Overall, there were about 424,000 separations for sub- and non-acute admitted patient care in 2011-12. This care comprises Rehabilitation, Palliative, Psychogeriatric, Geriatric evaluation and management and Maintenance care, which together accounted for about 4.6% of separations and 16.5% of patient days in public and private hospitals.
Rehabilitation care was the most commonly provided sub- or non-acute care type and was associated with long stays. It accounted for 1.7% of all separations and 8.6% of patient days for public hospitals and 6.1% of separations and 12.0% of patient days for private hospitals.
The volume of these services increased from 2007-08 to 2011-12, particularly for Rehabilitation in private hospitals (18% per year) and Geriatric evaluation and management care in public hospitals (20% per year) (Figure 41).
Who used these services?
About 56% of sub- and non-acute separations were for females, and less than 30% were for people aged under 65 (Figure 42).
Less than 1.0% of sub- and non-acute separations were for Indigenous Australians, compared with 4.6% of admitted patient separations overall.
Persons usually resident in Major cities had 20 sub- and non-acute separations per 1,000 population, compared with 17 per 1,000 nationwide.
Sub- and non-acute separation rates varied by socioeconomic status, from 13 per 1,000 population for those classified as being in the lowest SES group to 26 per 1,000 for those classified as being in the highest SES group.
How did people access these services?
About 46% of sub- and non-acute separations began as either transfers from another hospital or occurred within the same hospital when the patient's type of care had changed (for example, from Acute care to Rehabilitation). This contrasts with only 5% of separations overall that were transferred from another hospital or were a care type change.
How urgent was the care?
Less than 4% of separations for sub- and non-acute care were reported as emergency admissions, compared with 27% of separations overall.
About 66% were reported as elective admissions and 30% were other planned care.
Why did people receive this care?
The most common principal diagnosis was for Care involving use of rehabilitation procedures (325,000 separations).
Looking at second diagnoses for separations involving Rehabilitation care, the most common were:
- arthrosis of the knee (about 57,000 separations)
- arthrosis of the hip (25,000 separations)
- fracture of femur (hip fracture, 17,000 separations).
For Palliative care, 64% of principal diagnoses were cancer-related.
What care did they receive?
About 1.0 million procedures or other interventions were reported for sub- and non-acute separations. About 82% of sub- and non-acute separations in public hospitals and 95% in private hospitals involved a procedure.
The most commonly reported procedures were allied health interventions, including:
- physiotherapy (330,000 separations)
- occupational therapy (189,000 separations)
- social work (100,000 separations).
How long did they stay?
The average length of stay for sub- and non-acute separations was 5.1 days in private hospitals and 18.4 days in public hospitals.
- For Rehabilitation care, the average length of stay was 4.6 days in private hospitals and 17.0 days in public hospitals.
- Separations for Maintenance care had the longest average length of stay (32.0 days), followed by Geriatric evaluation and management and Psychogeriatric care (18.0 and 15.8 days, respectively).
Who paid for the care?
In public hospitals, about 76% of sub- and non-acute separations were public patients, 16% were funded by private health insurance and 6% were funded by the Department of Veterans' Affairs.
In private hospitals, private health insurance funded about 80% of sub- and non-acute separations, and 11% were funded by the Department of Veterans' Affairs.
How was care completed?
Just over 76% of separations for sub- and non-acute care ended in discharge of the patient to their usual place of residence, compared with over 92% of all admitted patient separations.
About 8% ended in discharge or transfer of the patient to another hospital or other health care accommodation and a further 4% ended in discharge of the patient to a residential aged care service (that was not their usual place of residence), compared with about 1% overall.
- For Rehabilitation care 87% of patients were discharged to their usual place of residence, compared with 29% of patients for Palliative care (figures 43 and 44)
- More than half (59%) of Palliative care separations ended in the death of the patient.