Admitted patient activity

The main measure of admitted patient activity is the number of hospitalisations, or episodes of admitted patient care. As episodes can vary in length from ‘same-day’ to many days or weeks, another useful measure of activity is patient days. Patient days are the total number of days of care provided to patients – a measure of activity that accounts for variations in the length of stay.

Explore the data

In the visualisations below, you can explore information on hospitalisations, patient days and patient day rates for admitted patients between 2017–18 and 2021–22.

Highlights

Hospitalisations

In 2021–22: 

• hospitalisations decreased by 2.1% compared with 2020–21 – from 11.8 million to 11.6 million
• public acute hospitalisations decreased by 1.9% (7 million to 6.8 million)
• the smallest decrease was for private free-standing day hospitals (1.2%, 1.09 million to 1.07 million)
• overnight hospitalisations decreased by 2.2% (4.4 million to 4.3 million) and same-day hospitalisations decreased by 2.0% (7.4 million to 7.3 million).

Changes over time

Before the COVID-19 pandemic, nationally, from 2014–15 to 2018–19, hospital admissions increased by 3.3%, on average, each year and hospital admissions per 1,000 population increased by 1.1%, on average each year. However, due to the restrictions and measures put in place to manage and prevent COVID-19, hospitalisations in 2019–20 decreased by 2.8% and hospitalisations per 1,000 population decreased by 4.8%. Since then, admitted patient activity has failed to return to pre-COVID trend levels, with many states and territories experiencing outbreaks as well as workforce shortages that have impacted on system capacity and activity.

Patient days

In 2021–22:

• public hospitals accounted for 68% of patient days of care (21.7 million)
• Private hospitals accounted for 32% of patient days (10.0 million).

Compared with 2020–21, in 2021–22:

• the number of patient days increased by 2.0% – from 31.2 million to 31.8 million patient days
• patient days increased by 4.0% in public hospitals and decreased by 2.3% in private hospitals
• patient days per 1,000 population increased from 1,077 to 1,088.

Over the five years to 2021–22:

• the number of patient days increased by 1.3%, on average, each year – from 30.2 million to 31.8 million patient days
• patient days increased, on average, each year by 1.9% in public hospitals and 0.2% in private hospitals
• patient days per 1,000 population decreased on average, each year by 0.5% - from 1,111 to 1,088 – consistent with longer term trends.

In 2021–22, 671 public hospitals in Australia provided admitted patient care services.

Hospitals are grouped by the type of service provided. In 2021–22:

• 31 Principal referral hospitals accounted for the highest proportion of public hospital hospitalisations (38%, 2.6 million hospitalisations) and public hospital patient days (38%, 8.2 million patient days)
• 63 Public acute group A hospitals accounted for a further 34% of hospitalisations and 32% of patient days
• 109 Very small hospitals accounted for less than 0.5% of both hospitalisations and patient days, with an average length of stay of 11.3 days which was much longer than the average length of stay in Principal referral hospitals (3.2 days)
• 36 Subacute and non-acute hospitals accounted for 0.9% of hospitalisations and 3.5% of patient days, with an average length of stay of 12.9 days.

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. This is not the same as the diagnosis or condition that a person might attend hospital for. A single type of care can be used to manage many different conditions. Care type can be classified as:

• Acute care
• Newborn care
• Subacute and non-acute care—Rehabilitation care, Palliative care, Geriatric evaluation and management, Maintenance care and Psychogeriatric care
• Mental health care.

Explore the data

In the data visualisation below you can explore the number of hospitalisations by care type for public and private hospitals between 2017–18 and 2021–22, and by hospital, between 2012–13 to 2021–22.

Highlights

In 2021–22, for the public and private sectors combined:

• 92% of hospitalisations were classified as episodes of Acute care
• 3.3% were classified as episodes of as Rehabilitation care
• 3.0% were classified as episodes of as Mental health care
• 0.5% were classified as episodes of as Newborn care (this only refers to situations where the newborn requires specific care – not all births.).

The proportions of hospitalisations for each care type varied by hospital sector. Public hospitals accounted for 60% of hospitalisations for Acute care, while private hospitals accounted for 81% of hospitalisations for Rehabilitation care.

Changes over time

Over the last five years, from 2017–18 to 2021–22, there has been an annual average increase for hospitalisations with Acute care by 0.7% in public hospitals and 1.8% in private hospitals.

Acute care

In 2021–22:

• around 9 in 10 hospitalisations in public (94%) and private hospitals (88%) were for Acute care
• the most common principal diagnosis reported for overnight acute hospitalisations was Single spontaneous delivery (3.1% of hospitalisations)
• almost 1 in 4 (24%) of same-day acute hospitalisations had a principal diagnosis of Care involving dialysis.

Changes over time

• Compared with 2020–21, in 2021–22, the number of hospitalisations with Acute care decreased by 2.1% for public hospitals and by 1.5% for private hospitals.
• Over the last five years, from 2017–18 to 2021–22, there has been an annual average increase for hospitalisations with Acute care by 0.7% in public hospitals and 1.8% in private hospitals.

Newborn care

Newborns receiving care may have both ‘qualified’ (where the baby requires specialised care) and ‘unqualified’ days (where routine care is provided as part of the care for the mother). Refer to ‘More information about the data’ section below for definitions on qualified and unqualified care.

In 2021–22:

• there were 81,800 hospitalisations for newborn care with at least one qualified day—the majority of these (85%) occurred in public hospitals
• 1 in 4 hospitalisations for newborn care had a principal diagnosis of Disorders related to short gestation and low birth weight, not elsewhere classified (24% of hospitalisations for qualified newborns) followed by Respiratory distress of newborn (13% of hospitalisations for qualified newborns)
• almost all (95%) hospitalisations for newborn care were Discharged home and less than 0.24% Died.

Changes over time

Compared with 2020–21, in 2021–22:

• hospitalisations for qualified newborns decreased by 0.7% in public hospitals and increased in private hospitals by 6.7%
• for unqualified newborns, hospitalisations decreased by 1.3% in public hospitals and increased by 5.9% in private hospitals.

Compared with 2017–18, in 2021–22:

• hospitalisations for qualified newborns increased by an annual average of 2.7% (from 62,400 to 69,400) in public hospitals and increased in private hospitals by 1.7% (11,600 to 12,400)
• for unqualified newborns, hospitalisations decreased by an annual average of 0.5% in public hospitals and increased by 3.8% in private hospitals. Victoria had the largest annual average increase over this period at 39.1% in private hospitals (from 2,000 hospitalisations to 7,600 hospitalisations).

Subacute and non-acute care

In 2021–22:  

• less than 1 in 20 hospitalisations (4.7%) were for Subacute and non-acute care
• over the previous year, from 2020–21 to 2021–22, the number of hospitalisations for Subacute and non-acute care increased by 7.7% in public hospitals and decreased by 10% in private hospitals
• over the last five years, from 2017–18 to 2021–22, there has been an annual average increase of 1.6% for Subacute and non-acute care hospitalisations in public hospitals and an annual average decrease of 5.1% in private hospitals.

Rehabilitation care

In 2021–22:

• there were around 382,000 Rehabilitation care hospitalisations, with 4 in 5 (81%) occurring in private hospitals
• New South Wales and Queensland combined accounted for 4 in 5 (79%) Rehabilitation care hospitalisations – 56% in New South Wales and 23% in Queensland.

Changes over time

• Over the previous year, from 2020–21 to 2021–22, the number of Rehabilitation care hospitalisations decreased by 10.1% in public hospitals and 11.4% in private hospitals.
• Over the last five years, from 2017–18 to 2021–22, there has been an annual average decrease of 6.0% for Rehabilitation care hospitalisations in public hospitals and an annual average decrease of 4.6% in private hospitals.

Palliative care

In 2021–22:

• nearly 9 in 10 (86%) of the 51,300 Palliative care hospitalisations occurred in public hospitals
• 1 in 2 (49%) hospitalisations for Palliative care had a neoplasm-related (cancer-related) principal diagnosis, with Malignant neoplasm of bronchus and lung accounting for 8% of Palliative care hospitalisations.

Mental health care

In 2021–22:

• over 3 in 5 (62%) of the 353,000 Mental health care hospitalisations occurred in private hospitals
• females (as identified in the data) accounted for 60% of all Mental health care hospitalisations.

Changes over time

Over the previous year, from 2020–21 to 2021–22, the number of Mental health care hospitalisations in private hospitals decreased by 6.0% (from 232,000 to 218,000). However, over the last five years, from 2017–18 to 2021–22, there has been an annual average increase of 2.9%.

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. It is essentially the main reason someone needed to be admitted to hospital.

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 2021–22.

Highlights

• In 2021–22, over 1 in 4 (25%, 2.9 million) hospitalisations had a principal diagnosis of Factors influencing health status and contact with health services – which includes Care involving dialysis (around 1.7 million separations), radiotherapy or chemotherapy.
• Principal diagnoses tend to differ in terms of the proportion that are admitted to public versus private hospitals. For example, 85% of hospitalisations for Certain conditions originating in the perinatal period and 87% of hospitalisations for Certain infectious and parasitic diseases were provided in public hospitals. While in private hospitals, Diseases of the eye and adnexa, and Diseases of the musculoskeletal system and connective tissue, were 75% and 71% of hospitalisations respectively.
• 1 in 2 (47%) hospitalisations for Indigenous Australians had a principal diagnosis of Factors influencing health status and contact with health services (for more information relating to hospitalisations for Indigenous Australians see the Aboriginal and Torres Strait Islander Health Performance Framework).

Most common principal diagnoses 

Same-day acute hospitalisations

In 2021–22:

• nearly 1 in 4 (24%, 1.7 million) same-day acute hospitalisations in both public and private hospitals were for Care involving dialysis and over 1 in 3 (35%)  same-day acute hospitalisations in public hospitals were for this diagnosis
• same-day acute hospitalisations for Pain in throat and chest (93%) and Care involving dialysis (79%) were most likely to be provided by public hospitals
• same-day acute hospitalisations for Procreative management (96%), Embedded and impacted teeth (95%), Other retinal disorders (87%), and Benign neoplasm of colon, rectum, anus and anal canal (79%) were the most likely to be provided in private hospitals.

Overnight acute hospitalisations

In 2021–22:

• over 2 in 3 overnight acute hospitalisations were provided in public hospitals (2.7 million or 71%)
• the most common principal diagnosis reported for overnight acute hospitalisations was Single spontaneous delivery, which accounted for 3.6% of overnight acute separations in public hospitals and 1.9% in private hospitals
• public hospitals provided a majority of overnight acute hospitalisations for Viral infection of unspecified site (98%), Viral pneumonia, not elsewhere classified (96%) and Other chronic obstructive pulmonary disease (90%)
• private hospitals provided a majority of overnight acute hospitalisations for Gonarthrosis (arthrosis of the knee, 76%), Coxarthrosis (arthrosis of hip, 74%) and Sleep disorders (68%).

Changes over time

Over the last five years, from 2017–18 to 2021–22:

• Overnight acute hospitalisations with the principal diagnosis Sleep disorders decreased by 27,000, from 76,000 cases in 2017–18 down to 49,000 cases in 2021–22.
• Overnight acute hospitalisations with the principal diagnosis Other chronic obstructive pulmonary disease decreased by 19,000, from 64,000 cases in 2017–18 down to 45,000 cases in 2021–22.

Data on hospitalisations involving a COVID-19 diagnosis are presented in the following visualisation and summarised in the sections below. It is presented by the demographic characteristics of patients, the types of comorbid chronic diseases that were treated as part of their in-hospital care, and the severity of illness patients experienced.

In 2021–22, there were 263,400 hospitalisations involving a COVID-19 diagnosis and the average length of stay for these patients was 7 days.

Who received hospital care for a COVID-19 diagnosis?

In 2021–22:

• Almost 1 in 4 (23%) hospitalisations were for people 65 to 84 years of age and 7.5% were for people 85 years and above.
• Over 1 in 4 (26%) hospitalisations were for patients between 0 and 24 years of age.

Where did patients with a COVID-19 diagnosis live?

There were more hospitalisations involving a COVID-19 diagnosis for patients who lived in cities and in areas classified as being the most disadvantaged.

In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:

• Almost 9 in 10 hospitalisations (88%, or 232,600 hospitalisations) were for people living in Major cities and Inner regional areas combined.
• Less than 4% of hospitalisations were for patients who usually lived in Remote or Very Remote areas.
• Over 1 in 4 (27%) hospitalisations involving a COVID-19 diagnosis were for patients living in the lowest socioeconomic areas.
• 14% of hospitalisations were for patients living in the highest socioeconomic areas.
• 7.9% of hospitalisations involving a COVID-19 diagnosis were for people of Aboriginal and Torres Strait Islander origin.

Intensive care for hospitalisations involving COVID-19 diagnosis

Hospitalisations in which the person spent time in an Intensive care unit (ICU) and/or received continuous ventilatory support (CVS) are an indication that the patient required a higher level of acute care. During these hospitalisations, patients had at least one hour of ICU or CVS recorded, or a combination of both.

In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:

• 3.0% of hospitalisations involved a stay in ICU, during which patients received a median of 86 hours in ICU care.
• 1.3% involved CVS
• 2.0% of patients died in hospital.

Hospitalisations involving a COVID-19 diagnosis with a comorbid chronic condition

Patients who receive care during their hospitalisation may receive treatment for one or multiple conditions. Patients hospitalised with a COVID-19 diagnosis may have received care for another chronic condition, which is recorded as a primary diagnosis or an additional diagnosis. For this analysis, these diagnoses are referred to as ‘comorbid chronic conditions’.

In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:

• Over 7 in 10 (72%) hospitalisations recorded no comorbid chronic condition.
• Around 1 in 5 (19%) hospitalisations recorded one comorbid chronic condition.
• 9.3% of hospitalisations recorded two or more chronic comorbid conditions.

In 2021–22, hospitalisations involving a COVID-19 diagnosis for patients recorded with one or more comorbid chronic conditions were more likely to receive acute care in ICU and/or CVS.

Of the 24,600 hospitalisations with two or more recorded comorbid chronic conditions:

• 13% of hospitalisations involved time spent in ICU
• 5.9% involved CVS
• 11% died in hospital.

In comparison, hospitalisations involving no comorbid chronic conditions were less likely to involve time spent in ICU and/or CVS. Of the 189,000 hospitalisations with no recorded comorbid chronic conditions:

• 1.0% of hospitalisations involved time spent in ICU
• 0.3% involved CVS
• 0.4% died in hospital.

Patients who received treatment in ICU and/or CVS with a recorded comorbid condition

The most common comorbid conditions associated with COVID-19 hospitalisations were type 2 diabetes (12%; 31,600) and cardiovascular disease (11.6%; 30,500).

Of the 31,600 hospitalisations with a recorded comorbid diagnosis of type 2 diabetes:

• 7.6% of hospitalisations involved time spent in ICU
• 3.2% involved CVS
• 5.9% died in hospital.

Of the 30,500 hospitalisations with a recorded comorbid diagnosis of cardiovascular disease:

• 15% of hospitalisations involved time spent in ICU
• 7.7% involved CVS
• 9.6% died in hospital.

Surgery and other interventions

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:

• surgical procedures – operating room procedures
• non-surgical investigative and therapeutic procedures – such as X-rays, diagnostic testing, and dialysis
• patient support interventions that are neither investigative nor therapeutic – such as general anaesthesia, physiotherapy, and other allied health interventions
• physiological assessments undertaken by doctors, nurses, and allied health professionals
• manufacture and fitting of devices, aids, or equipment
• psychological therapies and skills training.

How many interventions were provided to admitted patients?

In 2021–22:

• 24.8 million interventions were reported, with 12.7 million performed in public hospitals and 12.0 million in private hospitals
• 77% of hospitalisations in public hospitals and nearly all (96%) hospitalisations in private hospitals involved at least one intervention
• public hospitals accounted for nearly 4 out of 5 Obstetric procedures (including childbirth) (79%) and Procedures on respiratory system (78%)
• 75% of Radiation oncology procedures were performed in public hospitals
• private hospitals accounted for over 4 out of 5 Dental services procedures (83%) provided and Procedures on nervous system (80%).

From 2020–21 to 2021–22, the number of interventions fell by 4.3%, from 25.9 million interventions in 2020–21 to 24.8 million interventions in 2021–22. This decrease was higher for public hospital interventions, which fell by 4.7%, from 13.4 million interventions in 2020–21 to 12.7 million in 2021–22.

How many interventions were provided to patients receiving same-day acute care?

In 2021–22:

• 11.5 million interventions were reported for patients in same-day acute care hospitalisations
• Cerebral anaesthesia (general anaesthesia and sedation, 2.6 million procedures), Haemodialysis (1.7 million) and Administration of pharmacotherapy (mostly chemotherapy, 1.1 million) accounted for almost half (46%) of all procedures.

From 2020–21 to 2021–22, the number of interventions reported for same-day acute separations decreased by 2.7%, from 11.8 million down to 11.5 million separations.

How many interventions were provided to patients receiving overnight acute care?

In 2021–22:

• 11.0 million interventions were reported for patients receiving overnight acute care hospitalisations
• around 3 in 4 (73%) of these hospitalisations in public hospitals involved at least one intervention, and in private hospitals, it was 9 in 10 (90%) hospitalisations
• 43% of interventions in public hospitals (3.1 million) were Generalised allied health interventions (for example, physiotherapy and other rehabilitation procedures).

From 2020–21 to 2021–22:

• the number of interventions reported for overnight acute separations decreased by 5.1% from 11.6 million down to 11.0 million separations
• Arthroplasty of knee decreased by 12.6% from 61,000 down to 53,000 overnight acute separations
• Non-invasive ventilatory support increased by 13.2% from 96,000 to 108,000 overnight acute separations.

How many surgical procedures were provided?

This section presents information on hospitalisations involving a surgical procedure undertaken in an operating theatre. In 2021–22:

• 2.8 million hospitalisations (or 24% of all hospitalisations) involved surgery, with 3 in 5 (61%) of these occurring in private hospitals
• hospitalisations involving surgery accounted for 16% of all hospitalisations in public hospitals and 36% of all hospitalisations in private hospitals

• there were 2.3 million elective admissions involving surgery and 70% of these occurred in private hospitals
• for public hospitals 62% of surgical hospitalisations were elective admissions, 29% were emergency admissions, and 9% did not have an urgency status assigned
• for private hospitals, 94% of surgical hospitalisations were elective admissions, 3% were emergency admissions, and 3% did not have an urgency status assigned.

From 2020–21 to 2021–22, hospitalisations involving surgery decreased by 200,000 (or 5.8%), from 3 million to 2.8 million.

Emergency hospitalisations involving surgery

In 2021–22:

• there were 373,000 emergency hospitalisations involving surgery (where hospitalisation was required within 24 hours). 86% of these occurred in public hospitals
• the most common principal diagnosis associated with these hospitalisations was Acute appendicitis and Fracture of femur
• Other debridement of skin and subcutaneous tissue was the most common surgical intervention (at the procedure block level) for emergency admissions involving surgery, and most (91%) of these were performed in public hospitals.

From 2020–21 to 2021–22, emergency hospitalisations involving surgery decreased by 15,000 (or 3.7%), from 388,000 down to 373,000.

Elective hospitalisations involving surgery

In 2021–22:

• there were 2.3 million elective hospitalisations involving surgery (where surgery did not need to be performed within 24 hours), with 7 in 10 of these occurring in private hospitals
• Other cataract surgery was the most common surgical intervention (at the procedure block level) for elective hospitalisations involving surgery with over 76% of these performed in private hospitals.

From 2020–21 to 2021–22, elective hospitalisations involving surgery decreased by 160,000 (or 6.6%), from 2,420,000 down to 2,260,000.

This section presents information on the number of hospitalisations with the principal diagnosis Injury, poisoning and certain other consequences of external causes for public and private hospitals in 2021–22.

Highlights

In 2021–22:

• about 1 in 15 (6.8%, 783,000) hospitalisations had a principal diagnosis of Injury, poisoning and certain other consequences of external causes – the majority (77%) were treated in public hospitals
• almost half (47%, or 369,000 hospitalisations) of all injury hospitalisations had a principal diagnosis of Injuries to upper and lower limbs, and 17% (132,000 hospitalisations) had a principal diagnosis of Complications of medical and surgical care
• 2 in 5 injury hospitalisations were for Falls (39%, 302,000 hospitalisations)
• the rate of hospitalisation due to injury for Indigenous Australians was 53 per 1,000 population and the rate for other Australians was 27 per 1,000 population. For more information relating to hospitalisations for Indigenous population, see the Aboriginal and Torres Strait Islander Health Performance Framework website.

Changes over time

Compared to 2020–21, in 2021–22, hospitalisations due to Injury were lower by 59,000 – 841,000 in 2020–21 and 783,000 in 2021–22. However, the number in 2021–22 is the same as they were in 2017–18 (782,000).

Intensive care is provided to patients who are critically unwell and require complex, multisystem life support such as mechanical ventilation, extracorporeal renal support and invasive cardiovascular monitoring. This section presents information on this care.

Public hospitals that have either an approved level 3 adult Intensive Care Unit (ICU) or an approved paediatric and/or Neonatal ICU report the number of hours spent in an ICU for each hospitalisation and the number of continuous hours of ventilatory support provided, either within ICU, or in another location such as an emergency department. 

Hospitalisations involving ICU

From 2020–21 to 2021–22:

• hospitalisations involving a stay in a level 3 ICU decreased by 9% - from 156,000 to 141,800 hospitalisations
• the average duration of stay in level 3 ICU increased from 76.6 hours to 87.0 hours
• hospitalisations involving ICU as a proportion of total hospitalisations also decreased, from 13.2 hospitalisations involving a stay in level 3 ICU per 1,000 in 2020–21 to 12.2 in 2021–22.

Over the last five years, from 2017–18 to 2021–22:

• hospitalisations involving a stay in ICU has decreased by 12%, from 161,000 in 2017–18 down to 142,000 in 2021–22
• hospitalisations involving ICU as a proportion of total hospitalisations also decreased, from 14.4 hospitalisations involving a stay in level 3 ICU per 1,000 in 2017–18 to 12.2 in 2021–22.

Hours in intensive care provided to admitted patients

In 2021–22, 12.3 million hours of care in level 3 ICUs were reported for 142,000 hospitalisations. Compared with 2020–21, where there was 12.0 million hours reported for 156,000 hospitalisations. This was a 3.1% increase in hours (383,000 hours), but a 9.1% decrease in hospitalisations (14,200 hospitalisations).  

Public hospitals

In 2021–22: 

• for every 1,000 hospitalisations, 14.0 involved a stay in a level 3 ICU
• 93 hospitals provided ICU care in 96,000 hospitalisations – this care involved 10.1 million hours or 420,000 patient days of care.
• the average duration of stay in ICU was 106 hours (4.4 days).

From 2020–21 to 2021–22:

• the duration of stay in ICU increased by 11.4 hours, from 94.2 hours in 2020–21 to 105.6 hours in 2021–22
• hospitalisations involving a stay in ICU decreased by 7.2%, from 103,000 to 96,000.

Private hospitals

In 2021–22: 

• for every 1,000 hospitalisations, 9.6 involved a stay in a level 3 ICU
• ICU care was provided in 46,000 hospitalisations – 2.2 million hours and 91,700 patient days
• the average duration of stay in ICU was 48 hours per hospitalisation (2 days).

From 2020–21 to 2021–22:

• the duration of stay in ICU increased by 5.9 hours, from 42.1 hours in 2020–21 to 48.0 hours in 2021–22
• hospitalisations involving a stay in ICU decreased by 13%, from 53,000 to 46,000.

Hours of continuous ventilatory support provided to admitted patients

Continuous ventilatory support (CVS) refers to the use of invasive ventilatory support or mechanical ventilation (a machine to assist breathing).

In 2021–22, 4.8 million hours of CVS were reported for 45,600 hospitalisations in Australian hospitals. Compared with 2020–21, this was 472,000 hours of CVS more for 200 fewer hospitalisations. This increase in CVS hours is likely due to an increase in COVID-19 hospitalisations.

From 2017–18 to 2021–22:

• the total number of hours of CVS increased by 17%, from 4.1 million hours in 2017–18 to 4.8 million in 2021–22
• the average duration of CVS increased from 88 hours in 2017–18 to 104 hours in 2021–22.

Public hospitals

In 2021–22: 

• 4.4 million hours (183,400 patient days) of CVS was provided for 37,000 hospitalisations
• 5.4 hospitalisations per 1,000 involved CVS and the average duration of CVS was 120 hours per hospitalisation (5 days).

From 2020–21 to 2021–22:

• although hospitalisations involving CVS decreased by 2.5%, total hours of CVS increased by 12%, or 456,000 hours
• the average duration of CVS increased by 14%, from 105 hours to 120 hours.

Private hospitals

In 2021–22: 

• 355,800 hours (14,800 patient days) of CVS was provided in 8,900 hospitalisations
• for every 1,000 hospitalisations, 1.9 hospitalisations involved CVS and the average duration of CVS was 40 hours per hospitalisation (1.7 days).

From 2020–21 to 2021–22:

• hospitalisations involving CVS increased by 9.0%, from 8,100 to 8,800
• total hours of CVS increased by 4.6%, or 16,000 hours.

Overlap between ICU care and CVS

CVS is usually, but not always, involved with an ICU stay.

In 2021–22:

• 141,800 hospitalisations reported a stay in an ICU and of these, 37,100 reported a period of CVS
• 1 in 3 (31%) hospitalisations in public hospitals reporting a stay in ICU also reported a period of CVS
• 15% of hospitalisations in private hospitals reporting a stay in ICU also reported a period of CVS
• of the hospitalisations that did not involve a stay in ICU, a period of CVS was reported for 9,000.

The nature of the services provided to an admitted patient during an episode of care can be described in several ways including by a broad category of service and by a diagnosis group. In Australia, the diagnosis group is the Australian Refined Diagnosis Related Group (AR-DRG).

Broad category of service

Hospitalisations are categorised into the following broad categories of service.

• Childbirth – includes all childbirth care such as caesarean delivery and vaginal delivery. Does not include newborn care.
• Mental health – includes mental health care for conditions such as dementia and depression.
• General intervention (Surgical) – includes surgical care such as knee replacement.
• Medical – includes care not involving surgical care such as haemodialysis.
• Specific intervention (Other) – includes care that is not Surgical or Medical such as endoscopy.
• Subacute and non-acute care – includes rehabilitation, palliative, psychogeriatric, maintenance care or geriatric evaluation and management.

In 2021–22:

• of the 11.6 million hospitalisations, 55% of hospitalisations were for Medical, 1 in 4 (23%) were for General intervention (Surgical) and 12% were for Specific intervention (Other)
• public hospitals accounted for 3 in 4 Medical hospitalisations (76%) and almost 4 in 5 Childbirth hospitalisations (77%)
• private hospitals accounted for over 3 in 5 of surgical hospitalisations (62%) and mental health hospitalisations (62%).

Changes over time

• From 2020–21 to 2021–22, hospitalisations for General Intervention (Surgical) have decreased by 10.9% (from 1.1 million to 1 million) in public hospitals and 3.2% (1.7 million to 1.65 million) in private hospitals.
• From 2017–18 to 2021–22, hospitalisations for Rehabilitation have decreased from 465,900 to 382,000. In public hospitals, the decline on average is 6.0% per year and in private hospitals it is 4.6% per year.

Public hospitals

In 2021–22:

• Just over 3 in 4 acute care hospitalisations (5 million of 6.5 million) were Medical.
• 1 in 6 acute care hospitalisations (1.1 million) were General intervention (Surgical).
• Diseases and disorders of the kidney and urinary tract​ was the most common Major diagnostic category (MDC) accounting for almost 24% of hospitalisations in public hospitals.

Private hospitals

In 2021–22:

• 2 in 5 acute care hospitalisations (1.7 million of 4.2 million) were General intervention (Surgical)
• 38% of acute care hospitalisations (1.6 million) were Medical
• Diseases and disorders of the digestive system was the most common MDC accounting for 18% of hospitalisations in private hospitals.

Major diagnostic category and AR-DRG

Same-day acute care

In 2021–22:

• the 20 most common AR-DRGs accounted for 2 in 3 same-day acute hospitalisations
• 24% of same-day acute hospitalisations were for Haemodialysis (dialysis), with Chemotherapy the next most common AR-DRG (10%)
• public hospitals provided 4 in 5 same-day acute hospitalisations for Haemodialysis (dialysis)
• private hospitals provided 82% of same-day acute hospitalisations for Retinal procedures and 88% of Dental extractions and restorations.

Overnight acute care

In 2021–22:

• childbirth made up the top 3 AR-DRGs for overnight acute hospitalisations (Vaginal Delivery, Intermediate Complexity, followed Caesarean Delivery, Minor Complexity and Vaginal Delivery, Minor Complexity, and most of these (79%, 58% and 78%, respectively) were in public hospitals.
• private hospitals provided 88% of overnight hospitalisations for Other Shoulder Interventions.

OECD Indicators

The Organisation for Economic Co-operation and Development (OECD) presents comparative information on surgical procedures. The comparability of international surgical procedures 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:

• cataract surgeries
• tonsillectomies

The number of:

• caesarean sections per 100 live births
• coronary revascularisation procedures per 100,000 population, and the proportion of these that were coronary angioplasties
• hip replacement surgeries per 100,000 population
• knee replacement surgeries per 100,000 population

The proportion of surgeries performed laparoscopically for:

• cholecystectomies
• inguinal herniorrhaphies
• appendicectomies.

Highlights

Proportion of cataract surgeries that were performed on a same-day basis

A high proportion of cataract surgeries performed on a same-day basis may point to the efficient use of resources.

In 2021–22:

• the proportion of cataract surgeries performed as same-day procedures in Australia (98.1%) was higher than the 2020 OECD average (92.2%)
• the proportion of patients receiving cataract surgeries performed as same-day procedures has been increasing over time, with 97.3% performed as same-day procedures in 2017–18. 

Proportion of tonsillectomies that were performed on a same-day basis

In 2021–22:

• Australia’s proportion of tonsillectomies that were performed on a same-day basis (18.3%) was lower than the 2020 OECD average (34.2%)
• the proportion of tonsillectomies performed as same-day procedures has increased over time, from 13.6% in 2017–18 to 18.3% in 2021–22.

​Number of caesarean sections per 100 live births  

In 2021-22, Australia’s rate of caesarean sections per 100 live births (39.6) was higher than the 2020 OECD average (24.2). This is an increase of 1.3 caesarean sections per 100 live births when compared to 2020–21 (38.3 per 100 live births), and an increase of 4.5 per 100 in 2017–18 (35.1 per 100 live births).

Number of coronary revascularisation procedures per 100,000 population

In 2021–22:

• the coronary revascularisation procedure rate for Australia was below the 2020 OECD average (178.9 and 196.3 per 100,000 population, respectively), and within the interquartile range
• coronary angioplasty accounted for 77.5% of all coronary revascularisation procedures in Australia, lower than the 2020 OECD average (86.9%).

Number of hip and knee replacement surgeries per 100,000 population

In 2021–22:

• Australia’s rate of hip replacement surgery in 2021–22 was below the 2020 OECD average (158.7 and 169.7 per 100,000 population, respectively)
• Australia’s rate of knee replacement surgery was above the 2020 OECD average (181.4 and 107.8 per 100,000 population, respectively).

Proportion of selected surgical procedures that were performed laparoscopically

Laparoscopic (keyhole) surgery is less invasive (and therefore considered to be safer) than ‘open’ approaches.

In 2021–22, Australia had higher proportions of the 3 selected procedures that were performed laparoscopically:

• 95.3% of cholecystectomies in Australia were performed laparoscopically, compared with the 2020 OECD average (91.8%). This has increased over time, with 94.2% performed laparoscopically in 2017–18.
• 93.6% of appendicectomies in Australia were performed laparoscopically, compared with the 2020 OECD average (79.3%). This has increased over time, with 91.4% performed laparoscopically in 2017–18.
• 48.6% of inguinal herniorrhaphies in Australia were performed laparoscopically, compared with the 2020 OECD average (35.9%). This has increased over time, with 44.0% performed laparoscopically in 2017–18.

This section presents analysis of average weekly hospitalisations (presented by date of admission) over 4 years (2018–19 to 2021–22) to highlight the impact of COVID-19 on hospitalisations and allow comparison between years.

Explore the data

The data visualisations below present data on hospitalisations (by date of admission) for 2018–19 to 2021–22, including:

• average daily hospitalisations (by week) by
  • state and territory
  • urgency category

• actual and projected hospitalisations (by date of admission) for 2018–19 to 2021–22 (by month).

Highlights

Hospitalisations decreased in 2019–20

Nationally, over the five years between 2014–15 and 2018–19, the number of hospitalisations increased on average by 3.3% each year. However, between 2018–19 and 2019–20, the number of hospitalisations overall decreased by 2.8%:

• hospitalisations in public hospitals decreased by 1.7%
• hospitalisations in private hospitals decreased by 4.5%.

This decrease was due to changes in behaviours and healthcare provision during the COVID-19 pandemic, including restrictions on non-urgent elective surgery. These effects varied between public and private hospitals.

For public hospitals, in 2019–20:

• same-day hospitalisations decreased by 0.2% compared with 2018–19 and overnight hospitalisations decreased by 3.4%
• hospitalisations with an urgency category of Emergency decreased by 2.8% and Elective admissions decreased by 2.6%.

For private hospitals, in 2019–20:

• same-day hospitalisations decreased by 4.1% compared with 2018–19 and overnight hospitalisations decreased by 5.5%
• hospitalisations with an urgency of admission of Emergency decreased by 3.3% and Elective admissions decreased by 6.2%.

Admitted patient activity returning to normal in 2020–21

In 2020–21, admitted patient activity increased when compared with 2019–20, approaching levels projected based on pre-COVID year-on-year average increases: 

• Overall, hospitalisations increased by 6.3% from 11.1 to 11.8 million hospitalisations.
• Overnight hospitalisations increased by 3.3% and same-day hospitalisations increased by 8.1%.
• The largest increase was for hospitalisations in private free-standing day hospitals (13.9%) compared with hospitalisations in public acute hospitals (3.6%).
• Hospitalisations in Other private hospitals, (or private hospitals offering a mix of same-day and overnight hospitalisations) increased 9.5%.

Admitted patient activity decreased compared with 2020–21

In 2021–22: 

• Hospitalisations decreased by 2.1% compared with 2020–21 – from 11.8 million to 11.6 million.
• Overnight hospitalisations decreased by 2.2% (4.4 million to 4.3 million) and same-day hospitalisations decreased by 2.0% (7.4 million to 7.3 million).
• The smallest decrease was for private free-standing day hospitals (1.2%, 1.09 million to 1.07 million).
• Patient days per 1,000 population decreased by 0.5% - from 1,110 in 2017–18 to 1,088 in 2021–22 – consistent with longer term trends.

See ‘More information about the Data’ section below for information on how the projected presentations data were calculated.