Admitted patient activity

OECD indicator: Length of stay

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:

• 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

National trends

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 2017–18:

• the proportion of cataracts performed as same-day procedures in Australia (97.3%) was higher than the 2016 OECD average (69.1%).

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

In 2017–18:

• Australia’s proportion of tonsillectomies that were performed on a same-day basis (13.6%) was lower than the 2016 OECD average and (32.8%).

​Number of caesarean sections per 100 live births

In 2017–18:

• Australia’s rate of caesarean sections per 100 live births (35.10) was higher than the 2016 OECD average (26.4).

Number of coronary revascularisation procedures per 100,000 population

The 2017–18:

• the Coronary revascularisation procedure rate for Australia was below the 2016 OECD average (201.0 and 247.0 per 100,000 population, respectively), and within the interquartile range
• Coronary angioplasty accounted for 78.6% of all Coronary revascularisation procedures in Australia, similar to the 2016 OECD countries average (78.9%).

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

In 2017–18:

• Australia’s rate of hip replacement surgery in 2017–18 was below the 2016 OECD average (164.0 and 174.3 per 100,000 population, respectively)
• Australia’s rate of knee replacement surgery was above the 2016 OECD average (205.0 and 131.6 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 2017–18, Australia had higher proportions of the 3 selected procedures that were performed laparoscopically:

• 94.2% of cholecystectomies in Australia were performed laparoscopically, compared with the 2016 OECD average (85.1%)
• 91.5% of appendicectomies in Australia were performed laparoscopically, compared with the 2016 OECD average (63.6%)
• 44.1% of cholecystectomies in Australia were performed laparoscopically, compared with the 2016 OECD average (25.3%).

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:

• 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 
2013–14 and 2016–17, and by hospital, between 2011–12 to 2016–17.

National trends

In 2017–18, for the public and private sectors combined:

• 90.9% of hospitalisations were classified as episodes of Acute care
• 4.1% of hospitalisations were classified as episodes of as Rehabilitation care
• 3.0% of hospitalisations were classified as episodes of as Mental health care
• 0.5% of hospitalisations were classified as episodes of as Newborn care (with at least one qualified day).

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.

Acute care

In 2017–18:

• overall, 91% of hospitalisations were classified as episodes of Acute care, public hospitals accounted for 62% of hospitalisations for Acute care
• the most common principal diagnosis (at the 3-chartacter level) reported for same-day acute hospitalisations was Care involving dialysis and accounted for 34% of same-day acute hospitalisations in public hospitals
• the most common principal diagnosis (at the 3-chartacter level) reported for overnight acute hospitalisations was Single spontaneous delivery.

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

Newborn care

This section presents information on Newborn care provided for 2017–18. Newborns receiving care may have both ‘qualified’ and ‘unqualified’ days.

In 2017–18:

• there were almost 308,000 newborn hospitalisations, the majority of these (82%) occurred in public hospitals
• newborns with at least one qualified day accounted for 24% of all newborn care hospitalisations—25% of hospitalisations in public hospitals and 21% of hospitalisations in private hospitals
• the most common diagnosis for newborns with at least one qualified day was Disorders related to short gestation and low birth weight, not elsewhere classified (29% of hospitalisations) followed by Respiratory distress of newborn (12% of hospitalisations)
• overall, 95% of newborn hospitalisations had a separation mode of Discharged home.

Between 2013–14 and 2017–18:

• hospitalisations for qualified newborns decreased by an average of 7.9% per year for private hospitals and by 4.8% per year for public hospitals (most of these decreases reflects changes in the assignment of qualification status in New South Wales between 2016–17 and 2017–18)
• for unqualified newborns, Newborn care hospitalisations decreased by an average of 2.6% per year for private hospitals, and increased by an average of 3.1% per year for public hospitals (however, as above, these figures reflects changes in the assignment of qualification status in New South Wales between 2016–17 and 2017–18).

Subacute and non-acute care

Between 2013–14 and 2017–18:

• overall, the number of hospitalisationsfor Subacute and Non-acute care rose from 462,000 to about 610,000, an average increase of 7.2% per year
• hospitalisations for Subacute and Non-acute care rose by 1.3% each year for public hospitals and by 10.8% each year for private hospitals.

Rehabilitation care

In 2017–18:

• there were almost 466,000 Rehabilitation care hospitalisations, with the majority (80%) occurring in private hospitals
• Rehabilitation care accounted for 91% of subacute and non-acute hospitalisations for private hospitals and 46% for public hospitals
• females accounted for more than half (57%) of all Rehabilitation care hospitalisations
• Indigenous Australians had lower hospitalisations rates for Rehabilitation care than other Australians (8.2 per 1,000 and 16.0 per 1,000, respectively)
• people in Major cities had much higher rates of Rehabilitation care compared to people who live in other remoteness areas (19 hospitalisations per 1,000 population compared to 16 per 1,000 nationally)
• more than half (51%, 236,000) of Rehabilitation care hospitalisations in public and private hospitals had a principal diagnosis in the ICD-10-AM chapter Diseases of the musculoskeletal system and connective tissue—which includes conditions such as arthrosis of the knee or hip, back pain and other joint disorders.

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

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.

In 2017–18:

• there were almost 46,000 hospitalisations with a care type of Palliative care, the majority (86%) of these occurred in public hospitals
• the average length of stay for Palliative care hospitalisations was 9.5 days in public hospitals, and 12.6 days in private hospitals
• neoplasm-related (cancer-related) conditions accounted for 55% of principal diagnoses reported for Palliative care hospitalisations, with Malignant neoplasm of bronchus and lung accounting for 9% of Palliative care hospitalisations
• the most common non-neoplasm-related principal diagnoses for Palliative care included heart failure and respiratory disorders.

Between 2013–14 and 2017–18:

• Palliative care hospitalisationsremained stable overall in private hospitals and increased by 4.7% per year for public hospitals
• Palliative care hospitalisations accounted for less than 0.5% of all hospital hospitalisations over the 5-year period.

Mental health care

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.

In 2017–18:

• there were 337,000 Mental health care hospitalisations, with the majority (58%) occurring in private hospitals
• the majority (84%) of Mental health care hospitalisations in public hospitals involved a stay of at least one night
• for private hospitals, the majority (78%) of Mental health care hospitalisations were for same-day care
• females accounted for more than half (58%) of all Mental health care hospitalisations
• people aged 15 to 64 accounted for 87% of Mental health care hospitalisations.

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. 

National trends

Hours in intensive care

For public hospitals in 2017–18:

• just over 1.7% of hospitalisations involved time in an ICU and the average period in ICU was 90 hours per hospitalisation (just under 4 days)
• 10.4 million hours (434,000 patient days) were spent in an ICU for 115,000 hospitalisations.

For private hospitals in 2017–18:

• data was only available for New South Wales, Victoria, Queensland, Western Australia and South Australia
• 2.3 million hours (98,500 patient days) were spent in an ICU for 46,000 hospitalisations
• just over 1.0% of hospitalisations involved time in an ICU and the average period in ICU was 51 hours per hospitalisation (just over 2 days).

Hours of continuous ventilatory support

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:

• 4.1 million hours of CVS were reported for 46,000 hospitalisations in Australian hospitals
• 0.6% of hospitalisations in public hospitals involved CVS and the average duration of CVS was 97 hours per separation (just over 4 days)
• public hospitals provided 3.7 million hours (154,000 patient days) of CVS for 38,000 hospitalisations.

For private hospitals in 2017–18:

• data was only available for New South Wales, Victoria, Queensland, Western Australia and South Australia
• 373,000 hours (15,500 patient days) of CVS was provided for 8,000 hospitalisations
• fewer than 0.2% of hospitalisations in private hospitals involved CVS and the average duration of CVS was 47 hours per separation (just under 2 days).

Overlap between ICU and CVS

CVS is usually, but not always, provided within an ICU. Some stays in ICUs do not involve ventilatory support.

In 2017–18:

• 161,000 hospitalisations reported a stay in ICU and 46,000 hospitalisations reported periods of CVS
• overall, 24% of hospitalisations (39,500 of 161,400) that reported hours in an ICU also reported hours of CVS—28% for public hospitals and 15% for private hospitals
• over 85% of hospitalisations that reported hours of CVS also reported hours in an ICU (39,500 of 46,400).

The nature of the services provided to an admitted patient during an episode of care can be described in a number of ways including:

• the broad category of service
• the Australian Refined Diagnosis Related Groups (AR-DRGs)—this includes the numbers of hospitalisations by Major Diagnostic Category (MDC) and AR-DRGs
• the intent of care—including who used these services, why they received care, how the care was completed and who paid for the care.

National trends

Broad category of service

Hospitalisations are categorised into the following broad categories of service:

• Childbirth
• Mental health
• Surgical
• Medical
• Other
• Subacute and non-acute care

See the 'More information about the data' section below for more information on Broad category of service.

In 2017–18:

• 54% of hospitalisations were for medical care, 23% were for surgical care and 12% for other acute care
• public hospitals accounted for the majority of Emergency hospitalisations (92%), Medical hospitalisations (77%) and Childbirth hospitalisations (77%)
• private hospitals accounted for 59% of surgical hospitalisations and 58% of mental health hospitalisations
• Emergency hospitalisations in public hospitals had shorter stays (5.7 days, on average) compared with Emergency hospitalisations in private hospitals (6.4 days)
• for Childbirth hospitalisations, Emergency medical and Emergency surgery, the average lengths of stay were longer in private hospitals than in public hospitals.

Changes over time

Between 2013–14 and 2017–18:

• in public hospitals, Emergency surgical hospitalisations increased by an average of 3.0% each year, and Emergency medical hospitalisations increased by an average of 4.6% each year
• in private hospitals, Non-emergency medical hospitalisations increased by an average of 3.6% each year.

Between 2016–17 and 2017–18:

• Emergency hospitalisations increased by 5.9% in private hospitals and by 1.3% in public hospitals.

Major diagnostic category (MDC) and AR-DRG

In 2017–18, for public hospitals:

• Medical DRGs accounted for 75% of hospitalisations (4.8 million)
• Surgical DRGs accounted for 18% of hospitalisations (1.1 million)
• Diseases and disorders of the kidney and urinary tract was the most common MDC for public hospitals (23% of hospitalisations).

In 2017–18, for private hospitals:

• Surgical DRGs accounted for 40% of acute care hospitalisations (1.6 million)
• Medical DRGs accounted for 37% of acute care hospitalisations (1.4 million)
• Diseases and disorders of the digestive system was the most common MDC (17%)
• private hospitals accounted for 70% of acute care hospitalisations for Diseases and disorders of the eye.

Same-day acute care

In 2017–18:

• the 20 most common AR-DRGs accounted for almost two-thirds (61%) of same day acute hospitalisations
• almost one-quarter (23%) of same-day acute hospitalisations were for Haemodialysis (dialysis), with Chemotherapy the next most common AR-DRG (9%)
• public hospitals provided the majority (81%) of same-day acute hospitalisations for Haemodialysis (dialysis)
• private hospitals provided 89% of same-day acute hospitalisations for Retinal procedures and 83% of Dental extractions and restorations.

Overnight acute care

In 2017–18:

• the 2 most common AR-DRGs for overnight acute hospitalisations were for childbirth, followed by respiratory infections
• public hospitals provided the majority of overnight hospitalisations for Vaginal delivery, intermediate complexity and Vaginal delivery, minor complexity (80% and 79%, respectively)
• private hospitals provided 81% of overnight hospitalisations for Sleep apnoea, minor complexity and 81% of overnight hospitalisations for Other shoulder procedures.

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:

• Indigenous status
• The external cause of injury and poisoning

National trends

In 2017–18:

• about 782,000 hospitalisations (about 30 per 1,000 population) had a principal diagnosis for injury or poisoning, the majority (78%) were treated in public hospitals
• about 46% of these hospitalisations, in public and private hospitals combined, had a principal diagnosis for Injuries to upper and lower limbs
• public hospitals had notably higher proportions (more than 97%) of hospitalisations with external causes of Intentional self-harm, Assault, Accidental poisoning, and Accidental drowning and submersion, than private hospitals

​Indigenous Australians

• Indigenous Australians were hospitalised with a principal diagnosis of injury or poisoning at almost twice the rate of other Australians (55 per 1,000 and 29 per 1,000, respectively)
• Injuries to upper and lower limbs accounted for 40% of these hospitalisations for Indigenous Australians and 46% for other Australians,
• Injuries to the head and neck accounted for 25% of hospitalisations for Indigenous Australians and 16% for other Australians
• Falls (20%) and Assault (20%) were the most commonly reported external cause of injury and poisoning for Indigenous Australians, accounting for 40% of all reported external causes of injury and poisoning
• Falls (37%, 288,000 hospitalisations) and Complications of medical and surgical care (18%, 138,000 hospitalisations) were the most frequently reported external causes of injury or poisoning
• Falls was also the most commonly reported external cause for other Australians (38%), followed by Complications of medical and surgical care (18%)
• Transport accidents accounted for a similar proportion of external causes of injury for both Indigenous Australians and other Australians (about 9% each).

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.

National trends

ICD-10-AM chapters

In 2017–18:

• over one-quarter (24%, 2.7 million) of hospitalisations in public and private hospitals had a principal diagnosis in the ICD-10-AM chapter Factors influencing health status and contact with health services—which includes Care involving dialysis (close to 1.5 million separations), radiotherapy and chemotherapy
• the relative distribution of hospitalisations by ICD-10-AM chapter varied across public and private hospitals. For example, about 84% of hospitalisations for both Certain infectious and parasitic diseases and 85% for Certain conditions originating in the perinatal period were from public hospitals. For Diseases of the eye and adnexa, about 72% of hospitalisations were from private hospitals
• about 49% of hospitalisations for Indigenous Australians in 2017–18 had a principal diagnosis in the ICD-10-AM chapter Factors influencing health status and contact with health services, compared with 23% for other Australians
• the ICD-10-AM chapter Injury, poisoning and certain other consequences of external causes was the second most common principal diagnosis chapter among Indigenous Australians, accounting for 6.6% of hospitalisations. It accounted for 7.0% of hospitalisations for other Australians
• separation rates for Indigenous Australians were almost 7 times the rate for other Australians for Factors influencing health status and contact with health services (which includes Care involving dialysis), and more than twice the rate for Endocrine, nutritional and metabolic diseases (which includes Diabetes mellitus), Diseases of the skin and subcutaneous tissue, and Diseases of the respiratory system.

Most common principal diagnoses

Same-day acute separations

In 2017–18:

• the most common principal diagnosis (at the 3-character level) reported for same-day acute separations was Care involving dialysis, which accounted for 34% of same-day acute separations in public hospitals
• public hospitals provided the majority of same-day acute separations for Pain in throat and chest (91%) and Care involving dialysis (81%)
• private hospitals provided the majority of same-day acute separations for Procreative management (96%), Other retinal disorders (91%), Embedded and impacted teeth (91%) and Benign neoplasm of colon, rectum, anus and anal canal (80%). The principal diagnosis Other cataract (70%) also contributed to high counts of private hospital same-day acute separations.

Overnight acute separations

In 2017–18:

• the most common principal diagnosis (at the 3-character level) reported for overnight acute separations was Single spontaneous delivery, which accounted for 3.9% of overnight acute separations in public hospitals and 2.0% in private hospitals
• public hospitals provided the majority of overnight acute separations. Private hospitals provided a large majority of overnight acute separations for Sleep disorders (71%), Gonarthrosis (arthrosis of knee, 67%) and Coxarthrosis (arthrosis of hip, 66%).

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

National trends

In 2017–18:

• 23.7 million interventions were reported, with 12.1 million performed in public hospitals, and 11.6 million in private hospitals
• 76% (5.1 million) of public hospital separations and 95% (4.3 million) of private hospital separations involved at least one intervention
• public hospitals accounted for 78% of Obstetric procedures (which includes childbirth), 77% of Procedures on the respiratory system and 72% of Procedures on the urinary system (mainly for dialysis)
• private hospitals accounted for 75% of Dental services procedures, 74% of Procedures on nervous system and 72% of Procedures on the breast.

Interventions for same-day acute care

In 2017–18:

• 10.6 million interventions were reported
• 79% of separations in public hospitals and 99% of separations in private hospitals involved an intervention
• Cerebral anaesthesia (general anaesthesia and sedation, 2.4 million procedures), Haemodialysis (1.5 million) and Administration of pharmacotherapy (mostly chemotherapy, 888,000) accounted for 45% of all procedures.

Interventions overnight acute care

In 2017–18:

• 10.7 million interventions were reported
• 72% of separations in public hospitals and 90% of separations in private hospitals involved at least one intervention
• Generalised allied health interventions (for example, physiotherapy and other rehabilitation procedures) accounted for 39% of interventions in public hospitals (2.7 million).

Surgery

This section presents information on all surgical separations (operating room procedures). 

In 2017–18:

• 1 in 4 hospitalisations (24%) involved surgery and 58% of these occurred in private hospitals
• there were 352,000 emergency admissions involving surgery and 86% of these occurred in public hospitals. The most common emergency surgery performed was Appendicectomy
• there were 2.3 million elective admissions involving surgery and 66% of these occurred in private hospitals. 

Surgical separations

In 2017–18:

• a surgical procedure was reported for 24% of all separations (2.7 million)—17% of public hospital separations and 35% of private hospital separations
• 4% of surgical separations had an urgency of admission of Not assigned (for example, for childbirth or other planned procedures) or not reported
• for public hospitals, 66% of surgical separations were elective admissions, 26% were emergency admissions and 7% did not have an urgency assigned
• for private hospitals, 95% of surgical separations were elective admissions and 3% were emergency admissions and 2% did not have an urgency assigned.

Changes over time

Between 2013–14 and 2017–18:

• elective admissions involving surgery rose by an average of 1.7% per year—by 2.0% for public hospitals and by 1.6% for private hospitals.

Emergency admissions involving surgery

In 2017–18:

• there were 352,000 emergency admissions involving 652,000 surgical interventions in Australian hospitals
• public hospitals accounted for the majority (86%) of emergency admissions involving surgery
• nationally, there were 13.6 emergency admissions involving surgery per 1,000 population
• Other debridement of skin and subcutaneous tissue was the most common surgical intervention (at the procedure block level) for emergency admissions involving surgery, and 92% of these were performed in public hospitals.

Changes over time

Between 2013–14 and 2017–18:

• emergency admissions involving surgery increased by 2.9% on average per year for public hospitals, and increased in all states and territories
• emergency admissions involving surgery increased by 5.1% on average per year for private hospitals, and increased in most states and territories. 

Elective admissions involving surgery

In 2017–18:

• there were 2.3 million elective admissions involving surgery in Australia’s public and private hospitals
• nationally, there were 86 elective admissions involving surgery per 1,000 population
• public hospitals provided 29 elective admissions involving surgery per 1,000 population and private hospitals provided 57 per 1,000 population
• the most common principal diagnosis was Other cataract (229,000 or 10%), with 71% of these occurring in private hospitals
• 96% of admissions with a principal diagnosis of Procreative management and 93% of those with a principal diagnosis of Obesity were in private hospitals
• more than half (52%) of admissions with a principal diagnosis of Cholelithiasis (gallstones) occurred in public hospitals.

Changes over time

Between 2013–14 and 2017–18:

• elective admissions involving surgery rose by an average of 1.7% per year—by 1.9% per year in public hospitals and 0.9% per year in private hospitals
• over this period, private hospitals consistently accounted for the majority (66%) of elective admissions involving surgery.

Themain 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. 

Explore the data

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.

National trends

Hospitalisations

In 2017–18: 

• there were 11.3 million hospitalisations in Australia’s public and private hospitals
• almost 60% (6.7 million) occurred in public hospitals.

Between 2013–14 and 2017–18:

• the number of hospitalisations rose by 3.8% on average each year—by 4.2% for public hospitals and by 3.3% for private hospitals. In 2017–18, there were 423 hospitalisations per 1,000 population, compared with 395 per 1,000 in 2013–14.

Coverage changes in public hospitals between 2013–14 and 2017–18 may influence changes over time.

Patient days

In 2017–18:

• public hospitals accounted for 67% of patient days (20.3 million)
• for jurisdictions whose private hospital data could be reported, the proportion of patient days that were in private hospitals ranged from 20% in New South Wales to 40% in Queensland.

Changes over time

Between 2013–14 and 2017–18:

• the number of patient days increased by an average of 2.1% each year, from 27.9 million to 30.2 million
• the number of patient days in private hospitals increased by 2.5%. Private hospitals accounted for between 32% to 33% of all patient days over this period.

 Between 2013–14 and 2017–18:

• overall patient days per 1,000 population fluctuated for Public acute hospitals, Private free-standing day hospital facilities and Other private hospitals but there was an overall decrease over time.

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.

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.

National trends

Public hospitals

In 2017–18:

• there were 693 public hospitals in 2017–18 and of these, 674 provided admitted patient care data
• about 25% of public hospitals (179) were located in Major cities. The greatest number of public hospitals was reported for Outer regional areas (210, or 30%)
• most of the larger public hospitals are located in the more populated areas, and this is evidenced by the number of hospital beds that were located in each remoteness area.

Between 2013–14 and 2017–18:

• there were 693 public hospitals in 2017–18 compared with 747 in 2013–14. Much of this decrease was due to the reclassification of 46 establishments in Queensland between 2013–14 and 2014–15.

Public hospitals peer groups

• 31 Principal referral hospitals accounted for the highest proportion of public hospital separations (2.5 million separations, or 37%) and public hospital patient days (7.6 million patient days, or 38%).
• 63 Public acute group A hospitals accounted for a further 33% of separations and 31% of patient days.
• 110 Very small hospitals accounted for fewer than 1% of both separations and patient days.
• 37 Subacute and non-acute hospitals accounted for 1% of separations and 4% of patient days, with an average length of stay of 13.4 days.

Public local hospital networks

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.

In 2017–18:

• there were 135 LHNs, including 85 in Victoria, and 1 each in Tasmania and the Australian Capital Territory
• many LHNs in Victoria consist of a single public hospital. Other networks might consist of a Principal referral or Public acute group A hospital and a range of smaller and/or more specialised hospitals.

Private hospitals

Between 2012–13 and 2016–17:

• the number of private hospitals reporting to rose from 601 to 657
• numbers of private hospitals increased for all jurisdictions.