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An emergency department (ED) presentation occurs following the arrival of the patient at the ED, and is the earliest occasion of being registered clinically or triaged.
Explore the number of presentations to Australia’s public hospital EDs in 2018–19 in the data visualisation below.
Information is presented by:
The data can also be explored by:
What other information is available?
Appendix information is available to download in the Info and downloads section.
Previous reports can be accessed in the Reports section.
Further information about the concepts on this page can be found in the Glossary.
Emergency department (ED) waiting time is the time elapsed for each patient from presentation in the ED to commencement of clinical care.
The data visualisation below present the following emergency department waiting time statistics:
The data is presented by:
By selecting a geography in the visualisation below, the data can also be explored by:
Appendixes are available to download in the Info and downloads section.
The data in this section relates to the waiting times of people who presented to the ED with a type of visit of Emergency presentation.
The progress of the patient through the ED is recorded using 5 different time points: presentation time, triage time, clinical care commencement,
episode end time and physical departure time, as depicted in Figure 1.
These can be used to calculate the waiting times for 50% and 90% of patients, as well as the proportion of patients seen on time.
The waiting time is calculated as the time between arrival at the ED and commencement of clinical care.
An emergency department (ED) stay is the period between a patient presenting at an ED, and when that person is recorded as having physically departed the ED (regardless of whether they were admitted, referred, discharged or left at their own risk).
The data visualisation below presents the most recent data on the proportion of patients with a length of stay of 4 hours or less by:
Previous emergency department care reports can be accessed in the Reports section.
Elective surgery activity is measured by the number of additions to and removals from public hospital elective surgery waiting lists, and the number of patients admitted for their awaited procedure.
This data visualisation below presents information on additions, removals and admissions in 2018–19 and changes between 2014–15 and 2018–19.
Information is also presented by:
Between 2014–15 and 2018–19, the total number of removals from public hospital elective surgery waiting lists increased by an average of 2.3% each year.
To explore elective surgery waiting times by hospital or LHN see My local area.
Appendixes and caveat information for this data is available to download in the Info and downloads section.
Definitions of the terms used in this section are available in the Glossary.
The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery. This section presents information on the type of elective surgery provided, by surgical speciality in 2018–19 and changes between 2014–15 and 2018–19.
Information on 11 categories of surgical speciality is presented. The ‘other’ category contains data for surgeons whose speciality was not one of the 11 specified categories. From 1 July 2016, surgical speciality was revised to include Paediatric surgery.
The data visualisation below presents elective surgery waiting list additions, removals and admissions by state and territory between 2014–15 and 2018–19.
Between 2014–15 and 2018–19:
The intended surgical procedure describes the type of elective surgery provided by public hospitals.
In the data visualisations below, you can explore admissions from elective surgery waiting lists by:
Between 2017–18 and 2018–19:
The length of time waited by patients on public hospital elective surgery waiting lists before being admitted for surgery between 2014–15 and 2018–19. Waiting times for elective surgery can vary depending on:
In the data visualisation below, you can explore waiting times for elective surgery by peer group and clinical urgency category.
50th percentile (median) waiting time
Between 2014–15 and 2018–19, the waiting time of 50% of patients:
90th percentile waiting time
Between 2014–15 and 2018–19, the 90th percentile waiting time:
Patients who waited more than 365 days
Between 2014–15 and 2018–19, the proportion of patients who waited more than 365 days to be admitted:
When a patient is placed on the public hospital elective surgery waiting list, a clinical assessment is made of the urgency within which they require elective surgery (the clinically recommended time). The proportion of patients seen within the recommended time is the percentage of patients removed from elective surgery waiting lists who were admitted for surgery within the clinically recommended time for each clinical urgency category.
The ‘overdue wait’ is the amount of time spent waiting while overdue—that is, after 30, 90 or 365 days for clinical urgency categories 1, 2 and 3, respectively. The average overdue wait time (in days) is calculated for patients who were still waiting for their elective surgery as at 30 June 2018, who were ready for care, and who had waited beyond the recommended time.
Due to the lack of comparability of clinical urgency categories between states and territories, these data are presented for each state and territory separately.
The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery.
In the data visualisation below, you can explore elective surgery waiting times by surgical speciality for 2018–19 and between 2014–15 and 2018–19. Waiting times are presented at national, state and territory, LHN, and hospital level.
Waiting list statistics for intended surgical procedures can indicate performance in particular areas of elective surgery. Information on the types of elective surgery provided by public hospitals is shown by the intended surgical procedure, for selected procedures only.
In the data visualisations below, you can explore elective surgery waiting times by:
In 2018–19, for the top 25 intended procedures:
Between 2014–15 and 2018–19, for the 15 indicator procedures:
Patients with a cancer-related diagnosis often require more urgent admission from elective surgery waiting lists than patients awaiting surgery for other conditions.
In the data visualisations below, you can explore 50th percentile waiting times for admissions for neoplasm related principal diagnoses (or other principal diagnoses) by specialty of surgeon, and over time for patients with a lung, bowel or breast neoplasm-related (cancer) principal diagnosis by hospital (noting hospital and LHN data only available for 2011–12 and 2012–13).
The time within which 50% of patients with a principal diagnosis of:
Hospitals account for a large share of the funds Australia spends on the health sector each year. One way to assess hospital efficiency is to see how much money each hospital uses in comparison to its peers to provide specific treatments or procedures.
Making comparisons is difficult, as some hospitals may use more resources to treat patients with the same diagnosis because the patients they treat are sicker and have more complex care requirements. Therefore, it is important to adjust for these differences before comparing the cost of care between hospitals.
To assist in the comparing the cost of care between hospitals, the former National Health Performance Authority developed Cost per National Weighted Activity Unit (NWAU). Cost per NWAU adjusts for the factors that increase hospital costs to allow comparison. The measure provides an indicator of relative efficiency across more than 80 of Australia’s largest public hospitals.
In the visualisation below you can explore information on the cost per NWAU, Total national weighted activity unit, and Percentage of private patients over the three-year period from 2012–13 to 2014–15 by hospital in each state and territory.
Between 2012–13 and 2014–15:
The National Weighted Activity Unit (NWAU) was developed by the Independent Hospital Pricing Authority to set the pricing of public hospital services eligible for Activity Based Funding (ABF). ABF is a system that funds hospitals according to the number and complexity of patients they treat, and the NWAU allows different hospital activities to be expressed in terms of a common unit of activity.
An ‘average’ public hospital service is worth 1 NWAU. More intensive and expensive activities are worth more than 1 NWAU, and simpler and less expensive activities are worth less. For example, a typical case of cellulitis might be assigned 0.7 NWAUs, as this condition requires fewer hospital resources than, for example, a typical knee replacement, which is assigned 4.0 NWAUs. Because of this weighting, the NWAU accounts for differences in the complexity of patients’ conditions or procedures, and a selection of individual patient characteristics (such as the patient remoteness area).
Cost per NWAU
Cost per NWAU is the cost associated with providing one ‘average’ unit (1 NWAU) of public hospital service, based on public hospital services provided to acute admitted patients whose treatment was eligible for ABF. It is an indicator of hospital efficiency.
To ensure the national comparability of public hospitals, the cost per NWAU:
Cost per NWAU is calculated by dividing the total comparable running costs by the total NWAUs for acute admitted patients. This reflects the average cost of care for a hospital.
Various types of care are provided to admitted patients. The care type describes the overall nature of a clinical service provided to an admitted patient during an episode of care. Care type can be classified as:
In the data visualisation below you can explore the number of hospitalisations by care type for public and private hospitals between 2014–15 and
2018–19, and by hospital, between 2011–12 to 2018–19.
In 2018–19, for the public and private sectors combined:
The proportions of hospitalisations for each care type varied by hospital sector. Public hospitals accounted for 62% of hospitalisations for Acute care, while private hospitals accounted for 80% of hospitalisations for Rehabilitation care.
Between 2014–15 and 2018–19 the number of hospitalisations for Acute care increased by 3.4% on average per year for public hospitals, and by 1.0% per year for private hospitals.
This section presents information on Newborn care provided for 2018–19. Newborns receiving care may have both ‘qualified’ and ‘unqualified’ days. (Refer to below ‘More information about the data’ section to find definitions for qualified and unqualified care)
Between 2014–15 and 2018–19, Rehabilitation care rose by an average of 5.0% per year in private hospitals and fell by 2.3% per year in public hospitals.
Palliative care is defined as care in which the primary clinical purpose or treatment goal is optimisation of the quality of life of a patient with an active and advanced life-limiting illness.
Mental health care is defined as care in which the primary clinical purpose or treatment goal is improvement in the symptoms and/or psychosocial, environmental and physical functioning related to a patient’s mental disorder.
For 2018–19, mental health care refers to hospitalisations for which the care type was reported as Mental health. The care type Mental health was introduced from 1 July 2015. Prior to this, mental health admitted patient activity was assigned to one of the other care types.
What other information is available?
More information, Appendixes and caveat information, and data tables are available in the Info & downloads section.
Definitions of the terms used in this section are availabe in the Glossary.
An episode of Acute care for an admitted patient is one in which the principal clinical intent is to do one or more of the following:
Rehabilitation care is care in which the primary clinical purpose or treatment goal is improvement in the functioning of a patient with an impairment, activity limitation, or participation restriction due to a health condition.
Rehabilitation care is always:
Palliative care is defined as care in which the primary clinical purpose or treatment goal is optimisation of the quality of life of a patient with an active and advanced life-limiting illness. The patient will have complex physical, psychosocial and/or spiritual needs.
Palliative care is always:
Mental health care:
Mental health care differs from mental health-related care reported in AIHW Mental health services reports. A separation is classified as mental health-related if:
A day is considered ‘qualified’ for health insurance benefits purposes when a newborn meets at least 1 of the following criteria:
A newborn admission to hospital can occur at any time within the first 9 days of life, including at the time of birth.
The reporting of unqualified newborns has changed over time and varies across jurisdictions. Prior to 2017–18, newborn episodes involving unqualified care were routinely excluded from national reporting on the basis that they didn’t meet admission criteria for all purposes. However, due to changes in Newborn care practices (such as care being provided to unqualified newborns on the ward rather than in a special care nursery) stakeholders have expressed interest in the reporting of all newborn episodes, regardless of qualification status. Newborn care is reported in this section in total, or for both qualified and unqualified newborns, as indicated.
Last updated 20/02/2020 v24.0
Staphylococcus aureus (also S. aureus, or ‘Golden staph’) is a type of bacteria that can cause Staphylococcus aureus bacteraemia (SAB), an infection of the bloodstream.
SAB can be acquired after a patient receives medical care or treatment in a hospital. Contracting a Staph. aureus bloodstream infection while in hospital can be life threatening and hospitals aim to have as few cases as possible.
This measure is sourced from the National Staphylococcus aureus Bacteraemia Data Collection (NSABDC). Data for public hospitals are provided by state and territory health authorities, while data for participating private hospitals are provided on a voluntary basis by individual private hospitals and private sector hospital groups.
The current nationally agreed benchmark set under the National Healthcare Agreement (NHA) is no more than 2.0 cases of healthcare-associated Staph. aureus bloodstream infections per 10,000 days of patient care for public hospitals in each state and territory.
In the data visualisation below you can explore information on healthcare associated infections by hospital between 2010–11 and 2018–19.
Changes over time
Private hospitals participate in the NSABDC on a voluntary basis. The casemix of patients treated in private hospitals may also be different to that in public hospitals, therefore direct comparisons are unreliable. Not all private hospitals report data and reported data may not be representative of the sector as a whole.
NSABDC Data Quality Statement
National Healthcare Agreement: PI 22-Healthcare associated infections: Staphylococcus aureus bacteraemia
Appendixes and caveat information is available on the About the data page.
Data for public hospitals are provided by state and territory health authorities. Data for private hospitals are voluntarily provided by individual private hospitals and private sector hospital groups. The nationally agreed benchmark set under the National Healthcare Agreement (NHA) is no more than 2.0 cases of healthcare-associated S. aureus per 10,000 days of patient care for public hospitals in each state and territory.
The SAB infection rate is calculated as the number of healthcare-associated cases of S. aureus divided by the total number of patient days under surveillance (x 10,000).
Rates based on less than 5,000 patient days under surveillance are denoted as NP.
If the surveillance rate (patient days under surveillance/total number of patient days) is less than 95%, the rate is reported as interpret with caution (using the symbol *), as the sample under surveillance may not be representative of the hospital.
A case (patient-episode) of SAB infection is defined as a positive blood culture for S. aureus. For surveillance purposes, only the first isolate per patient is counted, unless at least 14 days has passed without a positive blood culture, after which an additional episode is recorded.
A SAB infection is considered to be healthcare-associated if the first positive blood culture is collected more than 48 hours after hospital admission or less than 48 hours after discharge, or if the first positive blood culture is collected 48 hours or less after admission and one or more of the following clinical criteria was met for the case of S. aureus:
The definition of healthcare-associated S. aureus was developed by the Australian Commission on Safety and Quality in Health Care (the Commission). The Commission changed the definition in 2016, with clarification of the neutropenia criterion above. This definition of a healthcare-associated case of S. aureus was used by all states and territories for the 2015–16, 2016–17, 2017–18 and 2018–19 reporting years.
Data for 2010–11 to 2014–15 are provided according to the previous neutropenia criterion available at: http://meteor.aihw.gov.au/content/index.phtml/item id/598734.
Patient days under surveillance is the total number of days of admitted patient care under surveillance by infection control surveillance systems within the hospital.
Antimicrobial resistance occurs when some of the bacteria that cause infections resist the effects of the medicines used to treat them. This may lead to ‘treatment failure’, or the inability to treat the cause of the infection (Department of Health, 2020). Methicillin is an antimicrobial used to treat SAB infections.
A SAB infection that is identified by a laboratory as being caused by a methicillin-resistant strain of S. aureus is referred to as MRSA. A SAB case that is identified by a laboratory as being caused by a S. aureus strain that is sensitive to commonly used antimicrobials (methicillin-sensitive) is referred to as MSSA.
SAB infection caused by MRSA may cause more harm to patients and is associated with poorer patient outcomes as there are fewer antimicrobials available to treat the infection.
More information on antimicrobial resistance is available from the Department of Health website.
Hand hygiene ‘moments’
Hand hygiene is a key intervention to prevent or reduce Hospital Acquired Infections (HAIs), including S. aureus bloodstream (SAB) infections. Hand hygiene in hospitals generally refers to the washing and/or use of alcohol-based rubs by healthcare workers to clean their hands. Hand hygiene rates are calculated using the number of observed correct hand hygiene ‘moments’, or opportunities, in a specified audit period. ‘Moments’ of hand hygiene indicate when there is a perceived or actual risk of pathogen transmission from one surface to another via a person’s hands, and are defined in the World Health Organization (WHO) Guidelines on Hand Hygiene.
The National Hand Hygiene Initiative (NHHI) aims to educate and promote standardised hand hygiene practice in all Australian hospitals, and includes auditing and reporting processes for hospitals to measure how they are performing. The NHHI measures correct hand hygiene in the 5 critical moments determined by the WHO (modified slightly to reflect Australian health care conditions):
As of 1 November 2019, the NHHI coordination and support role is provided by the Australian Commission for Safety and Quality in Health Care (ACSQHC). The AIHW is currently working with the ACSQHC to review and establish new processes for publication of hand hygiene data from both public and private hospitals.
Hand hygiene data on MyHospitals currently reflects NHHI historical information to 2015. These will be updated when the current review process is complete and new arrangements are in place for reporting.
Hand hygiene data are provided by state and territory health authorities for public hospitals and by individual private hospitals. The data are derived from audits of hand hygiene opportunities, ‘moments’, that are conducted up to three times per year under the National Hand Hygiene Initiative.
Hospitals that provide information on hand hygiene report:
The estimated rate is compared to the national benchmark and is reported as:
Calculation of hand hygiene rates
The estimated hand hygiene rate for a hospital is a measure of how often (as a percentage) hand hygiene is correctly performed. It is calculated by dividing the number of observed hand hygiene ‘moments’ where proper hand hygiene was practised in a specified Audit Period, by the total number of observed hand hygiene ‘moments’ in the same Audit Period, and multiplying by 100. The rate is rounded to one decimal place.
Hand hygiene rate estimates and confidence intervals
Since the hand hygiene rates are based on audits from a sample of hand hygiene ‘moments’, in a sample of hospital wards the calculation is only an estimate of the true rate for that hospital, and is associated with a 95% confidence interval.
A ‘confidence interval’ is a statistical term describing the range (‘interval’) within which we can be sure (‘confident’) the true rate falls. Confidence intervals indicate the reliability of the estimated rate and are calculated using data provided by hospitals.
When only a small number of ‘moments’ are audited, the confidence interval is larger, meaning we are less sure of the true rate. When a large number of ‘moments’ are audited, the confidence interval is smaller, meaning we are more sure of the true rate.
Interim national benchmark
An interim benchmark (compliance rate) of 70% for hand hygiene reporting was initially advised by the Australian Commission on Safety and Quality in Health Care. This benchmark was increased to 75% in 2016, and increased again to 80% in 2017.
Length of stay is the number of days between admission to hospital, and separation. The Average Length of Stay (ALOS) is calculated as the total number of patient days reported for the hospital (or group of hospitals), divided by the number of hospitalisations.
The Organisation for Economic Co-operation and Development (OECD) presents comparative information on the ALOS for overnight hospitalisations as an indicator of efficiency. The comparability of international ALOS may be affected by differences in definitions of hospitals, collection periods and admission practices.
The ALOS for selected AR-DRGs is an indicator of Efficiency and sustainability under the Australian Health Performance Framework (AHPF).
In the data visualisation below, you can view the ALOS by selected medical procedures, by state and territory, and by type of hospital (peer group).
Significant changes in ALOS over time may be related to changes in admission practices and improvements in the coverage of reporting.
Average length of stay
The average length of stay (ALOS) is calculated as the total number of patient days reported for the hospital (or group of hospitals), divided by the number of separations. Two measures for ALOS are presented:
Performance indicator: Average length of stay for selected AR-DRGs
The ALOS for selected AR-DRGs is an indicator of Efficiency and sustainability under the Australian Health Performance Framework (AHPF). The selected AR-DRGs were chosen on the basis of:
Due to changes in the AR-DRG classification, the data presented here are not comparable with the data presented in previous years.
A specialised service unit is a facility or unit dedicated to the treatment or care of patients with particular conditions or characteristics, such as an intensive care unit.
In 2018–19, the most common specialised service units offered by public hospitals were:
There were 83 intensive care units (level III and above), and 30 Neonatal intensive care units (level III and above).
The data visualisation below provides a list of selected services provided by individual hospitals, including specialised care units, in the 2018-19 reporting period.
The information about services provided by a particular hospital is intended as a general guide only. There is the potential for some omissions or errors in this information and readers should contact a hospital directly for the latest advice on the services available.
A list of the types of specialised units is available in the more information about the data section below.
Types of specialised service unit include:
Acquired Immune Deficiency Syndrome (AIDS) unit - A specialised facility dedicated to the treatment of Acquired Immune Deficiency Syndrome (AIDS) patients.
Acute renal dialysis unit - A specialised facility dedicated to dialysis of renal failure patients requiring acute care.
Acute spinal cord injury unit - A specialised facility dedicated to the initial treatment and subsequent ongoing management and rehabilitation of patients with acute spinal cord injury, largely conforming to Australian Health Minister’s Advisory Council guidelines for service provision.
Alcohol and drug unit - A facility/service dedicated to the treatment of alcohol and drug dependence.
Bone marrow transplantation unit - A specialised facility for bone marrow transplantation.
Burns unit (level III) - A specialised facility dedicated to the initial treatment and subsequent rehabilitation of the severely injured burns patient (usually >10 per cent of the patient’s body surface affected).
Cardiac surgery unit - A specialised facility dedicated to operative and peri-operative care of patients with cardiac disease.
Clinical genetics unit - A specialised facility dedicated to diagnostic and counselling services for clients who are affected by, at risk of, or anxious about genetic disorders.
Comprehensive epilepsy centre - A specialised facility dedicated to seizure characterisation, evaluation of therapeutic regimes, pre-surgical evaluation and epilepsy surgery for patients with refractory epilepsy.
Coronary care unit - A specialised facility dedicated to acute care services for patients with cardiac diseases.
Diabetes unit - A specialised facility dedicated to the treatment of diabetics.
Domiciliary care service - A facility/service dedicated to the provision of nursing or other professional paramedical care or treatment and non-qualified domestic assistance to patients in their own homes or in residential institutions not part of the establishment.
Geriatric assessment unit - Facilities dedicated to the Commonwealth-approved assessment of the level of dependency of (usually) aged individuals either for purposes of initial admission to a long-stay institution or for purposes of reassessment of dependency levels of existing long-stay institution residents.
Heart, lung transplantation unit - A specialised facility for heart including heart lung transplantation.
Hospice care unit - A facility dedicated to the provision of palliative care to terminally ill patients.
In-vitro fertilisation unit - A specialised facility dedicated to the investigation of infertility provision of in-vitro fertilisation services.
Infectious diseases unit - A specialised facility dedicated to the treatment of infectious diseases.
Intensive care unit (level III) - A specialised facility dedicated to the care of paediatric and adult patients requiring intensive care and sophisticated technological support services.
Liver transplantation unit - A specialised facility for liver transplantation.
Maintenance renal dialysis centre - A specialised facility dedicated to maintenance dialysis of renal failure patients. It may be a separate facility (possibly located on hospital grounds) or known as a satellite centre or a hospital-based facility but is not a facility solely providing training services.
Major plastic/reconstructive surgery unit - A specialised facility dedicated to general purpose plastic and specialised reconstructive surgery, including maxillofacial, microsurgery and hand surgery.
Neonatal intensive care unit (level III) - A specialised facility dedicated to the care of neonates requiring care and sophisticated technological support. Patients usually require intensive cardiorespiratory monitoring, sustained assistance ventilation, long-term oxygen administration and parenteral nutrition.
Neurosurgical unit - A specialised facility dedicated to the surgical treatment of neurological conditions.
Nursing home care unit - A facility dedicated to the provision of nursing home care.
Obstetric/maternity - A specialised facility dedicated to the care of obstetric/maternity patients.
Oncology unit, cancer treatment - A specialised facility dedicated to multidisciplinary investigation, management, rehabilitation and support services for cancer patients. Treatment services include surgery, chemotherapy and radiation.
Pancreas transplantation unit - A specialised facility for pancreas transplantation.
Psychiatric unit/ward - A specialised unit/ward dedicated to the treatment and care of admitted patients with psychiatric, mental, or behavioural disorders.
Rehabilitation unit - Dedicated units within recognised hospitals which provide post-acute rehabilitation and are designed as such by the State health authorities.
Renal transplantation unit - A specialised facility for renal transplantation.
Sleep centre - A specialised facility linked to a sleep laboratory dedicated to the investigation and management of sleep disorders.
Specialist paediatric - A specialised facility dedicated to the care of children aged 14 or less is provided within an establishment.
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