How diverse are public hospitals?

The 753 public hospitals are very diverse in size and the types of services provided for admitted and non-admitted patients (Table 2). The diversity of admitted patient services provided by each type can be gauged by the average number of diagnosis related groups reported (AR-DRGs). In 2009–10, there were:

• 75 Principal referral hospitals, located mainly in major cities, with at least one in each state and territory. They provided a wide range of services, including emergency department, outpatient and admitted patient services (including 5 or more separations for 454 AR-DRGs on average). These hospitals accounted for a total of 3.3 million separations or 65% of the total for public hospitals (Figure 3). There was a total of 10.9 million days spent by patients in these hospitals or 61% of the total for public hospitals (Figure 4).
• 11 Specialist women’s and children’s hospitals, located in Sydney, Melbourne, Brisbane, Perth and Adelaide. They recorded an average of 20,635 separations, specialising in maternity and other specialist services for women, and/or specialist paediatric services.
• 43 Large hospitals, 26 in Major cities and 17 in regional and remote areas. They provided emergency department, outpatient and admitted patient services, generally with a range of activities less than for the Principal referral hospitals (5 or more separations for 265 AR-DRGs), with an average of 15,190 separations per hospital.
• 92 Medium hospitals, 23 in major cities and 69 in regional areas. They delivered an average of 5,899 separations per hospital (with a narrower range of services than the Large hospitals). Most had accident and emergency services (rather than formal emergency departments) and some had outpatient clinics.
• 154 Small acute hospitals, 116 in regional areas and 38 in remote areas.  They delivered mainly acute care for admitted patients, with an average of 1,218 separations per hospital in the year, with a relatively narrow range of services. They generally did not have emergency departments although most provided accident and emergency services. 
• 17 Psychiatric hospitals, specialising in the treatment and care of people with mental health problems. They were located in Sydney, Melbourne, Brisbane, Perth, Adelaide and Hobart with 3 in regional Queensland centres.
• 8 specialist Rehabilitation hospitals, located in Sydney, Perth and Adelaide.
• 8 specialist Mothercraft hospitals, located in Sydney, Melbourne, Brisbane and Canberra.
• 83 Small non-acute hospitals, mainly in regional and remote areas. The services they provided tended to be mainly non-acute, so the average length of stay was longer than in the hospitals that provided mainly acute care.
• 78 Multipurpose services, mainly in regional and remote areas. These hospitals were generally combined with services for residential aged care, and mainly provide
  non-acute admitted patient care.
• 184 other hospitals, mainly small hospitals or particular specialist hospitals, such as hospices.

Figure 3: Separations for admitted patients, by public hospital type, 2009-10

Figure 4: Patient days for admitted patients, by public hospital type, 2009-10

The majority of beds were in larger hospitals and in more densely populated areas. In 2009–10, the largest public hospital had over 1,000 beds, but over 70% of hospitals had fewer than 50 beds.

The proportion of hospital beds in different size hospitals varied greatly by state. The Northern Territory did not have any public hospitals with either more than 500 beds or 10 beds or fewer. For Victoria, almost 40% of public hospital beds were in hospitals with 200 to 500 beds (Figure 5).

Figure 5: Proportion of beds by hospital size, states and territories, 2009-10