Ambulance Victoria

Ambo-AODstats

Introduction

Welcome to Ambo-AODstats, Victoria’s interactive monitoring tool for alcohol and drug trends.

Ambo-AODstats provides statistics and maps on alcohol and drug-related events attended by ambulance in Victoria, using data from Turning Point’s “Ambo Project: Alcohol and Drug-Related Ambulance Attendances.” It delivers the most recent available information and is a convenient statistical and epidemiological resource for policy planners, drug service providers, health professionals and other key stakeholders.

Background

The Ambo Project is an ongoing monitoring project undertaken by Turning Point since 1998, in collaboration with Ambulance Victoria and funded by the Victorian Department of Health and Human Services. Previous annual reports were published online in pdf format. Prospective annual reporting will be modelled on AODstats, utilising online interactive platforms to improve timeliness and usefulness of the data.

How to use Ambo-AODstats

A user guide on how to use the interactive maps is available here: Ambo-AODstats Userguide [PDF file]

Permitted uses of Ambo-AODstats

You may use data from Ambo-AODstats provided that you do so for a purpose that is reasonably related to the aims for which Ambo-AODstats has been developed, and that you acknowledge that the source of the information is Ambo-AODstats and that it is owned by Turning Point.

Launch Ambo-AODstats

Click on the links below to launch each of the three maps (LGA map, State map and Metro/Regional map).

Launch Ambo-AODstats Local Government Area (LGA) map

Launch Ambo-AODstats Victoria State map

Launch Ambo-AODstats Metro_Regional map

Last updated: 30 November 2016

Data source

Data for Ambo-AODstats have been sourced from the Turning Point Ambo Project, which examines alcohol- and other drug-related events that are attended by ambulance paramedics. Fatal heroin overdoses were increasing in Victoria in the late 1990’s (Dietze et al 2001), and in response to increasing concern about the prevalence of overdose, this project was established to examine non-fatal heroin overdoses using ambulance service records (Dietze et al 1998). Inclusion of alcohol, pharmaceutical drugs and illicit substances other than heroin expanded the reach of the research. Importantly, this project provides consistent, detailed and timely data on harms associated with alcohol and other drug (AOD) use, not captured by other data systems.

More information on the data sources and methods used can be found here: Ambo-AODstats Methods [PDF file]

Project Database

In 1997, following discussions with the Metropolitan Ambulance Service (now Ambulance Victoria), Turning Point established this project to comprehensively examine non-fatal heroin overdose in metropolitan Melbourne. Preliminary data demonstrated the value of ambulance records for surveillance and the database was expanded from June 1998 to include ambulance attendances involving AOD other than heroin. Data for regional Victoria became available in mid-2011. The database has in excess of 500,000 records from 1st June 1998. Data may vary slightly from that published earlier due to ongoing data review. Fatal events are now included, although they will be under-reported. Drug-related deaths are more completely described in other systems, such as coronial records (see AODstats website).

Ambulance Victoria

Ambulance Victoria (AV) is the Victorian Government enterprise charged with the state-wide role of ensuring that the people of Victoria receive the most appropriate response to personal and community medical emergencies, and medical transport. It is a critical link in Victoria’s healthcare and emergency management systems. Ambulance Victoria operates across the state, with major administrative centres in Melbourne and Ballarat. It employs approximately 3,000 career paramedics supported by approximately 1,000 volunteers. Air ambulance services are provided by 4 fixed wing and 5 helicopter aircraft delivering fast access for rural communities to major specialist facilities in the metropolitan region. Ambulance Victoria also provides adult medical retrieval services staffed by medical personnel and utilise advanced tele-health systems. In servicing the community, Ambulance Victoria is supported by other organisations, including AV auxiliaries, the Emergency Services Telecommunications Authority (ESTA), Victoria Police, Country Fire Authority (CFA), Metropolitan Fire Brigade (MFB), and health care providers. Ambulance Victoria aims to improve the health of the community by delivering innovative, high-quality ambulance services. Research is integral to Ambulance Victoria achieving its vision for better health in the community.

Data Release

Data will typically be presented across a ten year period (where available), retrospectively analysed and updated on a yearly basis. This means that each year, new ambulance data will be added as it becomes available and existing data will be amended where required.

Analysis

Analysis of ambulance attendances involving AOD in Victoria were included with twenty drug categories examined:

  1. Alcohol intoxication (with or without other drugs)
  2. Alcohol only (intoxication without other drugs)
  3. Any Illicit drug (any one or more of amphetamines, cannabis, GHB, heroin, inhalants, stimulants hallucinogens)
  4. Amphetamines (all types)
  5. Crystal methamphetamine
  6. Cannabis
  7. GHB
  8. All Heroin
  9. Heroin overdose (with response to naloxone)
  10. Other heroin (without naloxone administration or response)
  11. Inhalants (includes volatile substances)
  12. Other Stimulants (excludes amphetamines)
  13. Hallucinogens
  14. Any pharmaceutical (any one of antidepressants, antipsychotics, anticonvulsants, benzodiazepines, opioids, opioid pharmacotherapy, other analgesics, pharmaceutical stimulants or other medications)
  15. Antidepressants
  16. Antipsychotics
  17. Benzodiazepines
  18. Opioids
  19. Opioid Pharmacotherapy
  20. Other analgesics

References:

  • Dietze PM, Fry C, Rumbold G, Gerostamoulos J. The context, management and prevention of heroin overdose in Victoria, Australia: The promise of a diverse approach. Addiction Research & Theory. 2001;9(5):437-58.
  • Dietze PM, Cvetkovski S, Rumbold G, Miller P. Non-fatal Heroin Overdose in Melbourne: Establishment and Analysis of a Database of Ambulance Service Records Project Report 1997/1998. Fitzroy, Victoria: Turning Point Alcohol and Drug Centre, 1998.

Acknowledgements

We would like to thank Ambulance Victoria for access and provision of Ambulance data for use in the maps.

Investigators

  • Dr. Belinda Lloyd
  • Ms Jessica Killian
  • Ms. Sharon Matthews
  • Dr. Cherie Heilbronn
  • Dr. Gennady Baksheev
  • Mr. Mark Hoffmann

Project Staff

Staff members from Turning Point’s Population Health Research Team who have coded ambulance data for alcohol and drug involvement and also been involved with any analysis and data extraction.

Project Sponsor

Victorian Department of Health and Human Services

Software

The mapping software used is StatPlanet Plus v3.3 (for more information see http://www.statsilk.com/)

Frequently Asked Questions

How is drug involvement/overdose determined in ambulance data?

The attribution of a drug or substance as being involved in the event is formed on the basis of ambulance paramedic mention of the involvement of these substances, established through paramedic clinical assessment, patient self-report or information provided by someone else at the scene, such as family or associates. The core criterion project staff use in determining the involvement of a drug or substance is: “Is it reasonable to attribute the immediate or recent (not merely chronic) over- or inappropriate ingestion of the substance or medication as significantly contributing to the reason for the Ambulance Victoria attendance?”

Which drugs are classified as an illicit drug?

An illicit drug is any one of the following:

  1. Amphetamines (all types)
  2. Cannabis
  3. GHB
  4. Heroin
  5. Inhalants
  6. Other Stimulants (excluding amphetamines and pharmaceutical stimulants)
  7. Hallucinogens
  8. Ketamine
  9. Synthetic cannabinoids
  10. Emerging psychoactive substancese

Which drugs are classified as a pharmaceutical drug?

A pharmaceutical drug is any one of the following:

  1. Antidepressant
  2. Antipsychotic
  3. Anticonvulsant
  4. Benzodiazepine
  5. Analgesics
  6. Opioid
  7. Opioid pharmacotherapy
  8. Pharmaceutical stimulant
  9. Other medication

How do I get state or metropolitan/regional totals for comparison against LGA totals?

Currently state totals are provided in a separate map on the Ambo-AODstats website, as are metropolitan/regional totals. You need to go to the Ambo-AODstats home page and then select the Victoria State map or the metro/regional map.

Can I download all data at once, rather than by individual category or individual year?

Yes, you can download all the data at once (e.g. all years and categories for attendances). To do this you need to first select your indictor and then in the bottom left corner there is a table icon which you select. You can then select the ‘Show all years’ box and “Show all indicators” box and this will give you all the years and categories (i.e. Male, Female, Age) for that drug type.

Can I compare across drug types?

No, it is not possible to compare across drug types as there are often multiple drugs involved and therefore drugs cannot be added together.

The numbers presented on Ambo-AODstats for alcohol and drug categories (‘illicit’, ‘pharmaceutical’ and their sub-categories) are not mutually exclusive. Alcohol intoxication cases might also be positive for one or more other drugs, and vice versa, and are included in all relevant categories. The exception to this rule is for Alcohol Only, which is a subset of alcohol intoxication and is for cases relating to alcohol only with no other drugs involved in the attendance.

How are rates calculated and are they crude rates or age/standardised?

Rates are crude rates using the most recent Australian Bureau of Statistics (ABS) estimated resident population (ERP) data. For a calendar year the ERP used is of the same year (taken at June – e.g. 2015 data uses June 2015 ERP). For a financial year the ERP used is that of the beginning of the financial year (e.g. 2014-15 data uses June 2014 ERP).

Crude rates allow for adjustment of population size across different areas. However, they do not adjust for certain demographic attributes (specifically age and sex). From a public health perspective there are advantages to standardising for age and/or sex, as it allows comparisons across areas to be made more accurately. However, from a policy perspective, knowing what is impacting the rates is equally important. Given that age and gender are key contributors to alcohol harms and use, if an area has more or fewer men and younger people than other areas, this information is important in terms of developing and delivering targeted policies and services.

Do you have data on ethnicity and other demographic information?

Many indicators do not collect other demographic information such as ethnicity and so this data is typically not available.

How do you download the data from Ambo-AODstats?

There are several ways to download data from Ambo-AODstats. Click the symbol export icon (Export) from the Menu on the bottom-left of the Main page. Alternatively, you can click ‘Data Table’ symbol, table icon, from the main menu. Another option is to right-click on any area on the screen and then select ‘Copy data’.

Further details of how to download data can be found in the User Guide, which is downloadable from the Ambo-AODstats website.

How frequently/when is the data updated?

New ambulance data will be added to Ambo-AODstats on an annual basis and existing data will be amended where required. Please see the table on the ‘Data’ tab on the homepage for details on data release.

When I download the data, why are some cells blank?

Statistics based on numbers less than five are not report and therefore do not show up in downloaded data. However, where a number is less than five, it will show up in the data box when hovering over the map area as “<5”. Also, statistics have been masked where a category could be calculated by subtracting from the total. These will also be indicated when hovering over the map area.

Can I look at various specific/individual areas that are from various pre-determined regions or can I create my own regions?

Nine pre-determined regions have already been created for you and these include the eight Victorian health regions and a metropolitan region. These can be found in the Regions pull-down menu in the top right hand corner of the website.

Yes, it is possible to select a group of areas and to create a Custom region based on this selection. The easiest way to create a region can be by clicking directly on the Map, or selecting from the Region selector panel. To create the Custom region, click on the green tick icon located on the top left of the Region selector panel. The panel will only list the selected regions. Further information on Custom Regions can be found in the User Guide.

What’s the different between an area having “0” or having “No data”?

The number ‘0’ indicates that there are no cases for this area in the year selected (i.e., on which the slider is). The term ‘No data’ in the map legend refers to numbers less than five for the selected year. It is important to note that an area with ‘No data’ label may actually have zero or more than four cases for the years that are not selected. As such, the graph will show data points for those years.

Can I see changes over time on the one map?

Yes, changes over time can be seen using the time-scale bar. The Play button play icon on the right will cycle through the time period available from the earliest year to the most recent year, and animate the graph and the map. This can be useful to see whether a particular region has changed its position relative to other regions over time.

Can I customise the maps or graphs?

Yes, there is an options menu, which can customise the maps and graphs to suit your needs. The spanner icon spanner icon will allow you to do this.

Are the data for residential location or event/scene location?

Ambulance attendances are presented by event/scene location.

What determines the upper (e.g. > XX) and lower (e.g. < XX) boundaries of the key and why aren’t they the same for each area (e.g. why aren’t all > 100 or > 50, and < 5)?

By default, StatPlanet determines the best-fit values for each graduation in the legend, and therefore the upper and lower boundaries for a distribution. This can be modified choosing Options->Map and checking the box named ‘Legend: show maximum & minimum values’.

Contact us

Please email us if you have any questions or requests concerning our services.

Email: ambo.aodstats@turningpoint.org.au

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AODstats

AODstats provides information on the harms related to alcohol, illicit and pharmaceutical drug use in Victoria using a wide range of data sources. Please visit AODstats for AOD data using indicators other than Ambulance data.

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