Western District Health Service (Vic)

An ED presentation occurs following the arrival of the patient at the ED and commences at the point of being registered or triaged. Triage is the process during which a health professional assesses the urgency of the care needs, including assigning one of five urgency categories to the health record.

Explore the data

Explore the number of presentations to Australia’s public hospital EDs in 2022–23 and for recent years in the data visualisation below.

Information is presented by the following patient characteristics:

• age and sex (as recorded in the data)
• Indigenous status
• the remoteness of the patient's residential address
• the socioeconomic status of the area that the patient lives in.

The data can also be explored by:

• state and territory
• hospital peer group
• local Hospital Network (LHN) (where data is available)
• hospital (where data is available).

Highlights

In 2022–23:

• there were 8.80 million presentations to emergency departments in Australia – a rate of 334 per 1,000 population
• most ED presentations were to Principal referral and women’s and children’s and Public acute group A hospitals (71%, combined).

Emergency presentations have increased over the last five years, from 8.35 million in 2018–19 to 8.80 million in 2022–23, representing an average annual increase of 1.3% per year. However the number of presentations fluctuated during the years that were affected by COVID, decreasing in 2019–20, increasing in 2020–21 and decreasing again 2021–22.

Presentations to Public acute group C hospitals have increased the most (3.9% per year since 2018–19).

Age and sex

• In 2022–23, while, overall, males accounted for 49% of all ED presentations and females accounted for 51%, there were differences across age groups. In age groups under 15 years, a higher proportion of presentations were for males, but for age groups between 15 to 44 years and 85 years and over, most presentations were for females. In the age groups between 45 and 84 years, presentations were more evenly split between males and females. 
• For both males and females, the highest rates of presentation per 1,000 population were for patients aged 85 or over – 941presentations per 1,000 population for males, and 764 per 1,000 population for females.
• The second highest presentation rates for both males and females were seen in  patients aged 4 and under – who presented at EDs at a rate of 707 per 1,000 population for males and 592 per 1,000 population for females. 
• While ED presentation rates were highest in the very young and very old age groups, 44% of all ED presentations were for people aged between 25 and 64. 

Indigenous status

• Overall, 8.4% of ED presentations were for Aboriginal and Torres Strait Islander (First Nations) people (who make up 3.8% of the Australian population).
• Across all age groups, the presentation rates per 1,000 population were greater for First Nations people compared to Other Australians. The largest difference was for people aged 40–44 where the presentation rate was 980 per 1,000 population for First Nations people and 256 per 1,000 population for Other Australians.  

Remoteness area of usual residence 

• People living in Major cities (who make up 72% of the Australian population), accounted for 62% of ED presentations – 294 presentations per 1,000 people. 
• People living in Remote and Very remote areas (who make up 1.9% of the population) accounted for 3.6% of presentations.
• Information on presentation rates should be interpreted with caution as the scope of the ED data collection is ‘formal’ EDs that meet specific criteria and may not be evenly accessible to people across all geographic areas. 

Socioeconomic status of area of usual residence

• People living in the lowest socioeconomic (most disadvantaged) areas were most likely to visit an ED, accounting for 24% of ED presentations (410 presentations per 1,000 people). This was followed by people who lived in areas classified as being in the second lowest socioeconomic position – who presented at a rate of 386 presentations per 1,000 population. 
• People living in the highest socioeconomic (least disadvantaged) areas were least likely to visit an ED. They accounted for 14% of all ED presentations (233 presentations per 1,000 people).

Emergency department (ED) waiting time is the time elapsed for each patient from presentation in the ED to commencement of clinical care.

A patient is considered to have been 'seen on time' when the time between arrival at the ED and the time that their clinical care starts is within the time specified in the definition of the triage category they are assigned:

• Resuscitation: Immediate (within seconds)
• Emergency: within 10 minutes
• Urgent: within 30 minutes
• Semi-urgent: within 60 minutes
• Non-urgent: within 120 minutes.

Explore the data

The data visualisation below presents the following emergency department waiting time statistics by triage category:

• proportion seen on time
• 50th percentile (median) waiting time (half of all people waited less than this time)
• 90th percentile waiting time (90% of people waited less than this time).

In addition to the national data, the data can also be explored for recent years by:

• state and territory
• hospital (where data is available)
• local Hospital Network (LHN) (where data is available).

Highlights

Over the last five years, the proportion of patients ‘seen on time’ has decreased and the time in which 90% of presentations were seen has increased.

In 2022–23: 

• the proportion of patients ‘seen on time’ was 65%, down from 67% in 2021–22 and from 71% in 2018–19
• Principal referral and Women’s and children’s hospitals and Public acute group A hospitals had the lowest overall proportion of presentations ‘seen on time’ (61%), and Other hospitals had the highest proportion (92%)
• 50% of patients were seen within 20 minutes, consistent with the previous year and higher than the preceding three years
• the time within which 90% of presentations were seen was 2 hours and 4 minutes, an increase from 1 hour and 40 minutes in 2018–19.

An emergency department (ED) stay is the period between a patient presenting at an ED, and when that person is recorded as having physically departed the ED (regardless of whether they were admitted, referred, discharged or left at their own risk).

Explore the data

The data visualisation below presents the following measures related to time spent in the emergency department:

• proportion of patients with a length of stay of 4 hours or less
• 50th percentile (median) time spent in the ED (half of all people waited less than this time)
• 90th percentile time spent in the ED (90% of people waited less than this time).

The data is presented by:

• state and territory
• admission status
• triage category
• peer group.

The data can also be explored by:

• trends over time
• local Hospital Network (LHN) (where data is available)
• hospital (where data is available).

Highlights

Nationally, over the last five years, the time in which 90% of presentations were completed has increased, and the proportion of presentations completed within 4 hours has decreased. 

In 2022–23:

• 50% of ED presentations were completed within 3 hours and 39 minutes, which is around 41 minutes longer than in 2018–19 (2 hours, 58 minutes)  
• the time in which 50% of patients completed their ED care was longer for patients who were subsequently admitted to the hospital (6 hours, 4 minutes) than for patients who were not admitted (3 hours, 4 minutes)
• 90% of ED presentations were completed within 10 hours and 32 minutes which is just over 3 hours longer than in 2018–19 (7 hours, 29 minutes)
• the time in which 90% of patients completed their ED care was longer for patients who were subsequently admitted to the hospital (18 hours, 23 minutes) than for patients who were not admitted (7 hours, 19 minutes)
• 56% of patients who presented to ED had their care completed within 4 hours compared to 61% in 2021–22 and 70% in 2018–19
• for patients subsequently admitted to the same hospital, one-third (31%) of ED presentations were completed within 4 hours
• for patients not subsequently admitted, two-thirds (66%) of ED presentations were completed within 4 hours
• 79% of ED presentations occurred between the hours of 8 a.m. and 10 p.m.

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%.

Length of stay is the number of days between admission to hospital, and separation. 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 hospitalisations. 

OECD indicator: Length of stay

The Organisation for Economic Co-operation and Development (OECD) presents comparative information on the ALOS for overnight hospitalisations as an indicator of efficiency. The comparability of international ALOS may be affected by differences in definitions of hospitals, collection periods and admission practices.

Performance indicator: Average length of stay for selected AR-DRGs

The ALOS for selected AR-DRGs is an indicator of Efficiency and sustainability under the Australian Health Performance Framework (AHPF).

Explore the data

In the data visualisation below, you can view the ALOS by selected medical procedures, by state and territory, and by type of hospital (peer group).

Highlights

In 2021–22:

• the ALOS for overnight hospitalisations in Australia was 5.7 days (5.9 days for public hospitals and 5.2 days for private hospitals), which is 1.8 days lower than the OECD average (7.5 days)
• there were notable differences (more than 1 day) in the ALOS between public and private hospitals for 6 of the 20 selected diagnosis groups – the AR-DRGs, (for example, the ALOS for Chronic obstructive airways disease, minor complexity was 2.9 days for public hospitals and 6.0 for private hospitals).

Between 2017­–18 and 2021–22, the overall ALOS for hospitalisations in Australia continued to fluctuate, only increasing from 2.70 days to 2.74 days. Prior to this, the ALOS declined over the years as the ALOS was 3.0 days in 2012–13, dropping to 2.8 days in 2016–17.

The ALOS for overnight hospitalisations in public hospitals increased by 2.3% per year (5.4 to 5.9 days), whilst private hospitals decreased by 0.2% (5.21 to 5.17 days).

Significant changes in ALOS over time may be related to changes in admission practices and improvements in the coverage of reporting.