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In 2010–11, over a quarter of the 8.9 million hospitalisations (separations) in Australia’s public and private hospitals included a visit to an operating room for surgery. This bulletin provides an overview of these 2.4 million hospitalisations involving surgery.

This information was sourced from the AIHW’s National Hospital Morbidity Database and National Elective Surgery Waiting Times Data Collection.

How much surgery occurred in 2010–11?

In 2010–11, over one-quarter of all hospitalisations involved surgery. There were 1.0 million episodes in public hospitals and 1.4 million in private hospitals.

Between 2006–07 and 2010–11, hospitalisations involving surgery increased by an average of 2.4% for public hospitals and 4.1% for private hospitals each year. Between  2009–10  and 2010–11,  the increase was higher for public hospitals than for private hospitals (2.7% and 2.1%, respectively).

How urgent was the care?

Admissions can be categorised as Emergency (required within 24 hours), or Elective (required at some stage beyond 24 hours). Some admissions (for example, for obstetric care and other planned care) are not assigned an urgency status.

Between 2006–07 and 2010–11, emergency admissions consistently accounted for about 12% of hospitalisations involving surgery and the majority of these occurred in public hospitals (Figure 1).

Figure 1: Hospitalisations (‘000s) involving surgery by urgency of admission, public and private hospitals, 2006–07 to 2010–11

Stacked bar chart shows breakdown of hospitalisations involving surgery by urgency of admission, from 2006-07 to 2010-11, in public and private hospitals. Over time, the total number of hospitalisations increased and, generally, the greatest number of separations was associated with private-elective surgery, followed by public-elective, public-emergency, and the fewest for private-emergency.

Over this period, about 82%–83% of hospitalisations involving surgery were elective admissions (in 2010–11, about 1.9 million), with about two-thirds of these occurring in private hospitals.

About 4% of surgical admissions were childbirth-related and 1% were for other planned care.

Who had surgery?

Men and boys accounted for about 55% of emergency admissions involving surgery.

In contrast, about 56% of elective admissions involving surgery were for women and girls.

Compared with other Australians, Indigenous Australians had:

  • a higher rate of emergency admissions involving surgery (about twice as high) and
  • a lower rate of elective admissions involving surgery (about 60%).

Compared with the national rates, people living in Very remote areas had: 

  • the highest rate of emergency admissions involving surgery and
  • the lowest rate of elective admissions involving surgery.

For elective admissions involving surgery, the rate of hospitalisation:

  • for public hospitals—was highest for those living in areas classified in the lowest socioeconomic group
  • for private hospitals—was highest for those living in areas classified in the highest socioeconomic group (Figure 2).

Figure 2: Elective admissions involving surgery, by socioeconomic status group, public and private hospitals, 2010–11

Bar chart shows the number of separations (per 1,000 population) for elective admissions from public and private hospitals by socioeconomic status. The number of separations from private hospitals increased as socioeconomic status increased, with over 70 separations per 1,000 from private hospitals for the most advantaged groups compared to less than 40 per 1,000 in the most disadvantaged groups. The number of separations from public hospitals was much lower and these decreased as socioeconomic status increased, with almost 40 separations per 1,000 in the most disadvantaged groups compared to less than 20 per 1,000 in the most advantaged groups.

Why did people receive this care?

For emergency admissions, the most common reasons (principal diagnoses) for hospitalisation involving surgery were acute appendicitis, hip fracture and acute myocardial infarction (heart attack) (Figure 3).

Figure 3: Top 5 principal diagnoses for emergency admissions involving surgery, public and private hospitals, 2010–11

Bar chart shows the top 5 principal diagnoses for emergency admissions involving surgery, and compares these for public and private hospitals, for 2010-11. For public hospitals, the most common reasons for hospitalisation included: fracture of the forearm, fracture of the lower leg (including ankle), acute myocardial infarction, fracture of the femur (including hip), and acute appendicitis.

For elective admissions, the most common reasons were cataracts, skin cancer, knee disorders and procreative management (including IVF treatment) (Figure 4).

Figure 4: Top 5 principal diagnoses for elective admissions involving surgery, public and private hospitals, 2010–11

Bar chart shows the top 5 principal diagnoses for elective admissions involving surgery, and compares these for public and private hospitals, for 2010-11. For private hospitals, the most common reasons for hospitalisation included: gonarthrosis (arthrosis of knee), procreative management (including IVF), internal derangement of knee, malignant neoplasm of skin (non-melanoma), and cataracts (non-senile).

What care was provided?

In 2010–11, over 70% of hospitalisations involving surgery reported a surgical procedure in one of five groups:

  • the musculoskeletal system (for example, hip and knee replacements)
  • gynaecology
  • the digestive system
  • dermatological and plastic procedures
  • the eye and adnexa, (for example, cataract extraction).

For patients having surgery on the respiratory system, the cardiovascular system and the digestive system, a relatively high proportion were emergency admissions (47%, 26% and 23%, respectively).

For emergency admissions, the most common surgical procedures were appendicectomy and coronary angioplasty (Figure 5).

Figure 5: Top 5 surgical procedures for emergency admissions, public and private hospitals, 2010–11

Bar chart shows the top 5 surgical procedures for emergency admissions, and compares these for public and private hospitals, in 2010-11. For public hospitals, the most common surgical procedures were: debridement of skin and subcutaneous tissue (not for burn), fixation of fracture of pelvis or femur, excision procedures on selected musculoskeletal sites, transluminal coronary angioplasty with stenting, and appendicectomy.

For elective admissions, the most common surgical procedures were cataract extraction and removal of skin lesions (Figure 6).

Figure 6: Top 5 surgical procedures for elective admissions, public and private hospitals, 2010–11

Bar chart shows the top 5 surgical procedures for elective admissions, and compares these for public and private hospitals, in 2010-11. For private hospitals, the most common surgical procedures were cataract extraction and excision of lesion of skin and subcutaneous tissue.

How long did patients stay?

Just over 50% of hospitalisations involving surgery were same-day admissions, accounting for:

  • 40% of surgical hospitalisations in public hospitals (8% of emergency admissions and 52% of elective admissions) and
  • 57% in private hospitals (11% of emergency admissions and 59% of elective admissions).

For overnight hospitalisations involving surgery, the average length of stay was:

  • 8.3 days for emergency admissions and 3.9 days for elective admissions in public hospitals
  • 8.2 days for emergency admissions and 3.3 days for elective admissions in private hospitals.

How long did patients wait?

Waiting times information was available for around 620,000 patients admitted from public hospital elective surgery waiting lists in 2010–11.

The median waiting time for elective surgery represents the number of days within which 50% of patients were admitted from the elective surgery waiting list.

In 2010–11, 50% of patients admitted from public hospital elective surgery waiting lists waited 36 days or less and 90% had been admitted within 252 days.

Ophthalmology was the surgical specialty with the longest median waiting time (70 days) and cardiothoracic surgery had the shortest (16 days).

Overall, the median waiting time for patients with cancer-related principal diagnoses (19 days) was 17 days shorter than the median waiting time for all patients (36 days). For orthopaedic surgery, 50% of patients with cancer waited 7 days or less, compared with 64 days (median) overall.

Waiting times varied according to the type of cancer. For example:

  • For lung cancer, 50% of patients waited 11 days or less for surgery and 90% had been admitted within 28 days
  • For prostate cancer, 50% of patients waited 33 days or less for surgery and 90% of patients had been admitted within 98 days (Figure 7).

Figure 7: Days waited for surgery, selected cancer-related principal diagnoses, public hospitals, 2010–11

Bar chart shows the days waited for surgery for selected cancer-related principal diagnoses in public hospitals in 2010-11, and compares the median and 90th percentile waiting times. Prostate cancer had the longest median waiting time, with 50% of patients waiting 33 days or less for surgery and 90% of patients having been admitted within 98 days. Lung cancer had the shortest median waiting time of 11 days, with 90% of patients having been admitted within 28 days.

For more information, please refer to the AIHW reports:

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