Elective surgery access

The length of time waited by patients on public hospital elective surgery waiting lists before being admitted for surgery between 2015–16 and 2019–20. 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.

Highlights

In 2019–20:

• the overall time within which 50% of patients were admitted (median waiting time) was 39 days, and the time within which 90% of patients were admitted was 281 days
• about 2.8% 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 (32 days) was shorter than for smaller hospitals Public acute group A hospitals and Public acute group B hospitals (42 days and 50 days, respectively).

Changes over time

50th percentile (median) waiting time

Between 2015–16 and 2019–20, the waiting time of 50% of patients:

• increased overall from 38 days to 39 days
• increased for all public hospital peer groups.

90th percentile waiting time

Between 2015–16 and 2019–20, the 90th percentile waiting time:

• increased overall from 262 days to 281 days
• decreased in Victoria (174 days to 161 days), Tasmania (452 days to 363 days) and the Australian Capital Territory (374 days to 304 days)
• increased for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.

Patients who waited more than 365 days

Between 2015–16 and 2019–20, the proportion of patients who waited more than 365 days to be admitted:

• fluctuated between 1.7% to 2.8%
• 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 2019–20:

• 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 2019–20 and between 2015–16 and 2019–20. Waiting times are presented at national, state and territory, LHN, and hospital level.

National trends

In 2019–20:

• Otolaryngology, head and neck surgery had the highest median waiting time (83 days)
• Cardiothoracic surgery had the lowest 90th percentile waiting time (85 days)
• Otolaryngology, head and neck surgery and Orthopaedic surgery had the highest proportion of patients who waited more than 365 days to be admitted (7.6% and 5.0% respectively).

Changes over time

Between 2015–16 and 2019–20:

• 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 and Otolaryngology, head and neck surgery, respectively from68 days and 75 days in 2015–16 to 76 days and 83 days in 2019–20.

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 2015–16 and 2019–20
• intended surgical procedure, by type of hospital (peer group) and over time between 2015–16 and 2019–20. Waiting times are presented at national, state and territory, LHN, and hospital level.

Highlights

In 2019–20, 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 19 days in Tasmainia and the Australian Capital Territory, and the 90th percentile waiting time varied from 36 days in Queensland to 87 days in Tasmainia
• Septoplasty (to fix a deviated nasal septum) had the highest median waiting time in 2019–20 (277 days), ranging from 137 days in Victoria to 332 days in New South Wales.

Changes over time

Between 2015–16 and 2019–20, for the 15 indicator procedures:

• Coronary artery bypass graft surgery consistently had the lowest median waiting time (18 days), 90th percentile waiting time (76 days) and proportion of patients who waited more than 365 days for surgery (0.0%)
• Septoplasty (to fix a deviated nasal septum) consistently had the highest median waiting time (ranging between 209 and 277 days)
• Myringoplasty/tympanoplasty (eardrum procedures) had the highest 90th percentile waiting time and proportion of patients who waited more than 365 days for surgery (429 days and 20.6%, respectively)
• the median waiting time for Haemorrhoidectomy (haemorrhoid surgery) decreased from 54 to 57 days, with the remainder of median waiting times remaining relatively stable.

Between 2018–19 and 2019–20:

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

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 2019–20, including information on the patients’:

• age and sex
• Indigenous status
• remoteness area of usual residence

• socioeconomic status of area of usual residence

Explore the data

In the data visualisations below, you can explore admissions from public hospital elective surgery waiting time data from Admitted patient care 2019–20.

Highlights

Age group and sex

Between 2015–16 and 2019–20, there were large increases in hospitalisations for people aged 65–74 and 75–84, specifically:

• for people aged 65–74, hospitalisations rose by 11%, an average increase of 2.7% each year
• for people aged 75–84, hospitalisations rose by 12%, an average increase of 3.0% each year.

In 2019–20, 5.8 million hospitalisations were for females (52%), and 5.3 million hospitalisations were for males (48%). In particular:

• women accounted for 64% of hospitalisations for people aged 20–39—the age range that includes most hospitalisations for childbirth
• females also accounted for more patient days than males (15.6 million and 14.5 million patient days, respectively)
• people aged 65 and over (who make up about 16% of the population) accounted for 43% of hospitalisations and 49% of patient days
• people aged 85 and over (who make up about 2% of the population) accounted for about 7% of hospitalisations and 12% of patient days.

Hospitalisation rates

In 2019–20:

• there were 439 separations per 1,000 population (age-specific rate)
• women had higher hospitalisation rates per 1,000 population in the age range of 15–44, which is likely in part due to those being prime reproductive years
• men were more likely than women to have a separation at the age of 55–64 (631 and 567 per 1,000, respectively) and onwards. But as they got older, the difference in the separation rate for men and women increased even further.

Aboriginal and Torres Strait Islander people

In 2019–20:

• 581,200 hospitalisations (5.2%) were reported for people of Aboriginal and Torres Strait Islander origin, who represent about 3.3% of the Australian population (ABS, 2018)
• 88% of hospitalisations for Indigenous Australians were from public hospitals (470,500), compared with 60% of hospitalisations for Non-Indigenous Australians.

Hospitalisation rates

In 2019–20:

• there were 970 hospitalisations per 1,000 population for Indigenous Australians—2.5 times the separation rate for Other Australians
• Indigenous Australians had high rates of same-day acute separations for dialysis (487 per 1,000 population), which was 11 times the rate for Other Australians (44 per 1,000 population)
• for Indigenous Australians, there were 267 overnight acute hospitalisations per 1,000 population, which was twice the rate for Other Australians (136 per 1,000).

Remoteness area of usual residence

In 2019–20:

• the numbers of hospitalisations per 1,000 population were highest for people living in Very remote and Remote areas (780 and 540 per 1,000 population, respectively)
• the standardised separation rate ratio (SRR) for people living in Very remote areas was 1.9, indicating that the separation rate was almost two times higher than the national separation rate
• for public hospitals, hospitalisation rates ranged from 649 per 1,000 for people living in Very remote areas to 222 per 1,000 for patients living in Major cities
• for private hospitals, hospitalisation rates ranged from 88 per 1,000 for people living in Remote areas to 169 per 1,000 for people living in Major cities, in part, this may reflect the distribution of private hospitals across remoteness areas.

Socioeconomic status of area of usual residence

In 2019–20:

• hospitalisation rates in public hospitals were highest for patients living in areas classified as being the lowest (most disadvantaged) SES group (303 per 1,000 population)
• for people of the lowest SES group, the separation rate ratio was 1.2 for public hospital separations—indicating that the hospitalisation rate was 20% higher than the national hospitalisation rate (1.0)
• patients living in areas classified as being the highest SES group (least disadvantaged) had the highest hospitalisation rates in private hospitals (221 per 1,000)—which had a separation rate ratio of 1.4.

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 neoplasm-related principal diagnoses by specialty of surgeon, and selected hospital and LHN level data are available for 2011–20 and 2012–13.

Data on cancer surgery waiting times is taken from the Admitted patient care data (NHMD elective surgery cluster), 2019–20.

Highlights

In 2019–20:

• 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 51 days, respectively).

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

• Lung cancer were admitted for surgery was 14 days, with 90% of patients admitted for surgery within 31 days
• Breast cancer were admitted for surgery was 14 days, with 90% of patients admitted for surgery within 29 days
• Prostate cancer were admitted for surgery was 28 days, with 90% of patients admitted for surgery within 97 days.