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Hospitals provide various types of care 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 2016–17 and 2020–21, and by hospital, between 2012–13 to 2020–21.
Type of care
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
This column graph shows the number of hospitalisations by care type and private/public between 2015–16 and 2019–20. National data is presented by public/private and care type (acute, geriatric evaluation and management, maintenance care, mental health care, newborn care, palliative care, psychogeriatric care and rehabilitation care). In 2019–20, there were 6,320,160 Acute care separations in public hospitals and 3,830,990 Acute care separations in private hospitals.
Hospitals and LHNs
This table explores on the number of hospital admissions between 2011–12 and 2016–17. Data is presented by measure (number of admissions and care type). Hospital-level data is available.
In 2020–21, for the public and private sectors combined:
The proportions of hospitalisations for each care type varied by hospital sector. Public hospitals accounted for 61% of hospitalisations for Acute care, while private hospitals accounted for 81% of hospitalisations for Rehabilitation care.
In 2020–21, the number of hospitalisations for Acute care increased by 3.8% for public hospitals and by 11.1% for private hospitals compared with 2019–20.
This section presents information on Newborn care provided for 2020–21. Newborns receiving care may have both ‘qualified’ and ‘unqualified’ days. Refer to ‘More information about the data’ section below for definitions of qualified and unqualified care.
Overall, almost all (95%) hospitalisations for newborn care were Discharged home—these hospitalisations include newborn care without qualified days and those with at least one qualified day, or a combination of the two.
Between 2019–20 and 2020–21, Rehabilitation care increased by 5.7% in private hospitals and fell by 6.7% 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.
In 2020–21 Palliative care hospitalisations decreased by 4.7% in private hospitals and increased by 2.7% for public hospitals compared with 2019–20.
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 2020–21, 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 on these data are available in the Admitted patient care 2020–21: What services were provided? data tables.
Definitions of the terms used in this section are available 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 is defined in this publication 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.
Mental health care:
Mental health care differs from mental health-related care reported in AIHW Mental health services reports. A hospitalisation is classified as mental health-related if:
A day is considered ‘qualified’ for health insurance benefits purposes when a newborn meet 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 did not 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.
Last updated 25/03/2021 v24.0
Staphylococcus aureus (S. aureus, or ‘golden staph’) bloodstream infections (SABSI) associated with hospital care can be serious, particularly when bacteria are resistant to common antimicrobials. SABSI can be acquired after a patient receives medical care or treatment in a hospital. Contracting SABSI 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. In 2020, the Victorian government granted an exemption to all Victorian hospitals from reporting routine surveillance during the period 1 April to 31 December inclusive due to some hospitals having resource issues due to pandemic response requirements. This included an exemption from submitting data on SABSI and hand hygiene audits.
The current nationally agreed benchmark set under the National Healthcare Agreement (NHA) is no more than 2.0 cases of healthcare-associated SABSI 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 2019–20.
This figure shows the number of healthcare-associated infections between 2010–11 and 2018–19. Data is presented by measure (number of healthcare-associated infections, number of patient days under surveillance, rate of healthcare-associated infections), infection category, public/private and peer group. Hospital data is available.
Changes over time
Between 2015–16 and 2019–20:
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 so reported data may not be representative of the sector as a whole.
In the absence of focused clinical studies, the relationship between Staphylococcus aureus bloodstream infections and COVID-19 is unclear. However, the impact of hand washing as means of combatting rates of infection transmission is significant. Between 2009 and 2017, among Australia's 132 major public hospitals, improved hand hygiene compliance was associated with declines in the incidence of healthcare-associated SABSI (incidence rate ratio 0.85; 95% CI 0.79–0.93; p≤0.0001) (Grayson et al., 2018). For every 10% increase in hand hygiene compliance, the incidence of healthcare-associated SABSI decreased by 15%.
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 SABSI per 10,000 days of patient care for public hospitals in each state and territory.
Note that the national benchmark changed to 1.0 cases per 10,000 patient days under surveillance from 1 July 2020. This will apply to NSABDC data from 2020–21.
The SABSI 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 SABSI 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 case of SABSI 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, 2018–19 and 2019–20 reporting years.
Patient days under surveillance
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 SABSI.
A case of SABSI that is identified by a laboratory as being caused by a methicillin-resistant strain of S. aureus is referred to as MRSA. A SABSI 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.
SABSI 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.
Grayson ML, Stewardson AJ, Russo PL, Ryan KE, Olsen KL, Havers SM et al. 2018. Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes. The Lancet. 18 (11), 1269-1277.
The COVID-19 pandemic affected many areas of people’s lives, including their use of health services such as hospitals. It also highlighted the importance of good hand hygiene to prevent the spread of disease. In response to COVID-19, the Australian Commission on Safety and Quality in Health Care promoted greater emphasis on using audit data to inform local quality improvement activities, and made Audit 2 (1 April to 30 June), 2020 voluntary for data submission. Audit 1 (1 November to 31 March) and Audit 3 (1 July to 31 October) remained mandatory for 2020.
In hospitals, patients are at greater risk of getting an infection because they may be undergoing invasive procedures, have weakened immune systems or may have a pre-existing infection. In addition to reducing the likelihood of transmitting viruses such as COVID-19 or influenza, good hand hygiene is a key first line defence to prevent or reduce hospital-acquired infections, including Staphylococcus aureus (‘golden staph’) bloodstream infections (SAB).
Hand hygiene in hospitals generally refers to the washing of hands or use of alcohol-based rubs by healthcare workers. The World Health Organization (WHO) has developed the following posters on performing hand hygiene:
Hand hygiene rates are calculated by dividing the number of correct observed hand hygiene moments by the number of observed moments by auditors in a specified audit period. In a hospital, good hand hygiene is important and there are particular occasions when the risk of transmitting disease is increased. These are:
These are known as hand hygiene opportunities or ‘moments’. Moments are defined in the World Health Organization (WHO) Guidelines on Hand Hygiene. In Australia, these moments have been modified slightly to reflect our healthcare conditions. See the Australian Commission on Safety and Quality in Healthcare’s website for more information on hand hygiene moments.
To measure how often healthcare workers in hospitals perform hand hygiene at these important moments, audits are continuously undertaken and reported three times a year.
The National Hand Hygiene Initiative (NHHI) aims to educate and promote correct hand hygiene practice in all Australian hospitals, and includes auditing and reporting processes for hospitals to measure how they are performing against the benchmark determined by the Australian Health Ministers Advisory Council. This benchmark has been progressively increasing and is now set at 80%. The performance of all participating hospitals has also been increasing across the country.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) coordinates the NHHI and has a range of resources available to support the continuing implementation of improved hand hygiene and the NHHI. The AIHW reports on hand hygiene rates for individual hospitals on the MyHospitals website. This can be explored below.
In the data visualisation below you can explore information on hand hygiene rates by hospital between 2010–2020.
This figure shows hand hygiene rates and observed hand hygiene moments for period 1 (end of March 2020) and period 2 (end of June 2020). Data is presented by measure (hand hygiene rate and observed hand hygiene moments and public/private. Hospital and national data is available.
This figure shows hand hygiene compliance between 2012 and 2020. Data is presented by audit period and hospital.
The National Hand Hygiene Initiative (NHHI) has been in operation for ten years, supported by the Australian Commission on Safety and Quality in Health Care, and since 1 November 2019, the Commission has coordinated and supported all aspects of the NHHI. Hand hygiene is a key element of a comprehensive suite of initiatives to prevent and reduce healthcare-associated infections in Australian healthcare settings.
The NHHI is implemented by states, territories and private health service organisations, and includes auditing of hand hygiene practice as well as educational and promotional activities.
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 moments that are conducted continuously over three reporting periods each year. These audit periods are:
Hospitals provide information on hand hygiene by providing the total number of moments observed and the total numbers of correct moments observed. The rate is then generated from these validated data.
Further information on the data collection process is described in the NHHI Manual.
Hand hygiene (HH) is a general term applying to the use of soap/solution (non-antimicrobial or antimicrobial) and water, or a waterless antimicrobial agent (e.g. alcohol-based handrub) to the surface of the hands (HHA, 2019).
Hand hygiene compliance is defined when HH is performed when considered necessary and is classified according to one of the “5 Moments”. If the action is performed outside of these Moments, then it is not included in the compliance audit.
The number of Moments observed constitutes the denominator for assessing HH compliance. The actual HH actions undertaken are compared to the number of Moments observed to calculate the rate of HH compliance (HHA, 2019). The rate is rounded to one decimal place.
HH non-compliance is defined when there is an indication for HH (i.e. a “Moment”) and yet no HH was undertaken.
Hand hygiene compliance rates are based on audits from a sample of hand hygiene moments, and 95% confidence intervals are provided for all breakdowns.
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 (for example, those associated with particular healthcare worker types), the confidence interval will be wider, indicating there is less certainty regarding the true compliance rate. When a large number of moments are audited, the confidence interval will be narrower, indicating there is more certainty regarding the true rate.
Confidence intervals are used to assess whether or not the compliance rate for the sample of moments meets the benchmark. If the confidence interval includes the value of the benchmark 80%, then that figure is considered to have met the benchmark.
In 2015, the Australian Health Ministers’ Advisory Council agreed to:
Hand Hygiene Australia 2019. Glossary of Terms. Melbourne: HHA
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).
Average length of stay
This bar graph shows the average length of stay for selected AR-DRGs in 2019–20. Data is presented by public/private. National data is available. In 2019–20, heart failure and shock had the longest length of stay for private hospitals at 6.1 days and knee replacement had the longest length of stay for public hospitals at 4.0 days.
This figure shows the average length of overnight stay between 2011–12 and 2016–17. Data is presented by measure (average length of overnight stay, number of hospital stays, number of overnight bed stays, and percentage of hospital stays that were overnight), procedure category and peer group. Hospital data is available.
Between 2016–17 and 2020–21:
Significant changes in ALOS over time may be related to changes in admission practices and improvements in the coverage of reporting.
More information about ALOS can be found in figures 2.2–2.3 in Admitted patient care 2019–20: How much activity was there?
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:
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.
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