• Print

Admission to hospital is a formal process. It follows a medical officer's decision that a patient needs to be admitted for appropriate management or treatment of their condition, or for appropriate care or assessment of their needs.

Admitted patient services are either provided on a same-day basis or involve a stay in hospital overnight or longer.

Separations and patient days (the number of days of care provided) are useful measures of admitted patient services.

How much activity was there?

The main measure of admitted patient care provided in Australian hospitals is the number of separations, or episodes of admitted patient care. Because separations can vary in length, another useful measure is patient days.

Separations

Between 2009–10 and 2013–14:

  • the number of separations increased by an average of 3.3% each year, faster than the population growth of about 1.6% over the same period
  • same-day separations accounted for around 59% of the total.

In 2013–14, there were about 9.7 million separations from Australian hospitals (Table 4):

  • 59% occurred in public hospitals, and half of these were same-day separations (2.9 million)
  • 41% occurred in private hospitals, and about two-thirds were same-day separations (2.6 million) (Figure 15).

Figure 15: Same-day and overnight separations, public and private hospitals, 2013-14

Image of a pie chart showing proportions of same-day and overnight separations for public and private hospitals. Same-day separations in public hospitals comprise 30%, overnight separations in public hospitals comprise 29%, same-day separations in private hospitals comprise 28%, and overnight separations in private hospitals comprise 13%.
Table 4: Separations ('000s), public and private hospitals, states and territories, 2013-14
Public and private hospitals NSW Vic Qld WA SA Tas ACT NT Total
Public hospitals
Public acute 1,766 1,509 1,087 595 415 113 97 124 5,705
Public psychiatric 5 <1 <1 1 1 1 .. .. 9
Total public hospitals 1,772 1,510 1,087 596 416 114 97 124 5,715
Private hospitals
Private free-standing day hospitals 213 217 224 134 74 n.p. n.p. n.p. 876
Other private hospitals 887 762 760 341 236 n.p. n.p. n.p. 3,112
Total private hospitals 1,100 979 984 475 310 n.p. n.p. n.p. 3,987
All hospitals 2,871 2,489 2,071 1,070 726 n.p. n.p. n.p. 9,702

.. not applicable, n.p. not published.

How does Australia compare?

The number of overnight separations per 1,000 population in Australia for 2013–14 was in the midd of the range reported for other Organisation for Economic Co-operation and Development (OECD) countries in recent years (Figure 16) (OECD 2014).

Differences in definitions of hospitals, collection periods and admission practices are likely to affect the comparability of international separation rates.

For more international comparisons, see Chapter 2 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 16: Overnight separations per 1,000 population, Australia, 2013-14 and selected OECD countries

Bar chart giving numbers of overnight separations per 1000 population for Australia and other nations. The nations given in order of number of separations from lowest to highest are: Mexico, Canada, Spain, USA, Italy, UK, New Zealand, Korea, Israel, Switzerland, France, Australia, Norway, Greece, Slovak Republic, Hungary, Germany, and Austria. Australia is positioned roughly in the middle of the graph with approximately 150 separations per 1000 population, between France and Norway.

Note: Data for OECD countries vary in collection periods, by financial year and calendar year. Data are for 2011 and 2012 except for Korea (2013) and Australia (2013–14).

Patient days

Between 2009–10 and 2013–14:

  • the number of patient days increased by an average of 1.4% each year—from 26.4 million to 27.9 million
  • the number of patient days in private hospitals increased by 2.3%, and the proportion of patient days that were in private hospitals increased from 31.3% to 32.5%.

In 2013–14, almost 27.9 million days of admitted patient care were spent in hospital and over two-thirds of these were in public hospitals (Table 5).

For more international comparisons, see chapters 2 and 6 of Admitted patient care 2013–14: Australian hospital statistics.

Table 5: Patient days ('000s), public and private hospitals, states and territories, 2013–14
Public and private hospitals NSW Vic Qld WA SA Tas ACT NT Total
Public hospitals
Public acute 6,225 4,638 3,153 1,783 1,471 357 333 308 18,267
Public psychiatric 241 53 156 45 38 24 557
Total public hospitals 6,465 4,691 3,309 1,828 1,509 381 333 308 18,824
Private hospitals
Private free-standing day hospitals 213 217 224 134 74 n.p. n.p. n.p. 876
Other private hospitals 2,275 2,160 2,058 810 568 n.p. n.p. n.p. 8,186
Total private hospitals 2,488 2,377 2,282 944 642 n.p. n.p. n.p. 9,062
All hospitals 8,953 7,068 5,591 2,772 2,151 n.p. n.p. n.p. 27,886

.. not applicable, n.p. not published.

Length of stay

Between 2009–10 and 2013–14, average lengths of stay for public acute and private hospitals fell slightly

  • from 3.6 to 3.3 days in public hospitals, an annual average decrease of 2.0%
  • from 2.4 to 2.3 days in private hospitals, an annual average decrease of 1.2%.

In 2013–14, the average length of stay was generally higher for subacute and non-acute care than for acute care. The average length of stay was:

  • 2.8 days in public hospitals and 2.1 days in private hospitals for acute care (Figure 17)
  • 16.2 days in public hospitals and 4.4 days in private hospitals for rehabilitation care.

Figure 17: Average length of stay (days) by care type, public and private hospitals, 2013–14

Image of a bar chart showing the average length of stay in days by care type for both public and private hospitals. Average length of stay for acute care is approximately 3 days in public hospitals and 2 days in private hospitals. Rehabilitation care is approximately 16 days in public hospitals and 4 days in private hospitals. Palliative care is approximately 11 days in public hospitals and 12 days in private hospitals. Other subacute and non-acute care is approximately 23 days in public hospitals and 10 days in private hospitals.

For patients who spent at least 1 night in hospital, the average length of stay was 5.7 days for public hospitals and 5.1 days for private hospitals.

For more information on length of stay, see chapters 2 and 4 of Admitted patient care 2013–14: Australian hospital statistics.

Performance indicator: relative stay index

Relative stay indexes summarise the length of stay for admitted patients, with adjustments for 'casemix' (the types of patients treated and the types of treatments provided) They are regarded as indicators of the efficiency of hospitals.

A relative stay index greater than 1.0 indicates that an average patient's length of stay is higher than expected, given the casemix for the separations being considered A relative stay index of less than 1.0 indicates that the length of stay was less than expected.

Overall in 2013–14, the relative length of stay was lower in public hospitals than in private hospitals.

There were relatively shorter lengths of stay for Medical separations in public hospitals (0.94, compared with 1.28 in private hospitals), and for Surgical separations in private hospitals (0.99, compared with 1.03 in public hospitals) (Figure 18).

For more information on relative stay indexes, see Chapter 2 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 18: Relative stay index (directly standardised), for medical, surgical and other care, public and private hospitals, 2013–14

Bar chart giving the relative stay index for medical, surgical, and other care in public and private hospitals. In all hospitals, the relative stay index is approximately 1.0 in all categories.

Performance indicator: average length of stay for selected types of separations

The average length of stay for selected types of separations is regarded as an indicator of the efficiency of hospitals.

There were notable differences (more than 1 day) in the average length of stay between public and private hospitals for seven of these types of separations .The average length of stay for chronic obstructive airways disease without catastrophic complications or comorbidities was 4.1 days for public hospitals and 7.4 days for private hospitals (Figure 19).

For more information on length of stay, see Chapter 2 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 19: Average length of stay (days) for selected types of separations, public and private hospitals, 2013–14

Image of a bar chart showing the average length of hospital stay in public and private hospitals for various separation types. For most cases, average length of stay in private hospitals is either around the same or a few days longer than in public hospitals. The shortest average stay in both public and private is around 1 day for tonsillectomy and/or adenoidectomy. The longest for public hospitals is around 6 days for hip replacement without CCC, while the longest for private hospitals is around 7 days for chronic obstructive airways disease without catastrophic CC.

CC—complications and/or comorbidities; CCC—catastrophic complications and/or comorbidities; CSCC—catastrophic or severe complications and/or comorbidities.

Who used these services?

Age group and sex

Between 2009–10 and 2013–14:

  • separations for people aged 65 to 74 increased by 26% overall, an average annual increase of 6% each year
  • separations for persons aged 85 and over increased by 28%, an average increase of 6% each year, faster than the population growth for this age group which was about 4.3% each year over the same period.

In 2013–14, there were 5.1 million separations for females and 4.6 separations for males. Overall:

  • 40% of separations were for people aged 65 and over (Figure 20) (people aged 65 and over make up 13% of Australia's population), accounting for 48% of patient days
  • 53% of separations were for females. Women aged 15 to 45 accounted for about 65% of separations for this age group.

Figure 20: Separations, by age group and sex, all hospitals, 2013–14

Image of a bar chart showing numbers of separations by age group and sex for all hospitals. The smallest group is females aged 10-14 with around 50000 separations. The largest group is males aged 65-69 with around 450000 separations.

Aboriginal and Torres Strait Islander people

In 2013–14, Aboriginal and Torres Strait Islander people were hospitalised at over twice the rate of other Australians (after accounting for age).

Aboriginal and Torres Strait Islander people were hospitalised:

  • almost 2 times as often for overnight stays (Figure 21)
  • almost 3 times as often for same-day care. However, if care for dialysis is excluded, Indigenous Australians were hospitalised for same-day care at a lower rate than for other Australians.

Figure 21: Separations per 1,000 population, by Indigenous status, all hospitals, 2013–14

Image of a bar chart showing separations per 1000 population for Indigenous and other Australians in all hospitals. For same-day  care including dialysis, Indigenous Australians account for approximately 600 separtions per 1000 population while other Australians account for 200 per 1000 population. For same-day care excluding dialysis both Indigenous and other Australians account for between 100 and 200 separations per 1000 population. For overnight care, Indigenous Australians account for approximately 250 separations per 1000 population while other Australians account for approximately 150.

Remoteness

Remoteness area categories divide Australia into areas depending on distances from population centres. Access to services can be measured by the number of separations per 1,000 population.

In 2013–14:

  • overall, separation rates were highest for persons living in Very remote areas
  • for public hospitals, the rates were highest for patients living in Very remote areas and lowest for patients living in Major cities (Figure 22)
  • for private hospitals, the rates were highest for patients living in Major cities and lowest for patients living in Very remote areas
  • the overnight separation rate in Very remote areas was 60% higher than the national rate.

Figure 22: Separations per 1,000 population, by remoteness area of usual residence, public and private hospitals, 2013–14

Image of a bar chart showing numbers of separations per 1000 population for public and private hospitals by the remoteness area of the patient's usual residence. The categories of remoteness are: major cities, inner regional, outer regional, remote, and very remote. As remoteness increases, separations for public hospitals increase and separations for private hospitals decrease.

Socioeconomic status

Data describing where patients live can be used to derive an approximation of their socioeconomic status which, in turn, can be categorised into five equal population groups of socioeconomic disadvantage/advantage. If use of admitted patient services is equal for all socioeconomic status groups, we would expect an equal number of separations for each group.

Overall, separations varied across the socioeconomic status groups and between public and private hospitals.

In 2013–14:

  • for public hospitals, the rates were highest for patients living in areas classified as the lowest socioeconomic status group (Figure 23)
  • for private hospitals, the rates were highest for patients living in areas classified as the highest socioeconomic status group.

Figure 23: Separations per 1,000 population, by socioeconomic status of area of usual residence, public and private hospitals, 2013–14

Image of a bar chart showing numbers of separations per 1000 population for public and private hospitals by the patient's socioeconomic group. As the socioeconomic group rises, separations for public hospitals decrease and separations for private hospitals increase.

Why did people receive care?

The reason that a patient receives admitted patient care can be described in a number of ways. These include the mode and urgency of admission, the type of care required and the principal diagnosis.

Mode of admission

Mode of admission can be categorised as:

  • Admitted patient transferred from another hospital
  • Statistical admission: care type change (a new admitted patient episode is created as a result of a change of clinical intent of care within the same hospital)
  • New admission to hospital (all other planned and unplanned admissions where a patient was not transferred from another hospital did not have a Statistical admission in the same hospital).

In 2013–14:

  • 94% of separations in public and private hospital had a mode of admission of New admission to hospital
  • public hospitals reported about 5% of patients transferred from another hospital compared with about 3% in private hospitals.

Urgency of admission

Admissions to hospital can be categorised as Emergency (required within 24 hours), or Elective (required at some stage beyond 24 hours). Urgency is not assigned for some admissions (for example, obstetric care and planned care, such as dialysis).

In 2013–14:

  • private hospitals accounted for about 59% of Elective admissions and public hospitals accounted for about 92% of Emergency admissions
  • 2 out of 5 public hospital separations were emergency admissions
  • 1 out of 20 private hospital separations were emergency admissions (Figure 24).

For more information see Chapter 4 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 24: Separations by same-day/overnight status and urgency of admission, 2013–14

Image of a stacked bar chart showing numbers of separations for public and private hospitals based on their time status and urgency of admission. The categories given are: same-day emergency, same-day elective, same-day other, overnight emergency, overnight elective, and overnight other. In both public and private hospitals, the category with the most separations was same-day elective, with around 2 million separatons. Public hospitals also had a large number of separations in the overnight emergency category with around 2 million separations. Private hospitals had a total of approximately 2 million fewer separations than public hospitals.

Care type

The care type can be classified as:

  • Acute care, or
  • Subacute and non-acute care (such as Rehabilitation, Palliative care, Geriatric evaluation and management, Maintenance care and Psychogeriatric care).

Most hospital separations are for acute care, that is, care with the intent to cure the condition, alleviate symptoms or manage childbirth.

Between 2009–10 and 2013–14:

  • the care types with the highest average increase per year were Geriatric evaluation and management in public hospitals and Rehabilitation in private hospitals
  • the number of separations for acute care increased on average by 2.9% per year for public hospitals and by 3.2% for private hospitals
  • Rehabilitation consistently accounted for about three quarters of subacute and non-acute separations.

In 2013–14:

  • acute care was reported for 9.2 million separations and accounted for:
    • 95% of separations (Figure 25) and 84% of patient days (Figure 26) overall
    • 92% of separations and 85% of patient days for private hospitals
  • subacute and non-acute care accounted for about 5% of all separations and 17% of patient days.

Figure 25: Separations by care type, public and private hospitals, 2013–14

Image of a pie chart showing proportions of separations by care type. Public acute care separations comprise 57%, private acute care separations comprise 38%, private subacute and non-acute care separations comprise 3%, and public subacute and non-acute care separations comprise 2%.

Figure 26: Patient days by care type, public and private hospitals, 2013–14

Image of a pie chart showing proportions of patient days by care type. Public acute care patient days comprise 56%, private acute care patient days comprise 28%, public subacute and non-acute care patient days comprise 12%, and private subacute and non-acute care patient days comprise 5%.

Principal diagnosis

The reason that a patient receives admitted patient care can be described in terms of a principal diagnosis or as a treatment for an ongoing condition (for example, dialysis for kidney failure).

In 2013–14:

  • over 2.6 million separations had a principal diagnosis in the ICD-10-AM chapter titled Factors influencing health status and contact with health services—which includes dialysis, rehabilitation, radiotherapy, chemotherapy and palliative care
  • the most common single reason for care was dialysis for kidney disease
  • the most common principal diagnoses reported for overnight acute separations in public hospitals were Single spontaneous delivery and Single delivery by caesarean section followed by Pain in throat and chest
  • the most common principal diagnosis for same-day acute separations in public and private hospitals was Care involving dialysis.

For more information about common principal diagnoses, see the Infographic: Australia's hospitals 2013–14: at a glance (1.8MB PDF) .

For more information on principal diagnoses for same day and overnight acute separations see Chapter 4 of Admitted patient care 2013–14: Australian hospital statistics.

Injury and poisoning

In 2013–14 about 6% of separations (624,000) were for injury or poisoning. The majority (81%) were treated in public hospitals. About 45% of these separations were for injuries to arms and legs.

Indigenous Australians were hospitalised for injury or poisoning at about twice the rate for other Australians.

Performance indicator: potentially preventable hospitalisations

Potentially preventable hospitalisations are separations that are thought to have been avoidable if timely and adequate non-hospital care had been provided, either to prevent the condition occurring, or to prevent the hospitalisation for the condition .They are identified based on the diagnoses reported for admitted patients and divided into three categories—vaccine-preventable, acute and chronic conditions.

Between 2009–10 and 2013–14:

  • rates of individual potentially preventable hospitalisations fluctuated, however the overall rate fell from 25.3 per 1,000 population to 24.4 per 1,000 population
  • rates of vaccine-preventable separations increased by 16%
  • for chronic conditions, the rate decreased from 13.4 per 1,000 population to 11.2 per 1,000 population.

In 2013–14:

  • 600,000 separations were thought to be potentially preventable—6.2% of all hospital separations
  • for Indigenous Australians, the overall rate of potentially preventable hospitalisations per 1,000 population was over 3 times the rate for other Australians
  • people living in Very remote areas had the highest rates of potentially preventable hospitalisations for chronic and acute conditions (Figure 27)
  • the overall rate generally decreased with increasing levels of socioeconomic advantage.

For more information on potentially preventable hospitalisations, see Chapter 4 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 27: Potentially preventable hospitalisations by remoteness area of usual residence, all hospitals, 2013–14

Image of a bar chart displaying numbers of separations per 1000 population for different types of potentially preventable hospitalisations by the remoteness of the patient's usual residence. The categories of remoteness are: major cities, inner regional, outer regional, remote, and very remote. For all levels of remoteness, the largest category of potentially preventable hospitalisation is 'acute'. As remoteness increases, numbers of separations for potentially preventable hospitalisations also increase.

Performance indicator: waiting for residential aged care

This indicator reports the number of hospital patient days taken up by Australians waiting for a residential aged care place .

In 2013-14:

  • about 9.5 patient days per 1,000 patient days were for patients waiting for a residential aged care place
  • waiting times were highest for patients residing in Very remote areas and for those in the two lowest socioeconomic status groups .

What services were provided?

Broad category of service

The broad categories of admitted patient service include Childbirth, Specialist mental health, Medical (not involving a procedure), Surgical (involving an operating room procedure), or a non-surgical procedure, such as endoscopy (Other).

In 2013-14:

  • 70% of public hospital separations were for Medical care, and 4% were for Childbirth (Figure 28)
  • 36% of private hospital separations were for Surgical care. Specialist mental health care was provided for 4% of private hospital separations
  • about 45% of same-day acute separations were for Non-emergency medical care and about 39% of overnight acute separations were for Emergency medical care.

Figure 28: Separations ('000) by broad category of service, public and private hospitals, 2013-14

Image of a stacked bar chart showing numbers of separations by service categories for public and private hospitals. The service categories are: non-surgical procedure, childbirth, specialist mental health, medical and surgical. For both public and private hospitals, the largest category is medical, although public hospitals had around 4 million medical separations while private hospitals had around 1.5 million. Private hospitals had a total of approximately 2 million fewer separations than public hospitals.

Intensive care

An intensive care unit can provide complex, multisystem life support. These units are located in tertiary referral centres and provide continuous mechanical ventilation, extracorporeal renal support and invasive cardiac monitoring for children or adults.

In 2013-14:

  • about 127,000 separations involved a stay in an intensive care unit and 30% of these included a period of ventilator support
  • the average duration of stay in an intensive care unit was almost 4 days in public hospitals and just over 2 days in private hospitals.

Rehabilitation care

Rehabilitation care, aimed at improved functioning, accounted for 1.7% of separations and 8.6% of patient days for public hospitals, and 6.3% of separations and 12.4% of patient days for private hospitals.

Between 2009-10 and 2013-14 Rehabilitation care increased by an average of 11% per year in private hospitals and by 5% per year in public hospitals.

In 2013-14:

  • 355,000 separations were reported for Rehabilitation care, with 72% occurring in private hospitals
  • the most common reasons for Rehabilitation care were osteoarthritis of the knee and hip and about 80% of separations for Rehabilitation care were for people aged over 60.

Palliative care

Palliative care is care in which the primary clinical purpose or treatment goal is to optimise the quality of life of a patient with an active and advanced life-limiting illness.

In 2013-14:

  • there were almost 39,000 separations for Palliative care
  • Indigenous Australians had almost twice the separation rates for Palliative care than other Australians
  • the rate of Palliative care in public hospitals varied from 0.9 per 1,000 population for people living in areas classified as the highest socioeconomic status group to 1.5 per 1,000 for people living in areas classified as being in the lowest socioeconomic status group
  • about 60% of Palliative care separations had a principal diagnosis related to neoplasm, other common principal diagnoses included heart failure and respiratory disorders.

How was the care completed?

Overall, about 92% of admitted patients are discharged home (to their place of usual residence) at the end of their episode of care. Almost 6% are transferred to some other health care accommodation, including another hospital. Less than 1% died.

In 2013–14, 95% of separations from private hospitals had a mode of separation of Discharged home compared with 89% in public hospitals (Figure 29). However, a larger proportion of separations from public hospitals were discharged to some other health care accommodation, including another acute or psychiatric hospital, residential aged care or other health care accommodation.

For more information about how the care was completed, see Chapter 5 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 29: Proportion of separations by mode of separation, public and private hospitals, 2013–14

Image of a stacked bar chart showing proportions of separations in public and private hospitals by mode of separation. For both public and private, over 85% of separations are cases of patients discharged home. 'Discharge/transfer to other health care' is the next largest category with around 5-8% for both public and private. 'Died' and 'other' make up a very small proportion of the chart in both public and private.

What procedures were performed?

Procedures reported for admitted patients can include surgical procedures, non operating-room procedures, procedures of a patient support nature and other interventions.

In 2013–14:

  • about 19.1 million procedures were reported, 9.8 million in public hospitals and 9.2 million in private hospitals
  • about 75% of public hospital separations and 95% of private hospital separations involved a procedure.

Performance indicator: rates of selected hospital procedures

The rates for these hospital procedures are presented as an indicator of appropriateness and may also be indicators of accessibility of care .

Figure 30 presents separations per 1,000 population for selected hospital procedures The national rate is accompanied by the range of rates for these procedures by state or territory. There was some variation among states and territories for the selected procedures. For example, the national rate for cataract extraction was 8.9 per 1,000 population, but the state/territory rate ranged from 7.4 per 1,000 to 10.6 per 1,000 population.

For more information on surgical procedures, see Chapter 6 of Admitted patient care 2013–14: Australian hospitals statistics.

Figure 30: Separations per 1,000 population for selected hospital procedures, all hospitals, 2013–14

Image of a bar chart showing numbers of separations per 1000 population for various hospital procedures in all hospitals. The national rate is given as well as the range of state and territory rates. The procedures given are: varicose veins stripping and ligation, tonsillectomy, septoplasty, prostatectomy, myringotomy (with insertion of tube), knee replacement, inguinal herniorrhaphy, hysterectomy (females aged 15-69), hip replacement, haemorrhoidectomy, cystoscopy, coronary artery bypass graft, coronary angioplasty, cholecystectomy, and cataract extraction. The procedure with the fewest separations is coronary artery bypass graft, and the procedure with the most separations is cataract extraction.

Who paid for the care?

In 2013–14:

  • 50% of all separations were for public patients, who were not charged for their stay
  • 42% of separations were funded by private health insurance
  • about 4% of separations were self-funded.

For more information about admitted patient funding sources, see Chapter 7 of Admitted patient care 2013–14: Australian hospital statistics.

What was the safety and quality of the care?

Some information is available on the safety and quality of admitted patient care in hospitals, but this does not provide a complete picture. There is no routinely available information on some aspects of quality, such as continuity or responsiveness of hospital services.

Performance indicator: adverse events

Adverse events are defined as incidents in which harm resulted to a person receiving health care .They include infections, falls resulting in injuries, and problems with medication and medical devices. Some of these adverse events may be preventable .

In 2013–14:

  • 5.6% of separations reported a diagnosis or external cause that indicated an adverse event had resulted in, or affected hospital admission
  • adverse events were indicated for 6.7% of public separations and 4.1% of private hospital separations.

The number of separations that reported an adverse event per 100 separations was generally higher for:

  • overnight separations—11.6% in public hospitals and 10.1% in private hospitals (Table 6)
  • subacute and non-acute care (for which lengths of stay are typically longer)—10.5% compared with 5.4% for acute care separations
  • emergency admissions—9.9% compared with 4.1% for non-emergency admissions.
Table 6: Separations with an adverse event per 100 separations, public and private hospitals, 2013–14
Separations Public hospitals Private hospitals Total
Separations with an adverse event 381,734 164,810 546,544
Separations with an adverse event per 100 separations
Same-day separations 2.0 1.5 1.7
Overnight separations 11.6 10.1 11.2
Acute care separations 6.4 3.9 5.4
Sub- and non-acute care separations 15.1 7.2 10.5
Emergency admission 9.7 12.3 9.9
Non-emergency admission 4.5 3.7 4.1
Total 6.7 4.1 5.6

For more information on separations with adverse events, see Chapter 8 of Admitted patient care 2013–14: Australian hospital statistics.

Performance indicator: Falls in hospital

In 2013–14, more than 30,000 separations reported a fall resulting in harm that occurred in a health care service area. More falls per 1,000 separations were reported for public hospitals (4.2) than for private hospitals (1.6).

Performance indicator: unplanned readmissions

Unplanned or unexpected readmissions within 28 days of surgery are identified as those with a principal diagnosis related to an adverse event.

In 2013–14:

  • rates of unplanned or unexpected readmissions were highest for Tonsillectomy and adenoidectomy, Prostatectomy and Hysterectomy (Figure 31)
  • for Cataract extraction, fewer than 4 per 1,000 separations were followed by a readmission within 28 days.

For more information on unplanned or unexpected readmissions, see Chapter 8 of Admitted patient care 2013–14: Australian hospital statistics.

Figure 31: Unplanned/unexpected readmissions within 28 days of selected surgical procedures, public hospitals, 2013–14

Image of a bar chart showing numbers of unplanned or readmissions to public hospitals per 1000 separations within 28 days of various surgical procedures. The procedures given are: cataract extraction, hip replacement, knee replacement, appendicectomy, hysterectomy, prostatectomy, and tonsillectomy and adenoidectomy. Cataract extraction has the fewest readmissions, with only around 3 per 1000 separations. Tonsillectomy and adenoidectomy has the most readmissions with around 33 per 1000 separations.

Performance indicator: healthcare-associated infections— Staphylococcus aureus bacteraemia in public hospitals

Staphylococcus aureus bacteraemia (SAB), also known as golden staph bloodstream infection, is an important measure of the safety of hospital care . The aim is to have as few cases of SAB as possible . One of the most effective ways to minimise the risk of SAB and other healthcare-associated infections is good hand hygiene.

In 2013–14:

  • 1,621 cases were reported for public hospitals over 18.6 million days of patient care under surveillance
  • all states and territories had SAB rates below the national benchmark of 2.0 cases per 10,000 days of patient care (Figure 32)
  • more than three-quarters of SAB cases were methicillin sensitive, and would have been treatable with commonly used antibiotics.

Figure 32: Cases of Staphylococcus aureus bacteraemia per 10,000 days of patient care in public hospitals, states and territories, 2013–14

Image of a bar chart showing numbers of cases of SAB per 10000 days of patient care in different states and territories. All are between 0.7 cases and 1.3 cases per 10000 days of patient care. ACT has the most cases and NT has the fewest.

For more information, see Staphylococcus aureus bacteraemia in Australian public hospitals 2013–14: Australian hospital statistics (AIHW 2014d).