 105 Immunology and Infections 122 456

Neurology 104 Gastroenterology 122 317


Over the period from 2004/05 to 2008/09, there was a 27.3 per cent growth in the number of same day separations at Atherton Hospital (Table 10). Most of the growth during the period occurred in the adult age group.

Table 10: Same day separations (all ages) for Atherton Hospital 2004/05–2008/09

2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Paediatric 226 305 253 261 240 6.2

Adult 1951 1988 2201 2193 2532 29.8

Total 2177 2293 2454 2454 2772 27.3


For the same period, overnight beddays (all ages) increased 13.4 per cent (Table 11). All of the increase occurred in the adult age groups.

Table 11: Overnight beddays (all ages) for Atherton Hospital 2004/05–2008/09


Paediatric 463 421 528 393 460 -0.6

Adult 11,475 11,106 12,164 12,938 13,076 14.0

Total 11,938 11,527 12,692 13,331 13,536 13.4


Projected activity

The profile of projected activity at Atherton and Mareeba Hospitals is not expected to change. However, with improved infrastructure, including modernised layouts or refurbished buildings, service provision could be enhanced. Maternity, emergency services, surgical and outpatient services could continue to grow and provide more efficient services.

The bed types and treatment spaces set out in Table 33 reflect the categories from the More Beds for Hospitals Strategy.2 It should be noted that many of the categories outlined in Table 33 and Table 34 are not applicable for rural hospitals.



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The projections have been calculated using aIM data and data templates developed by the Planning and Coordination Branch Statewide (Data) Team. The benchmarks used for calculating the projected bed categories are described in the Methodology section of Statewide Implications for Service Provision.

In rural hospitals beds are classified as multipurpose as they are not designated into specific bed type categories, because in Level 3 services (draft CSCF v3.0) there are no specialist clinical units. When projecting overnight beds, bed type categories have been limited to multipurpose beds only.

Projected activity for Atherton Hospital

Atherton Hospital currently has 57 multipurpose overnight beds. Projections indicate that 65 overnight beds will be required (applying an 85% occupancy rate) by 2021/22 or 78.9 overnight beds (applying a 70% occupancy rate) by 2021/22.

Atherton currently has 12 bed alternatives and no same day beds. Projections indicate by 2021/22 eight same day beds and 10 bed alternatives will be required.

The number of Emergency Department treatment spaces will need to increase from 10 to 16 by 2021/22 to meet demand. These treatment spaces will need to include a mix of acute treatment trolley spaces (including a resuscitation cubicle), consultation rooms and specific treatment rooms (e.g. plaster procedure and isolation rooms).

There are currently insufficient outpatient consultation rooms and delivery suites at Atherton Hospital. An additional 11 multipurpose outpatient consultation rooms and three maternity consultation rooms are required.

Atherton Hospital currently has two theatres which are sufficient to meet projected service activity requirements; however, an increased number of recovery spaces will be needed to support projected activity.

2.3.4 Mareeba Hospital inpatient activity

Current Activity

In 2008/09, District residents (all ages) accounted for 94.7 per cent of all overnight beddays and 94.7 per cent of same day separations at Mareeba Hospital (Table 12).

Table 12: Mareeba Hospital (all age) separations 2008/09

Same Day Overnight

Health Service District of Residence Seps

% of Total Seps Seps Beddays

% of Total Beddays

Cairns and Hinterland 1026 94.7 2119 10,856 94.7

Cape York 10 0.9 12 24 0.2

Central Queensland 2 0.2 3 3 0.0

Darling Downs–West Moreton 4 0.4 2 9 0.1

Gold Coast 1 0.1 1 1 0.0

Mackay 1 0.1 4 96 0.8

Metro North 0.0 5 158 1.4

Metro South 1 0.1 0.0

Mt Isa 4 0.4 12 68 0.6

Other States and Overseas 23 2.1 24 202 1.8

Sunshine Coast-Wide Bay 3 0.3 2 2 0.0

Townsville 8 0.7 7 41 0.4

Total 1083 2191 11,460 -




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At Mareeba Hospital in 2008/09, the most common reasons for overnight separations (all ages) were for non-subspecialty medicine respiratory medicine and obstetrics. The same Service Related Groups accounted for the largest number of beddays for the same period (Table 13), except for the non-acute beddays, which totalled over 4000 beddays in 2008/09. The average annual occupancy rate for 2008/09 was 75 per cent based on both overnight and same day activity.

Table 13: Top 10 (all ages) Service Related Groups (SRGs) at Mareeba Hospital in decreasing order for separations in 2008/09

Top 10 SRGs Same Day Seps Top 10 SRGs Overnight Seps Beddays

Non-subspecialty Surgery 191 Non-subspecialty Medicine 293 948

Cardiology 113 Respiratory Medicine 284 1181

Gastroenterology 98 Obstetrics 237 648

Orthopaedics 86 Cardiology 216 623

Respiratory Medicine 85 Non-subspecialty Surgery 172 550

Non-subspecialty Medicine 80 Gastroenterology 138 303

Neurology 74 Non-acute 116 4018

Obstetrics 70 Immunology and Infections 115 461

Immunology and Infections 50 Neurology 114 702

Drug and Alcohol 46 Orthopaedics 93 546


Over the period 2004/05–2008/09, there was a 59.3 per cent growth in same day separations at Mareeba Hospital (Table 14). Most of the volume of activity in 2008/09 occurred in the adult age groups (948 separations) and there was a 77.6 per cent growth of paediatric activity (135 separations).

Table 14: Same day separations (all ages) for Mareeba Hospital 2004/05–2008/09

2004/05 2005/06 2006/07 2007/08 2008/09 % Change

Over 5 Years

Paediatric 76 74 120 132 135 77.6

Adult 604 567 815 935 948 57.0

Total 680 641 935 1067 1083 59.3


Over the same period, overnight beddays (all ages) at Mareeba Hospital increased 28.8 per cent. Most of the volume (10,864 overnight beddays) occurred in the adult age group (Table 15).

Table 15: Overnight beddays (all ages) at Mareeba Hospital 2004/05–2008/09

2004/05 2005/06 2006/07 2007/08 2008/09 % Change

Over 5 Years

Paediatric 426 530 651 906 596 39.9

Adult 8474 8397 9216 9,757 10,864 28.2

Total 8900 8927 9867 10,663 11,460 28.8




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Projected activity for Mareeba Hospital

Mareeba Hospital currently has 46 multipurpose overnight beds. By 2021/22, projections indicate that 44.8 overnight beds will be required (applying an 85% occupancy rate), or 54.8 overnight beds (applying a 70% occupancy rate).

Currently, no Stage 2 recovery chairs are required, however, if day surgery services were to recommence (currently under consideration) sufficient chairs will be needed to meet scheduled day surgery activity. There is space for four chairs (currently used by the Red Cross Blood Service). The number of these chairs should not be double counted with same day bed numbers as these usually serve the same purpose in rural hospitals.

The number of Emergency Department treatment spaces will need to increase from eight to 18 by 2021/22. These treatment spaces will need to include a mix of acute treatment trolley spaces (including a resuscitation cubicle) consultation rooms and specific treatment rooms (e.g. plaster procedure and isolation rooms). In addition, 11 consultation rooms will be required for outpatient activity. As there is no Outpatient Department, this would need to be a new area.

Mareeba Hospital has a major Operating Theatre which is sufficient for current activity, but an additional Stage 1 recovery bay is needed to meet benchmark requirements. Currently there are sufficient delivery suites however, an additional multipurpose/staff/education room is needed.

Projected activity for Maternity Services

In 2007/08, there were 188 births at Mareeba Hospital. Using the High Series population projections for the District Statistical Local Areas, it is expected that births in the Mareeba catchment will increase to 236 (26%) by 2021/22 (Table 16).

In 2007/08, there were 297 births at Atherton Hospital. Using the High Series population projections for the District Statistical Local Areas, it is expected that births in the Atherton catchment will increase to 433 (46%) by 2021/22 (Table 16). Infrastructure improvements should also allow for a multipurpose/staff/education room and a child-friendly waiting area.

Table 16: Current and projected births for District by statistical local area

2007/08 2011/12 2016/17 2021/22

Total births for Cairns and Hinterland Health Service District as a district of residence

3458 3915 4252 4484

Atherton catchment 297 351 383 433

Mareeba catchment 188 226 230 236

*Live births by district of usual residence Queensland 2006–2008 source perinatal data collection Projections developed by Office of Economic and Statistical Research using Perinatal Data Collection and high series population projections.



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2.4 Core services

In March 2010, the Integrated Policy and Planning Executive Committee endorsed that rural hub facilities will provide a set of core services including surgical and procedural, medical, maternity and Emergency Department. Outlined below are descriptions of these four services provided at Atherton and Mareeba Hospitals.

Surgical and procedural

Atherton Hospital provides surgical and procedural services at a draft CSCF v3.0 Level 3 service. Atherton Hospital’s Operating Theatre is accessible 24 hours a day seven days a week. However, it does not meet the latest Australasian Building Facilities Guidelines3 . Most surgery is done on a weekly and/or monthly basis by visiting specialists.

In the rural sector allowance must be made for adequate bed numbers to accommodate scheduling and the case numbers on the theatre list on the days when specialists visit. Currently at Atherton Hospital there are 12 Stage 2 recovery chairs (10 chairs and two trolleys); if there are additional cases that cannot be accommodated in these recovery chairs, overnight beds are used.

Between 2004/05 and 2008/09, surgical overnight separations decreased at Atherton Hospital by 6.8 per cent. Same day surgical separations increased by 29.9 per cent (Table 17).

Table 17: Surgical separations at Atherton Hospital 2004/05–2008/09

Surgical 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Overnight 3504 3445 3616 3241 3265 -6.8

Same day 933 1014 1036 1125 1212 29.9

Source: Queensland Health Admitted Patient Data Collection April 2010. Note: Excludes Service Related Groups neonates psychiatry and ATODS extensive burns and unallocated.

Surgical separations were relatively low for Mareeba Hospital (Table 18) as there is currently a limited amount of day surgery happening. Indications from the District are that theatre utilisation at Mareeba may increase from 2010 as they are negotiating for visiting surgical services to recommence.

Medical

Table 18: Surgical separations at Mareeba Hospital 2004/05–2008/09

Medical 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Overnight 407 336 471 492 460 13.0

Same day 564 610 680 640 662 17.4

Source: Queensland Health Admitted Patient Data Collection April 2010 Note: Excludes Service Related Groups neonates psychiatry and ATODS extensive burns and unallocated



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Overnight medical separations at Atherton Hospital have increased by 23.8 per cent and same day by 24.7 per cent over the same period (Table 19).

Table 19: Medical separations at Atherton Hospital 2004/05–2008/09


Overnight 7988 7430 8619 9506 9892 23.8

Same day 1186 1229 1376 1266 1479 24.7

Source: Queensland Health Admitted Patient Data Collection April 2010. Note: Excludes Service Related Groups neonates psychiatry and Alcohol Tobacco and Other Drug Services extensive burns and unallocated

Between 2004/05 and 2008/09, overnight medical separations at Mareeba Hospital increased by 148.2 per cent, although the numbers remained relatively small with 551 separations in 2008/09.

Table 20: Medical separations at Mareeba Hospital 2004/05–2008/09


Overnight 222 251 400 495 551 148.2

Same day 1095 1262 1508 1607 1413 29.0

Source: Queensland Health Admitted Patient Data Collection April 2010 Note: Excludes Service Related Groups neonates psychiatry and ATODS extensive burns and unallocated

Renal Dialysis

In 2008/09, the majority of the renal dialysis activity for the two catchment areas occurred at Atherton Hospital. Most of the renal dialysis activity was for residents of the Mareeba Statistical Local Area.

Table 21: Renal haemodialysis separations by month at Atherton Hospital 2008/09

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Total

Haemodialysis 276 280 271 285 280 292 270 224 175 174 178 187 2892

Source: Casemix and Clinical Costing Unit Cairns Base Hospital

Maternity

Atherton and Mareeba Hospitals provide low risk maternity services with planned deliveries of ≥ 37 completed weeks gestation. Both hospitals have some ability to manage unplanned deliveries of 35–37 weeks gestation. Atherton Hospital provides for elective and emergency vaginal and assisted deliveries and selected low risk elective caesareans. Mareeba Hospital provides a low risk model of maternity care in conjunction with Cairns Base Hospital.

As the primary hubs for maternity services in the District, Atherton and Mareeba Hospitals provide a booking-in clinic, antenatal clinic and classes, birthing and postnatal care. Currently, the average length of stay after a vaginal delivery is 2.8 days, after a caesarean section 4.3 days, for a postnatal stay 2.5 days and 1.9 days for an antenatal admission.

This service is provided by local general practitioners, midwives and visiting specialists. Table 22 and Table 23 provide the maternity and gynaecology occasions of service 2004/05–2008/09 at Atherton and Mareeba Hospitals respectively.



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Table 22: Maternity and gynaecology occasions of service at Atherton Hospital 2004/05–2008/09

Clinics 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Gynaecology 149 215 166 372 181 Fluctuating

Maternity 1993 2518 2809 2574 3007 34


Table 23: Maternity and gynaecology occasions of service at Mareeba Hospital 2004/05–2008/09

Clinics 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Gynaecology 70 31 97 187 143 51

Maternity 4697 3629 4640 3607 3471 -35


Between 2004/05 and 2008/09, the number of maternity separations at Atherton Hospital decreased by 6.1 per cent (Table 24). Caesarean deliveries decreased by 26.2 per cent, while vaginal deliveries increased minimally (0.5 %). This is despite a 34 per cent increase in maternity outpatients over the same period.

Table 24: Births at Atherton Hospital 2004/05–2008/09


Vaginal 167 158 183 179 168 0.5

Caesarean 61 49 58 53 46 -26.2

Total 228 207 241 232 214 -6.1

Source: Queensland Health Admitted Patient Data Collection April 2010 Note: This data is for separations only - does not identify multiple births.

There are currently eight maternity beds located in the maternity/paediatric ward at Mareeba Hospital. The hospital operates a low risk maternity service with support from Cairns Base Hospital obstetricians.

Between 2004/05 and 2008/09, there was a 6.1 per cent decrease in the number of births at Mareeba Hospital and a 34 per cent decrease in non-admitted maternity occasions of service. There was however, a 51 per cent increase in gynaecology occasions of service.

Table 25: Births at Mareeba Hospital 2004/05–2008/09


Vaginal 127 141 153 140 131 3.1

Caesarean 21 8 12 12 8 -61.9

Total 148 149 165 152 139 -6.1

Source: Queensland Health Admitted Patient Data Collection April 2010 Note: this data is for separations only – does not identify multiple births.



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In conjunction with maternity services draft CSCF v3.0 Level 3, neonatal services (Attachment A) are required to provide routine care for unqualified babies and qualified neonates who require resuscitation and management while awaiting transfer out and management of back transferred babies. Additionally, neonates who require low risk care may be managed in this level of facility. Although Atherton Hospital does not have a special care nursery—nor is it indicated for a draft CSCF v3.0 Level 3 neonate service–during 2008/09 there were 166 qualified neonate beddays.

Paediatrics

In 2008/09, the most common reason for paediatric overnight separations at Atherton Hospital was for respiratory medicine. The largest number of paediatric same day separations were for non-subspecialty surgery and orthopaedics (Table 26).

Table 26: Top 10 Service Related Groups (SRGs) for same day and overnight paediatric separations at Atherton Hospital 2008/09


Non-subspecialty Surgery 70 Qualified Neonate 34 160

Orthopaedics 50 Non-subspecialty Medicine 54 86

Non-subspecialty Medicine 26 Immunology and Infections 24 61

Respiratory Medicine 19 Respiratory Medicine 32 52

Neurosurgery 15 Non-subspecialty Surgery 22 35

Immunology and Infections 12 Orthopaedics 16 16

Dentistry 9 Neurology 6 15

Ophthalmology 6 Neurosurgery 9 10

Qualified Neonate 6 Gastroenterology 3 5

Neurology 6 Endocrinology 4 5

Source: Queensland Health Admitted Patient Data Collection

Over the same period the most common reasons for paediatric overnight separations at Mareeba Hospital were for non-subspecialty medicine and respiratory medicine. The most common reasons for same day paediatric separations were for non-subspecialty medicine and surgery (Table 27).

Table 27: Top 10 Service Related Groups (SRGs) for same day and overnight paediatric separations at Mareeba Hospital 2008/09


Non-subspecialty Medicine 25 Non-subspecialty Medicine 98 162

Non-subspecialty Surgery 24 Qualified Neonate 28 138

Neurosurgery 17 Respiratory Medicine 49 96

Respiratory Medicine 14 Immunology and Infections 22 55

Orthopaedics 14 Dentistry 5 25

Neurology 9 Endocrinology 5 21

Immunology and Infections 9 Neurology 10 18

Drug and Alcohol 6 Non-subspecialty Surgery 11 14

Gastroenterology 5 Gastroenterology 10 13

Dermatology 4 Dermatology 3 13

Source: Queensland Health Admitted Patient Data Collection



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Emergency Department

The Emergency Department services at Atherton and Mareeba Hospitals are provided by staff, including nurses, general practitioners and hospital-employed doctors rostered on 24 hours a day, seven days a week. Both Emergency Departments are constrained by a lack of available space, space configuration and age of the current layout. Over the period 2004/05 to 2008/09, there has been a 36 per cent increase in emergency presentations at Atherton Hospital—from 10,758 to 14,625. There was a 28 per cent increase in emergency presentations at Mareeba Hospital for the same time period. During this time there has only been a three per cent increase in population of the District.

The majority of activity at both hospitals is comprised mainly of Category 4 and Category 5 presentations. Much of this increase in activity has been in Category 5 presentations with little change in the numbers of Category 1, 2 and 3 presentations, which only totalled between 20–30 per cent of all emergency presentations.

The Emergency Departments at Atherton and Mareeba Hospitals provide a draft CSCF v3.0 levels Level 3 service which means they are able to manage emergency care until transfer to a higher level hospital when required. They have no access to an Intensive Care Unit, although the service has access to monitored beds.

Both Atherton and Mareeba Hospitals have dysfunctional and aged layouts in their Emergency Departments. The triage room and desk for initial assessment are poorly located and make continual observation of the waiting room difficult. There is no central observation desk for health professionals to view patients who are ill in the acute treatment spaces. Additionally, there is no security to prevent the Emergency Department being used as a public thoroughfare.

Both Hospital Emergency Departments have capacity problems with consultation rooms being used for both outpatient appointments and emergency presentations, resulting in an inadequate number of consult rooms for emergency use. When specialists are visiting they often take over multiple rooms and hallways as waiting areas.

Between 2004/05 and 2008/09, presentations to the Atherton Hospital Emergency Department increased by 44.6 per cent (Table 28). During the same period, admissions to the wards from the Emergency Department decreased by 9.3 per cent. Approximately 80 per cent of presentations to Mareeba Hospital are Category 4 and 5.

Table 28: Emergency Department (ED) separations at Atherton Hospital 2005–2009

Modality 2005 2006 2007 2008 2009 %Change Over 5 Years

Presentations to ED 8,573 8,898 10,891 10,757 12,393 44.6

Admissions from ED 2,185 2,292 2,290 2,524 1,981 -9.3

Did not Wait 0 0 0 0 251

Died 0 1 0 1 0

Total ED Activity 10,758 11,191 13,181 13,282 14,625 35.9

% Growth per year 4.0 17.8 0.8 10.1 -

Source: Panorama 2010

Over the same period presentations to Mareeba Hospital Emergency Department increased 23.2 per cent. Admissions to the wards from the Emergency Department increased by 55.8 per cent.



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Table 29: Mareeba Hospital Emergency Department presentations 2005–2009

Modality 2005 2006 2007 2008 2009 % Change Over 5 Years

Presentations to ED 12,065 12,194 14,792 18,000 14,860 23.2

Admissions from ED 1,680 1,810 2,469 2,576 2,617 55.8

Did not Wait 0 0 0 0 180

Died 2 0 2 5 1

Total ED Activity 13,747 14,004 17,263 20,581 17,658 28.4

% Growth per year 1.9 23.3 19.2 14.2 -

Source: Panorama 2010

2.4.1 Non-admitted general medical services

There is no designated Outpatient Department at either Hospital. While Atherton Hospital is well served by private general practitioners, Mareeba Hospital is not. Both hospitals have demonstrated an increasing number of emergency presentations, although a large number of these are triage category four and five. General medical services at Atherton and Mareeba Hospitals are routinely provided by nursing, medical (general practitioner and senior medical officers) and allied health staff. In addition, there are visiting medical specialists who provide services on a regular basis.

2.4.2 Non-admitted occasions of services

Outpatient services at Atherton and Mareeba Hospitals provide a range of non-admitted services under the following broad categories, which are generally captured in Table 30 and Table 31. There is, however, varying levels of accuracy (as advised by the District) with regards to the Emergency Department and non-admitted occasions of service:

•••• general practice clinics (provided by hospital medical officers or visiting general practitioners)

•••• minor procedures clinic

•••• fracture clinic

•••• pre-admission/anaesthetic clinic

•••• ophthalmology clinic

•••• dressing/wound management clinic

•••• Rural and Isolated Practice Registered Nurse occasions of service

•••• telehealth clinics.

There is also a range of allied health and nursing services provided at the Hospitals.

Between 2004/05 and 2008/09, non-admitted occasions of service at Atherton Hospital decreased by 22.4 per cent overall, although obstetrics and gynaecology increased by 48.8 per cent and allied health/nurse service increased by 12.7 per cent. In 2008/09, the largest number of occasions of service were for allied health and nurse-led clinics (6736).



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Table 30: Non-admitted occasions of service Atherton Hospital 2004/05–2008/09

Specialty 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Allied Health/Nurse 5,979 5,239 5,926 5,810 6,736 12.7

Dental 3,919 2,708

Medical 7,460 7,564 7,465 8,311 4,979 -33.3

Obstetrics/Gynaecology 2,142 2,733 2,975 2,946 3,188 48.8

Paediatric/Medical 18 100 234 79

Paediatric/Surgical 143 127 162 178

Surgical 1,286 1,064 1,348 1,049 1,256 -2.3

Total 20,929 19,453 17,976 18,528 16,238 -22.4


Over the same period non-admitted occasions of service at Mareeba Hospital decreased by 36 per cent (Table 31).

Table 31: Non-admitted occasions of service Mareeba Hospital 2004/05–2008/09

Specialty 2004/05 2005/06 2006/07 2007/08 2008/09 % Change Over 5 Years

Allied Health/Nurse 5,697 4,332 5,555 5,929 4,694 -18

Dental 2,723 2,470

Medical 5,089 4,667 5,416 6,178 3,517 -31

Obstetrics/Gynaecology 4,767 3,660 4,737 3,794 3,614 -24

Paediatric/Medical 9 40

Paediatric/Surgical 226 260 166 118

Surgical 505 290 383 288 396 -22

Total 19,007 15,679 16,266 16,347 12,221 -36


Visiting specialist services

At Atherton and Mareeba Hospitals speciality and subspecialty services are provided as a visiting service. Visiting specialists utilise the facility on a weekly or monthly basis. The visiting specialist services have to share limited consultation space usually within designated emergency areas.

Visiting specialist services are generally provided from Cairns Base Hospital largely funded through the Medical Specialist Outreach Assistance Program and the occasions of data are outlined in Table 30 and Table 31.

Visiting services from Cairns for Atherton Hospital include:

•••• anaesthetics

•••• general medical


•••• orthopaedics

•••• paediatrics

•••• psychiatry

•••• endocrinology (adult and paediatrics)

•••• women’s health.

Visiting services from Cairns for Mareeba Hospital include:

•••• paediatric outreach



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•••• surgical

•••• anaesthetics

•••• psychiatry


•••• Red Cross Blood Service.

Outreach medical and allied health services are provided from Atherton Hospital to rural and remote facilities, including Croydon Forsayth and Georgetown. Outreach medical and allied health services are provided from Mareeba Hospital to Dimbulah and Chillagoe.

Table 32: Medical Specialist Outreach Assistance Program provided services to the Tablelands

Location Specialty Trips per year

Obstetrics and Gynaecology 8

Paediatrics 29

Diabetes 4

Psychiatry - Child and Adolescent 3

Surgery 48

Atherton

Telepaediatrics - Psychiatry 48

Obstetrics and Gynaecology 8

Paediatrics 17


Surgery - ENT 2

Surgery - General 24

Telepaediatrics - Psychiatry 48

Psychiatry - Adult 21

Mareeba


Psychiatry - Adult 21 Other Tablelands


2.4.3 Current support services for Atherton and Mareeba

Pathology

Atherton Hospital has a pathology service that includes a laboratory which provides uncomplicated testing of specimens to the community. Mareeba Hospital sends all specimens to Cairns.

Medical imaging

Medical imaging services are available at both Mareeba and Atherton Hospitals. A computerised tomography scanner is planned for Atherton Hospital in 2010, although Mareeba has the space for one. Plain film x-ray and ultrasound are also provided.

Pharmacy

A full time pharmacist is available at both Atherton and Mareeba Hospitals providing dispensing inventory management and ward imprest/bedside locker filling. Links and stock assurance are provided through the Cairns Base Hospital pharmacy service. Private pharmacies are also located in both Atherton and Mareeba.



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Dental/oral health services

The Oral Health program provides services to eligible adults from clinics at Atherton and Mareeba Hospitals. It is staffed by dentists, therapists, assistants, technicians and prosthetists, and provides emergency and routine dental care prosthetic and hygiene services. The program also includes a School Dental Program. The occasions of service data was available for two years in 2004/05 and 2005/06, however, the collection system changed and further data is not available.



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2.5 Primary health care and community health services

One of the major challenges of health services in the catchment is to effectively implement evidence-based interventions aimed at addressing preventable disease. The growth in the population, the travel required to access health services and the need to provide services to sparsely populated regions has created a need to reconsider current models of care and look for alternative service delivery models.

Implementation of alternative models of care such as Hospital in the Home, Hospital in the Nursing Home, integrated models of care across primary health care and acute services, and nurse practitioner led clinics, may achieve some efficiency in service delivery.

A key strategy in achieving these efficiencies will be expanding community-based resources for targeting, identifying and managing key chronic diseases and common conditions of ageing in collaboration with other local agencies.

Future community-based service requirements have been broadly considered in the context of the catchment and opportunities for enhancing community-based services. Detailed consideration of future community health services and capacity requirements will occur if the preliminary evaluation progresses to a Business Case.

2.5.1 Primary health care

Atherton and Mareeba Hospitals offer the following primary health care services:

•••• aged care

•••• people with disabilities

•••• child health

•••• women’s and men’s health

•••• health promotion and prevention

•••• Alcohol Tobacco and Other Drugs.

2.5.2 Integrated mental health services

Atherton and Mareeba Hospitals have integrated mental health services on-site supported by specialists from Cairns Base Hospital.

2.5.3 Allied health services

Atherton and Mareeba Hospitals offer a broad range of allied health services, including physiotherapy occupational therapy speech therapy social work and dietetics and nutrition, with both teams providing outreach support to primary health care and community health services.

Infrastructure Renewal Planning Project for Rural and Remote Areas Service Profile for Atherton & Mareeba Hospitals Paper 2 June 2010

“PRINTED COPIES ARE UNCONTROLLED”

Endorsed by IPPEC—does not represent Queensland Health policy at this time. 26

3 Current and future bed requirements

3.1 Summary of projected bed requirements

Table 33 and Table 34 present a high-level summary of the projected bed and other treatment space requirements for the Atherton and Mareeba Hospitals to 2021.

Table 33: Current and projected bed requirements for Atherton and Mareeba Hospitals

Current numbers Projections using 85% occupancy rates Projections using 70% occupancy rates

Atherton Mareeba Atherton Mareeba Atherton Mareeba

Beds/Alternatives 2010 2010 2011 2016 2021 2011 2016 2021 2011 2016 2021 2011 2016 2021

Overnight Beds

Total multipurpose overnight beds

57 44 49 57 65 35 40 45 59 69 79 43 49 55

Same day beds/ bed alternatives

Same day beds 6 7 8 3 4 4

Stage 2 recovery chairs 12* 0 10 10 10 0 0 0

Chemotherapy chairs *as

above 0 0 0 0

Renal dialysis chairs (in centre)

8 0 8 8 8 0 0 0

Other medical (inc. Discharge Lounge)

0 0 0 0 0 0 0 0

Total same day beds/ alternatives

20 0 24 25 26 3 4 4

* Stage 2 recovery chairs used as chemotherapy chairs at Atherton Hospital

Infrastructure Renewal Planning Project for Rural and Remote Areas Service Profile for Atherton & Mareeba Hospitals Paper 2 June 2010

“PRINTED COPIES ARE UNCONTROLLED”

Endorsed by IPPEC—does not represent Queensland Health policy at this time. 27

Other treatment spaces

Projected requirements for recovery spaces, delivery suites, outpatient clinic rooms and Emergency Department spaces currently exceed the current built capacity at Atherton and Mareeba Hospitals.

Table 34: Current and projected other treatment space requirements for Atherton and Mareeba Hospitals

Atherton Mareeba Atherton Mareeba

2010 2010 2011 2016 2021 2011 2016 2021

Operating Theatres 2 1 2 2 2 1 1 1

Procedure rooms 1 in ED 1 in ED 1 in ED 1 in ED 1 in ED 1 in ED 1 in ED 1 in ED

Stage 1 Recovery spaces 2 1 4 4 4 2 2 2

Delivery Suites 1 2 2 2 2 2 2 2

Outpatient clinic rooms 0 0 11 11 11 9 9 9

ED treatment spaces 10 8 10 15 16 14 17 18

X-ray rooms, Ultrasound, plain film x-ray

2 1 2 2 2 2 2 2

CT scanner 0 0 1 1 1 0 0 0


4 References 1 Australian Bureau of Statistics. Australian Statistical and

Geographical Categories. Australian Standard Geographical Classification (ASGC) 2009 (cat. no. 1216.0); Australian Standard Geographical Classification (ASGC) - Electronic Structures 2009 (cat. no. 1216.0.15.001) and Australian Standard Geographical Classification (ASGC) Correspondences 2009 (cat. no. 1216.0.15.002); 2009.

2 Queensland Government. More Beds for Hospitals Strategy. Queensland Health; 2006.

3 Australasian Health Infrastructure Alliance and University of New South Wales. Australasian Health Facilities Guidelines Revision v.3.0. Centre for Health Assets Australasia; 2009.


5 List of figures and tables Table 1: Summary of current and future bed requirements for Atherton Hospital .....................4 Table 2: Summary of current and future bed requirements for Mareeba Hospital.....................4 Figure 1: Map of Cairns and Hinterland Health Service District..................................................5 Table 3: Estimated resident population projections by age range for

Atherton Hospital catchment 2006–2026.....................................................................6 Table 4: Estimated resident population and projections by age range Mareeba SLA

2006–2021 ...................................................................................................................7 Table 5: Draft CSCF v3.0 service gap analysis for Atherton Hospital .......................................8 Table 6: Draft CSCF v3.0 service gap analysis for Mareeba Hospital.....................................10 Table 7: Summary of inpatient activity at Atherton Hospital 2004/05–2008/09 .......................11 Table 8: Separations (all age) by district of residence Atherton Hospital 2008/09 ..................11 Table 9: Top 10 all age Service Related Groups (SRGs) by separations at

Atherton Hospital 2008/09 .........................................................................................12 Table 10: Same day separations (all ages) for Atherton Hospital 2004/05–2008/09.................12 Table 11: Overnight beddays (all ages) for Atherton Hospital 2004/05–2008/09 ......................12 Table 12: Mareeba Hospital (all age) separations 2008/09 .......................................................13 Table 13: Top 10 (all ages) Service Related Groups (SRGs) at Mareeba Hospital in

decreasing order for separations in 2008/09 .............................................................14 Table 14: Same day separations (all ages) for Mareeba Hospital 2004/05–2008/09 ................14 Table 15: Overnight beddays (all ages) at Mareeba Hospital 2004/05–2008/09.......................14 Table 16: Current and projected births for District by statistical local area ................................15 Table 17: Surgical separations at Atherton Hospital 2004/05–2008/09.....................................16 Table 18: Surgical separations at Mareeba Hospital 2004/05–2008/09 ....................................16 Table 19: Medical separations at Atherton Hospital 2004/05–2008/09 .....................................17 Table 20: Medical separations at Mareeba Hospital 2004/05–2008/09.....................................17 Table 21: Renal haemodialysis separations by month at Atherton Hospital 2008/09................17 Table 22: Maternity and gynaecology occasions of service at Atherton Hospital

2004/05–2008/09 .......................................................................................................18 Table 23: Maternity and gynaecology occasions of service at Mareeba Hospital

2004/05–2008/09 .......................................................................................................18 Table 24: Births at Atherton Hospital 2004/05–2008/09 ............................................................18 Table 25: Births at Mareeba Hospital 2004/05–2008/09............................................................18 Table 26: Top 10 Service Related Groups (SRGs) for same day and overnight

paediatric separations at Atherton Hospital 2008/09 .................................................19 Table 27: Top 10 Service Related Groups (SRGs) for same day and overnight

paediatric separations at Mareeba Hospital 2008/09.................................................19 Table 28: Emergency Department (ED) separations at Atherton Hospital 2005–2009 .............20 Table 29: Mareeba Hospital Emergency Department presentations 2005–2009 ......................21 Table 30: Non-admitted occasions of service Atherton Hospital 2004/05–2008/09 ..................22 Table 31: Non-admitted occasions of service Mareeba Hospital 2004/05–2008/09..................22 Table 32: Medical Specialist Outreach Assistance Program provided services to the

Tablelands .................................................................................................................23 Table 33: Current and projected bed requirements for Atherton and Mareeba

Hospitals ....................................................................................................................26 Table 34: Current and projected other treatment space requirements for Atherton and

Mareeba Hospitals .....................................................................................................27

Documents

Service Profile for Atherton and Mareeba Hospitals€¦ · Atherton Hospital is a primary hub service located 81 kilometres south-west of the District’s major referral hospital