Elective surgery access

Waiting times data provides information about the length of time waited by patients on public hospital elective surgery waiting lists before being admitted for surgery.

Explore the data

In the data visualisation below, you can explore waiting times for elective surgery by hospital peer group and clinical urgency category of the surgery for 2020–21 and other recent years

The data can also be explored by:

• hospital (where data is available)
• Local Hospital Network (LHN) (where data is available).

Highlights

In 2020–21:

• the overall time within which 50% of patients were admitted (the median waiting time) was 48 days, and the time within which 90% of patients were admitted was 348 days
• 7.6% of patients waited more than 365 days for their surgery
• the 50th percentile (median) waiting time for patients admitted from waiting lists to Principal referral and Women’s and children’s hospitals (37 days) was shorter than for smaller hospitals categorised as Public acute group A hospitals and Public acute group B hospitals (53 days and 65 days, respectively).

Changes over time

Between 2019–20 and 2020–21, increases in the 50th and 90th percentile waiting times occurred across all states/territories. This is likely due to restrictions put in place for certain elective surgeries during 2019–20 in response to COVID-19, which resulted in delays in many types of elective surgery.

50th percentile (median) waiting time

Between 2016–17 and 2020–21, the 50th percentile waiting time:

• increased overall from 38 days to 48 days
• increased for all public hospital peer groups.

90th percentile waiting time

Between 2016–17 and 2020–21, the 90th percentile waiting time:

• increased overall from 258 days to 348 days.

Patients who waited more than 365 days

Between 2019–20 and 2020–21, the proportion of patients who waited more than 365 days to be admitted increased from 2.8% to 7.6%. Prior to 2020–21, this proportion fluctuated between 1.7% to 2.8%.

Waiting times by clinical urgency category

When a patient is placed on a public hospital elective surgery waiting list, a clinical assessment is made of the urgency with which they require elective surgery (the clinically recommended time). The proportion of patients seen within the recommended time is the percentage of patients 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 2021, 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.

In 2020–21:

• for New South Wales, 85% of patients were admitted within the clinically recommended time
• for Victoria; 80%
• for Queensland; 88%
• for Western Australia; 84%
• for South Australia; 74%
• for Tasmania; 48%
• for the Australian Capital Territory; 77%
• for the Northern Territory; 71%.

The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery.

Between 2016–17 and 2019–20, median waiting times for elective surgeries tended to remain relatively stable across most surgical specialties. However, at the end of the 2019–20 period, a range of measures were introduced in response to COVID-19, including restrictions on the elective surgeries that were able to be performed. This has impacted 2020–21 elective surgery waiting times across most surgical specialties.

Explore the data

In the data visualisation below, you can explore elective surgery waiting times by surgical speciality for 2020–21 and for other recent years.

In the data visualisations below, you can explore elective surgery waiting times for 2020–21 and other recent years by:

• the list of 11 surgical specialties
• state and territory
• Local Hospital Network (LHN), and hospital level.

Highlights

In 2020–21:

• the surgical speciality with the highest median waiting time was Ophthalmology (118 days)
• the surgical speciality with the lowest 50th and 90th percentile waiting time was Cardiothoracic surgery (18 days and 86 days respectively)
• the surgical specialities that had the highest proportions of patients who waited more than 365 days to be admitted were Otolaryngology, head and neck surgery and Orthopaedic surgery (17% and 15%, respectively).

Changes over time

Between 2019–20 and 2020–21:

• waiting times increased substantially at both the 50th and 90th percentiles for surgeries conducted in 7 of the 12 surgical specialty categories
• across 4 of the surgical speciality categories, median waiting times remained similar to recent years but increased substantially at the 90th percentile
• waiting times remained similar to recent years in just one surgical speciality area (Cardio-thoracic surgery).

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.

Between 2016–17 and 2019–20, median waiting times for elective surgeries tended to remain relatively stable across most surgical specialties. However, at the end of the 2019–20 period, a range of measures were introduced in response to COVID-19, including restrictions on the elective surgeries that were able to be performed. This has impacted 2020–21 elective surgery waiting times across most procedures.

Explore the data

In the data visualisations below, you can explore elective surgery waiting times for 2020–21 and other recent years by:

• the list of 15 indicator procedures
• state and territory
• Local Hospital Network (LHN), and hospital level (for all intended procedures).

Highlights

In 2020–21, for the top 25 intended procedures:

• Breast lump excision and/or biopsy had the shortest median and 90th percentile waiting times: the median waiting time was 16 days, the 90th percentile waiting time was 48 days, and the proportion of patients who waited more than 365 days was among the lowest (0.4%).
• Septoplasty (to fix a deviated nasal septum) had the highest waiting times across all of the measures: median waiting time was 330 days, 90th percentile waiting time was 500 days and 36% of patients waited more than 365 days for surgery.

Changes over time

Between 2016–17 and 2020–21, for the 15 indicator procedures:

• Coronary artery bypass graft surgery consistently had the lowest waiting times across all of the waiting time measures. In 2020–21, the median waiting time was 18 days, the 90th percentile waiting time was 82 days and the proportion of patients who waited more than 365 days for surgery was 0.1%.
• Septoplasty had the highest median waiting times across all of these years, although between 2016–17 and 2019–20, Myringoplasty/Tympanoplasty had higher waiting times at the 90^th percentile and in terms of the proportion of patients waiting more than 365 days for surgery.

The accessibility of public hospital elective surgery procedures can vary depending on the demographics of the patient. This section presents information on the variation of access to these services by demographic information for 2020–21, including information on the patients’:

• Indigenous status
• remoteness area of usual residence
• socioeconomic status of area of usual residence
• Funding source

Explore the data

In the data visualisations below, you can explore the impact of Indigenous status, remoteness and socioeconomic status on waiting times to admission from public hospital elective surgery waiting lists.

Indigenous status

Waiting times

In 2020–21:

• there were 29,100 admissions (4.1%) from public hospital elective surgery waiting lists for patients who identified as being of Aboriginal and/or Torres Strait Islander origin
• overall, the time within which 50% of Indigenous Australians were admitted for their awaited procedure was greater than that for Other Australians (58 days and 47 days, respectively)
• the greatest difference in the time within which 50% of patients were admitted was for Total hip replacement(239 days for Indigenous Australians, and 173 days for Other Australians)
• Myringoplasty/tympanoplasty, Haemorrhoidectomy, Coronary artery bypass graft, Tonsillectomy and Inguinal herniorrhaphy all had shorter waiting times for Indigenous Australians.

Separation rates

A separation rate ratio (SRR) greater than 1.0 indicates that the separation rate for an intended procedure for Indigenous Australians was higher than for Other Australians admitted for the same intended procedure.

In 2020–21:

• for 20 of the 24 intended procedures, the SRRs indicate that the separation rates for Indigenous Australians were at least 30% higher than the rates for other Australians
• the highest SRRs were for Myringoplasty/tympanoplasty (5.4, or 540% as high) and Coronary artery bypass graft (2.9, or 290% as high)
• the rates for Indigenous Australians were not notably different to the rates for Other Australians for Septoplasty (1.1), Skin lesion—excision of (1.1), Prostatectomy (1.2) and Breast lump —excision and/or biopsy (1.2).

Remoteness area of usual residence

In 2020–21:

• 64% of admissions from public hospital elective surgery waiting lists were for patients living in Major cities, 23% for patients in Inner regional areas, and 10% for patients in Outer regional areas.

Population rates

In 2020–21:

• rates of admission from elective surgery waiting lists differed by remoteness area of usual residence
• people living in Remote areas had the highest rate of admissions from public hospital elective surgery waiting lists (39.3 per 1,000 population), followed by Very remote (33.3 per 1,000), Outer regional (32.3 per 1,000) and Inner regional (31.4 per 1,000)
• Major cities had the lowest rate of admissions (23.3 per 1,000 population).

Socioeconomic status of area of usual residence

In 2020–21:

• the rate of admissions from waiting lists was highest for people living in areas classified as being in the lowest (most disadvantaged) SES group (30.9 per 1,000 population) and lowest for people living in areas classified as being in the highest (least disadvantaged) SES group (15.7 per 1,000 population).

Population rates

In 2020–21:

• people living in areas classified as being in the lowest socioeconomic areas had three times the admission rates compared with people living in the highest socioeconomic areas for:
  • Cholecystectomy (open/laparoscopic)y
  • Prostatectomy (transurethral or open)
  • Septoplasty, and
  • Thyroidectomy/hemi-thyroidectomy.

Waiting times

In 2020–21:

• the time within which 50% of patients were admitted ranged from 37 days for people living in areas classified as the highest SES group, to 54 days for people living in areas classified as the lowest SES group
• the intended procedure with the greatest variation in waiting times by socioeconomic status was Cataract extraction (with or without intra-ocular lens insertion), ranging from 102 days for people living in areas classified as being the highest SES group, to 214 days for people in the lowest SES group.

Funding Source

Differences in the type of surgery performed and in the urgency category assigned may account for some of the variation in waiting times by funding source. In 2020–21 for admissions from public hospital elective surgery waiting lists, 91% of hospitalisations in public hospitals were for Public patients, and 6.3% of hospitalisations were for patients who used Private health insurance to fund all or part of their admission.

In 2020–21, the time in which 50% of patients were admitted for their awaited procedure was: 

• 51 days for Public patients, compared to 23 days for Private health insurance funded patients and 20 days for Other patients
• longer for Public patients than Private health insurance patients for all of the 25 most common intended procedures
• longer for Public patients than Private health insurance patients for all surgical specialities.

Patients with a cancer-related diagnosis often require more urgent admission from public hospital elective surgery waiting lists than patients awaiting surgery for other conditions. 

Explore the data

In the data visualisations below, you can explore 50th percentile waiting times for admissions from public hospital elective surgery waiting lists for
cancer-related principal diagnoses by specialty of surgeon, and selected hospital and LHN level data are available for 2011–12 and 2012–13.

Data on cancer surgery waiting times is taken from the Admitted patient care data (NHMD elective surgery cluster), 2020–21.

Highlights

In 2020–21:

• patients with a cancer-related principal diagnosis had shorter waiting times (at the 50th percentile) compared with patients waiting for surgery for other reasons (22 days and 63 days, respectively).

The time within which 50% of patients with a principal diagnosis of:

• Lung cancer were admitted for surgery was 13 days, with 90% of patients admitted for surgery within 29 days
• Breast cancer were admitted for surgery was 15 days, with 90% of patients admitted for surgery within 29 days
• Prostate cancer were admitted for surgery was 30 days, with 90% of patients admitted for surgery within 106 days.