Hospitals
Conditions arising during the hospital stay
A condition onset flag (COF) is associated with each diagnosis. The COF identifies conditions that arose during a hospital stay (that is, conditions that were not present on admission). Some of these conditions may have been preventable, but others may not have been preventable.
In 2024–25:
- 1.0 million hospitalisations (8.1% of hospitalisations) recorded a condition that arose during the episode of care
- 10% of hospitalisations in public hospitals recorded a condition that arose during the stay compared with 5.1% of hospitalisations in private hospitals
- the Childbirth category had the highest proportion of hospitalisations with a condition that arose during the hospital stay (52% for same-day hospitalisations and 72% for overnight hospitalisations), reflecting the conditions that arise after admission that impact on obstetric care (for conditions that affect the mother)
- for General Intervention (Surgical): Emergency, 30% of overnight hospitalisations had a condition that arose during the hospital stay compared to 2.3% of same-day hospitalisations
- the most common condition which arose during the hospital stay was Hypotension (163,000), followed by Perineal laceration during delivery (84,300) and Other disorders of fluid, electrolyte and acid-base balance (77,900).
From 2020–21 to 2024–25, the proportion of hospitalisations that recorded a condition that arose during an overnight episode of care in public hospitals increased by 0.9 percentage points from 19.8% to 20.7%.
Data on type of care is available on Admitted patient care 2024–25: Safety and quality of health systems [XLSX 109kB]. These data are sourced from the National Hospital Morbidity database.
Information on the coverage of COF data is available on Admitted patient care 2024–25: Appendix A tables. Further information on the COF code is available on METEOR (796636).
Definitions of the terms used in this section are available in the Glossary.
More information, appendices and caveat information are available in the About the data section.
Conditions that arose during hospital stay
The National Hospital Morbidity Database (NHMD) includes ‘condition onset flags’ (COF) that can help to identify conditions that arose during hospital stay (that is, conditions that were not present on admission).
Conditions that arise during stay include adverse events (some of which may have been preventable) and therefore may provide information on the safety and quality of the care.
Conditions that arose during hospital stay include conditions that:
- result from a misadventure during surgical or medical care (for example, accidental laceration, foreign body left in cavity, medical infusion error)
- are abnormal reactions to, or later complications of, surgical or medical care (for example, postprocedural shock, disruption of wound, urinary tract infection)
- are newly arising conditions (for example, pneumonia, rash, confusion)
- have an impact on obstetric care that arises after admissions, including complications or unsuccessful interventions of labour and delivery or prenatal/postpartum management (for example, postpartum haemorrhage)
- affect neonates in the birth episode during birth events (for example, respiratory distress, jaundice, feeding problems, neonatal aspiration, conditions associated with birth trauma, newborn affected by delivery of intrauterine procedures)
The flag is not assigned for conditions previously existing or suspected on admission – such as the presenting problem, comorbidity, chronic disease, or disease status.
Data limitations
The clinical information available in the National Hospital Morbidity Database (NHMD) can be used to provide some information on the safety and quality of admitted patient care in hospitals, such as instances of actual or potential harm. However, the available information does not provide a complete picture. For example, there is no routinely available information on some aspects of quality, such as continuity of care or responsiveness of hospital services.
It should be noted that:
- the data in the NHMD are collected primarily for the purposes of recording care provided to admitted patients and that their use for purposes such as reporting adverse events has not been validated for accuracy in Australia
- it is not possible to identify adverse events or complications that arise after the patient was discharged. The results should therefore be treated with caution.
- the information presented for separate indicators safety and quality indicators in this report may not be mutually exclusive. This means that some individual events are counted in more than one indicator, so the overall total is less than the sum of the various indicators.
- the data for public hospitals are not comparable with the data for private hospitals due to differences in casemix, such as the proportion of overnight and same-day care or the types of patients treated and treatments performed, and recording practices may also differ (for example, in the classification of some same-day care as either admitted or non‑admitted patient care).Admitted patient care 2024–25: Safety and quality of health systems [XLSX 109kB]