Elective surgery access

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:

• State and territory
• Type of hospital (peer group)
• Clinical urgency category

Explore the data

In the data visualisation below, you can explore waiting times for elective surgery by peer group and clinical urgency category.

National trends

In 2018–19:

• the overall time within which 50% of patients were admitted (median waiting time) was 41 days, and the time within which 90% of patients were admitted was 279 days
• about 2.1% of patients waited more than 365 days for their surgery
• the 50th percentile (median) waiting time waiting time for patients admitted from waiting lists for Principal referral and women’s and children’s hospitals (35 days) was shorter than for smaller hospitals Public acute group A hospitals and Public acute group B hospitals (43 days and 50 days, respectively).

Changes over time

50th percentile (median) waiting time

Between 2014–15 and 2018–19, the waiting time of 50% of patients:

• increased overall from 35 days to 41 days
• increased for all public hospital peer groups.

90th percentile waiting time

Between 2014–15 and 2018–19, the 90th percentile waiting time:

• increased overall from 253 days to 279 days
• decreased in Victoria (177 days to 146 days)  and Tasmania (424 days to 343 days)
• increased for Queensland, Western Australia, South Australia, and the Australian Capital Territory, and remained stable in New South Wales.

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:

• fluctuated between 1.8% to 2.1%
• decreased in Public group A and increased in Principal referral, Women’s and children’s hospitals and Public group B.

Waiting times by clinical urgency category

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.

National trends

In 2018–19:

• for New South Wales, 97% of patients were admitted within the clinically recommended time
• for Victoria, it was 91%
• for Queensland; 94%
• for Western Australia; 88%
• for South Australia; 88%
• for Tasmania; 60%
• for the Australian Capital Territory; 83%
• for the Northern Territory; 92%.

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

Explore the data

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.

National trends

In 2018–19:

• Otolaryngology, head and neck surgery had the highest median waiting time (84 days)
• Cardiothoracic surgery had the lowest 90th percentile waiting time (79 days)
• Otolaryngology, head and neck surgery and Orthopaedic surgery had the highest proportion of patients who waited more than 365 days to be admitted (6.5% and 4.0% respectively).

Changes over time

Between 2014–15 and 2018–19:

• the surgical speciality with the lowest waiting time for 50% of patients was Cardiothoracic surgery, ranging between 16 and 19 days
• median waiting times increased for Otolaryngology, head and neck surgery, Neurosurgery, Ophthalmology surgery and Orthopaedic surgery
• the largest increase in median waiting time was for Orthopaedic surgery from—64 days in 2014–15 to 77 days in 2018–19.

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.

Explore the data

In the data visualisations below, you can explore elective surgery waiting times by:

• the list of 15 indicator procedures between 2014–15 and 2018–19
• intended surgical procedure, by type of hospital (peer group) and over time between 2014–15 and 2018–19. Waiting times are presented at national, state and territory, LHN, and hospital level.

National trends

In 2018–19, for the top 25 intended procedures:

• Breast lump excision and/or biopsy had the shortest median and 90th percentile waiting times across all states and territories. The median waiting time ranged from 14 days in Victoria to 49 days in Australian Capital Territory, and the 90th percentile waiting time varied from 31 days in South Australia to 350 days in Australian Capital Territory
• Septoplasty (to fix a deviated nasal septum) had the highest median waiting time in 2018–19 (241 days), ranging from 49 days in Australian Capital Territory to 328 days in the New South Wales.

Changes over time

Between 2014–15 and 2018–19, for the 15 indicator procedures:

• Coronary artery bypass graft surgery consistently had the lowest median waiting time (17 days), 90th percentile waiting time (75 days) and proportion of patients who waited more than 365 days for surgery (0.4%)
• Septoplasty (to fix a deviated nasal septum) consistently had the highest median waiting time (ranging between 209 and 248 days)
• Myringoplasty/tympanoplasty (eardrum procedures) had the highest 90th percentile waiting time and proportion of patients who waited more than 365 days for surgery (394 days and 16.3%, respectively)
• the median waiting time for Haemorrhoidectomy (haemorrhoid surgery) decreased from 56 to 49 days, with the remainder of median waiting times remaining relatively stable.

Between 2017–18 and 2018–19:

• there were marked increases in the proportions of patients who waited more than 365 days for admission for Myringoplasty/tympanoplasty (eardrum procedures) and Tonsillectomy.

Waiting times to admission for elective surgery can vary depending on the a number of factors, including:

• Indigenous status
• Remoteness area of usual residence
• Socioeconomic status of area of usual residence
• Funding source

Demographic information on public hospital elective surgery waiting times is taken the from admitted patient care data (NHMD elective surgery cluster), 2017–18.

Explore the data

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. 

National trends

Indigenous status

Waiting times

In 2017–18:

• there were 26,000 admissions (3.6%) from 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 (50 days and 41 days, respectively)
• the waiting time was shorter for 6 of the 25 most common intended procedures
• the greatest difference in the time within which 50% of patients were admitted was for Myringoplasty/tympanoplasty (116 days for Indigenous Australians, and 239 days for other Australians)
• Haemorrhoidectomy, Inguinal herniotomy/herniorrhaphy, Thyroidectomy/hemi-thyroidectomy, Myringotomy, Myringoplasty/tympanoplasty and Coronary artery bypass graft 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 2017–18:

• for 19 of the 25 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 (7.7, or 770% as high) and Coronary artery bypass graft (3.5, or 350% as high)
• the rates for Indigenous Australians were not notably different to the rates for other Australians for Septoplasty (0.8), Inguinal herniotomy/herniorrhaphy (1.1), Skin lesion—excision of (1.0) and Total hip replacement (1.1).

Remoteness area of usual residence

In 2017–18:

• 64% of admissions from waiting lists for elective surgery 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 2017–18:

• 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 elective surgery waiting lists, (38.3 per 1,000 population) followed by Very remote (33.9 per 1,000) and Inner regional (33.7 per 1,000)
• Major cities had the lowest rate (25.4 per 1,000 population).

Waiting times

In 2017–18:

• the time within which 50% were admitted for their awaited procedure varied by remoteness area of the patient’s usual residence, ranging from 33 days in Remote areas, to 44 days in Outer regional areas
• for Cataract extraction, people from Inner regional areas had the longest waiting time (50% admitted within 139 days), and people from Major cities had the shortest (50% admitted within 69 days)
• for people living in Very remote areas, the rate for Myringoplasty/tympanoplasty was 11 times the national rate, and the rate of Cataract extraction was twice the national rate.

Socioeconomic status of area of usual residence

In 2017–18:

• 25% of admissions from waiting lists were for people living in areas classified as being in the lowest (most disadvantaged) SES group, and 12% were for people living in areas classified as being in the highest (least disadvantaged) SES group.

Population rates

In 2017–18:

• across all intended procedures, people living in areas classified as being in the highest SES group had the lowest admission rates from public hospital elective surgery waiting lists (17 per 1,000 population), while people from the lowest SES area had the highest (34 per 1,000)
• people living in areas classified as being in the lowest SES group had three times the admission rates compared with people living in areas classified as being in the highest SES group for; Carpal tunnel release, Haemorrhoidectomy, Hysterectomy, Myringotomy, Septoplasty and Thyroidectomy/hemi-thyroidectomy

Waiting times

In 2017–18:

• the time within which 50% of patients were admitted ranged from 35 days for people living in areas classified as the highest SES group, to 44 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 Septoplasty, ranging from 198 days for people living in areas classified as being the highest SES, to 285 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 2017–18:

• for elective admissions involving surgery, 90% of separations in public hospitals were for Public patients, and 7% of separations were for patients who used Private health insurance to fund all or part of their admission
• in private hospitals, 82% of elective admissions involving surgery were for Private health insurance patients and 10% were Self-funded.

Waiting times

In 2017–18, the time in which 50% of patients were admitted for their awaited procedure was: 

• 44 days for Public patients, compared to 22 days for Private health insurance funded patents and 16 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 except Cardiothoracic surgery.

Patients with a cancer-related diagnosis often require more urgent admission from 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 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). 

National trends

In 2017–18:

• patients with a cancer-related principal diagnosis had shorter waiting times (at the 50th percentile) compared with patients waiting for surgery for other reasons (21 days and 50 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 34 days
• Breast cancer were admitted for surgery was 14 days, with 90% of patients admitted for surgery within 28 days
• Prostate cancer were admitted for surgery was 30 days, with 90% of patients admitted for surgery within 91 days.