The main measure of activity is the number of hospitalisations (separations, or episodes of admitted patient care). Because a hospitalisation can vary in length from ‘same-day’ to many days or weeks, another useful measure of activity is patient days, or the total number of days of care provided to patients.
This section presents information on the care provided information on:
This section also provides more detailed information on hospital care related to:
The Organisation for Economic Co-operation and Development (OECD) presents comparative information on the average length of stay (ALOS) for overnight separations as an indicator of efficiency. The comparability of international ALOS may be affected by differences in definitions of hospitals, collection periods and admission practices.
This section includes information on the proportion of surgeries performed on a same-day basis for:
The number of:
The proportion of surgeries performed laparoscopically for:
A high proportion of cataract surgeries performed on a same-day basis may point to the efficient use of resources.
Laparoscopic (keyhole) surgery is less invasive (and therefore considered to be safer) than ‘open’ approaches.
In 2017–18, Australia had higher proportions of the 3 selected procedures that were performed laparoscopically:
More information on how care was funded, Appendixes and caveat information is available in
of the Admitted patient care 2017–18 report and Data tables.
More information about international comparisons is available on the OECD website.
Definitions of the terms used in this section are available in the Glossary.
It should be noted that these statistics might be affected by variation in admission practices both within Australia and internationally. Data for Tasmania, the Australian Capital Territory and the Northern Territory are for public hospitals only. However, data for private hospitals in Tasmania, the Australian Capital Territory and the Northern Territory are included in the Australian total.
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.
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
2013–14 and 2016–17, and by hospital, between 2011–12 to 2016–17.
In 2017–18, 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 2013–14 and 2017–18 the number of hospitalisations for Acute care increased by 3.8% on average per year for public hospitals, and by 1.4% per year for private hospitals
This section presents information on Newborn care provided for 2017–18. Newborns receiving care may have both ‘qualified’ and ‘unqualified’ days.
Between 2013–14 and 2017–18:
Between 2013–14 and 2017–18 Rehabilitation care rose by an average of 9.8% per year in private hospitals and fell by 1.3% 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 2017–18, mental health care refers to hospitalisationsfor 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 type of care, appendixes and caveat information is available in Chapter 4: Why did people receive care? in the Admitted patient care 2017–18 report and Data tables.
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:
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.
Intensive care services are provided to patients who need specialised treatment and critical medical care. This section presents information on intensive care services for 2017–18.
Public hospitals that have either an approved level 3 adult Intensive Care Unit (ICU) or an approved paediatric ICU are required to report data for the number of hours which people spend in an ICU.
For public hospitals in 2017–18:
For private hospitals in 2017–18:
Continuous ventilatory support (CVS) refers to the use of invasive ventilatory support or mechanical ventilation (a machine to assist breathing).
Public hospitals in 2017–18:
CVS is usually, but not always, provided within an ICU. Some stays in ICUs do not involve ventilatory support.
Intensive care unit
A level 3 adult Intensive Care Unit (ICU) or a paediatric ICU must:
If a patient’s episode involves more than 1 period in an ICU, then the total number of hours in ICU are summed for reporting.
The quality of data submitted for separations involving ICU varies across jurisdictions.
Continuous ventilatory support
Continuous ventilatory support (CVS—also known as invasive ventilatory support or mechanical ventilation) refers to the use of a machine to assist breathing.
Periods of ventilatory support that are associated with anaesthesia during surgery, and which are considered an integral part of the surgical procedure, are not reported here. The quality of data submitted for separations involving CVS varies across jurisdictions.
The nature of the services provided to an admitted patient during an episode of care can be described in a number of ways including:
Hospitalisations are categorised into the following broad categories of service:
See the 'More information about the data' section below for more information on Broad category of service.
Between 2016–17 and 2017–18:
In 2017–18, for public hospitals:
In 2017–18, for private hospitals:
More information on services provided to admitted patients, Appendixes and caveat information is available in Chapter 5: What services were provided? of the Admitted patient care 2017–18 report and Data tables.
Broad categories of service
The broad categories of service are:
MDCs and AR-DRGs
Information on the numbers of acute care hospitalisations for Major Diagnostic Categories (MDCs) and Australian Refined Diagnosis Related Groups (AR‑DRGs) is presented.
The AR-DRG is a classification system developed to provide a clinically meaningful way of relating the number and type of patients treated in a hospital to the resources required by the hospital. Hospitalisations are assigned to MDCs and AR-DRGs mostly based on the diagnoses and interventions reported.
This section presents information on the number of hospitalisations with a principal diagnosis in the ICD-10-AM chapter Injury, poisoning and certain other consequences of external causes for public and private hospitals over 2017–18. The information is also presented by:
More information on type of care, Appendixes and caveat information is available in Chapter 4: Why did people receive care? in the Admitted patient care 2017–18 report and Data tables.
An external cause is defined as the environmental event, circumstance or condition that was the cause of injury, poisoning or adverse event. Whenever a patient has a principal or additional diagnosis of an injury or poisoning, an external cause code should be recorded. External causes may also be required for other selected diagnoses. More than one external cause code may be reported for a separation, and the external causes presented may not relate to the principal diagnosis.
Some hospitalisations for injury or poisoning may be considered potentially avoidable. It should be noted that the admitted patient care data provide only a partial picture of the overall burden of injury because the data do not include injuries that do not require admission to hospital: for example, that were not medically treated, were treated by general practitioners or were treated in emergency departments (without being admitted).
The principal diagnosis is the diagnosis established after study (for example, at the completion of the episode of care) to be chiefly responsible for causing the episode of admitted patient care. In some cases, the principal diagnosis is described in terms of a treatment for an ongoing condition (for example, Care involving dialysis).
This section presents information on the numbers of hospitalisations by ICD-10-AM chapters, and the 20 most common detailed principal diagnoses (at the 3-character level) for public and private hospitals for 2017–18.
Same-day acute separations
Overnight acute separations
Interventions include surgical procedures, non-surgical investigative procedures, and therapeutic interventions. They require specialised training and/or require special facilities or services available only in an acute care setting. Types of interventions include:
This section presents information on all surgical separations (operating room procedures).
More information on how care was funded, Appendixes and caveat information is available in Chapter 6: What interventions were performed? of the Admitted patient care 2017–18 report and Data tables.
Surgical separations are identified as separations with a ‘surgical AR-DRG’. Surgical separations for childbirth, and subacute and non-acute separations are included in these. Therefore, the data presented for 2015–16 to 2017–18 are not comparable with 2014–15 and earlier.
Emergency admissions involving surgery are identified as acute care separations with a ‘surgical AR-DRG’, and for which the urgency of admission was reported as Emergency—indicating that the patient required admission within 24 hours.
Elective admissions involving surgery are identified as separations with a ‘surgical AR DRG’ and for which the urgency of admission was reported as Elective—indicating that admission could be delayed beyond 24 hours. They do not include separations where the urgency of admission was Not assigned or was not reported.
. The main measure of activity is the number of hospitalisations, or episodes of admitted patient care. Because episodes can vary in length from ‘same-day’ to many days or weeks, another useful measure of activity is patient days, or the total number of days of care provided to patients—a measure of activity that is independent of length of stay.
In the visualisations below you can explore information on hospitalisations, patient days and patient day rates for admitted patients between 2013–14 and 2017–18.
Coverage changes in public hospitals between 2013–14 and 2017–18 may influence changes over time.
Between 2013–14 and 2017–18:
Coverage changes in public hospitals between 2013–14 and 2017–18 may influence changes over time. Also, the number of patient days reported for Public psychiatric hospitals was affected by the implementation of the Mental health care type from 1 July 2015.
More information on how care was funded, Appendixes and caveat information is available in Chapter 2: How much activity was there? of the Admitted patient care 2017–18 report and Data tables.
More data about patient admissions is available to explore in the Data downloads section.
Patient days refers to the number of days of patient care provided to admitted patients.
The patient day rates presented in this report (patient days per 1,000 population) are age standardised to eliminate the effect of differences in population age structures over periods of time or across geographic areas (for example, for states and territories).
This section presents information on the hospitals providing admitted patient care for 2017–18. The numbers of public and private hospitals in Australia can vary over time, reflecting the opening or closing of hospitals, the reclassification of hospitals as non‑hospital facilities (or vice-versa) and the amalgamation of existing hospitals. In addition, the number of hospitals reported can be affected by jurisdictional variations in administrative and/or reporting arrangements and is not necessarily a measure of the number of physical hospital buildings or campuses.
LHNs directly manage single or small groups of public hospital services and their budgets, and are directly responsible for hospital performance. They are defined as those entities recognised as LHNs by the relevant state or territory health authority.
The LHNs vary greatly in location, size and in the types of hospitals that they include. LHNs may include both public and private hospitals. The information presented below relates to public hospitals only.
Between 2012–13 and 2016–17:
More information on hospitals, Appendixes and caveat information is available in the
The most recent data available for private hospitals and private free-standing day hospital facilities is for 2016–17, based on the Australian Bureau of Statistics (ABS) in the Private Health Establishments Collection (PHEC). The PHEC data were discontinued after the 2016–17 reference period and therefore data for 2017–18 are not available.
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