Hospitals
Hospital-acquired complications
The Australian Commission on Safety and Quality in Health Care (ACSQHC) lists 16 hospital-acquired complications for which clinical risk mitigation strategies may reduce the risk of occurrence. These complications include pressure injuries, healthcare-associated infections, delirium, malnutrition, and neonatal birth trauma.
Highlights
In 2024–25:
- one or more hospital-acquired complications were reported for 220,000 hospitalisations from a potential 12.8 million hospitalisations
- the rate of complications was 2.2 per 100 hospitalisations for public hospitals and 0.9 per 100 hospitalisations for private hospitals
- the most common complications were Healthcare associated infection (29% of complications), followed by Medication complications (11.8%), Surgical complications requiring unplanned return to theatre (11.6%) and Delirium (11.5%)
- the 20 most common complications accounted for 87% of all complications.
Changes over time
The rate of hospital-acquired complications in 2024–25 is higher than the rate seen 5 years ago for public hospitals and the same for private hospitals:
- public hospitals had 2.0 complications per 100 hospitalisations in 2020–21 compared with 2.2 per 100 hospitalisations in 2024–25
- private hospitals had 0.9 complications per 100 hospitalisations in both 2020–21 and 2024–25.
Average length of stay for hospitalisations with at least one hospital acquired complication
Patients who stay longer in hospital often have more severe disease, which may further increase the risk of acquiring a complication compared to a patient with less severe disease staying for the same length of time. Furthermore, the occurrence of a complication may extend the hospital stay.
In 2024–25, the average length of stay (ALOS) for overnight hospitalisations with at least one hospital-acquired complication was 18.0 days in public hospitals and 14.0 days in private hospitals, longer than the ALOS without a complication reported (4.1 days and 3.5 days, respectively).
Data on hospital acquired complications can be found in the Admitted patient care 2024–25: Safety and quality of health systems [XLSX 109kB]. These data are sourced from the National Hospital Morbidity database.
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.
Hospital-acquired complications
Hospital-acquired complications include conditions that:
- are newly arising conditions (for example, pneumonia, rash, confusion, hypotension, electrolyte imbalance or cyst)
- are abnormal reactions to, or later complications of, surgical or medical care (for example, post-procedural shock, disruption of wound or urinary tract infection)
- result from a misadventure during surgical or medical care (accidental laceration during procedure, medication error)
- have an impact on obstetric care – including complications or unsuccessful interventions of labour and delivery, or prenatal/postpartum management
- for neonates, it includes conditions in the birth episode arising during the birth event (conditions associated with birth trauma, neonatal aspiration, or newborn affected by delivery or intrauterine procedures) or conditions that arose following birth (for example respiratory distress, jaundice, feeding problems).
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 in this chapter 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 profiles, 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).