WA Country Health Service

An emergency department (ED) presentation occurs following the arrival of the patient at the ED, and is the earliest occasion of being registered clinically or triaged.

Explore the data

Explore the number of presentations to Australia’s public hospital EDs in 2018–19 in the data visualisation below.

Information is presented by: 

• Age and sex
• Indigenous status

The data can also be explored by:

• Overall national trends
• State and territory
• Local Hospital Network (LHN) and hospital (where data is available)

National trends

Age and sex

• ED presentations were generally evenly split between males and females. However, for those aged 0–14, substantially more boys (56%) than girls (44%) presented to ED in 2018–19.
• Patients aged 4 and under (who make up less than 7% of the population), accounted for 11% of all ED presentations. Males accounted for 56% of presentations for patients aged 4 and under.
• Patients aged 65 and over (who make up about 15% of the population) accounted for 22% of all ED presentations in 2018–19.

Indigenous status

• About 7.1% of ED presentations (just under 587,000) were for Aboriginal and Torres Strait Islander people (Indigenous Australians), who represent about 3.3% of the Australian population.
• In all jurisdictions, the presentation rate per 1,000 population was greater for Indigenous Australians compared to Other Australians.

Remoteness area of usual residence 

• 63% of ED presentations were reported for people living in Major cities—who make up about 71% of the Australian population, with about 292  presentations per 1,000 people.
• People living in Remote and Very remote areas (who make up about 2% of the population) accounted for more than 3% of presentations.

Socioeconomic status of area of usual residence

• Almost 24% of ED presentations were reported for patients living in areas classified as being the lowest (most disadvantaged) SES group, with about 392 presentations per 1,000 people.
• The smallest number of presentations was reported for patients living in areas classified as being the highest (least disadvantaged) SES group (14% of the total), with about 241 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.

Explore the data

The data visualisation below present the following emergency department waiting time statistics:

• Proportion seen on time
• 50th percentile (median) waiting time
• 90th percentile waiting time

The data is presented by:

• Triage category

By selecting a geography in the visualisation below, the data can also be explored by:

• Overall national trends
• State and territory
• Local Hospital Network (LHN) and by Hospital (where data is available)

National trends

Proportion of patients seen on time

• 75% of Emergency presentations were ‘seen on time’.  
• Principal referral and women’s and children’s hospitals had the lowest overall proportion of presentations ‘seen on time’ (66%), and Other hospitals had the highest proportion (90%).
• The time within which 90% of presentations were seen was 1 hour and 40 minutes.
• 50% of patients were seen within 19 minutes, which was consistent with waiting times for the other years.
• Between 2014–15 and 2018–19, the proportion of patients ‘seen on time’ has declined from 74% to 71%.

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 most recent data on the proportion of patients with a length of stay of 4 hours or less by:

• State and territory
• Admission status
• Peer group
• Triage category

The data can also be explored by:

• Overall national trends
• State and territory
• Local Hospital Network (LHN) and by Hospital (where data is available)

National trends

In 2018–19:

• 90% of ED presentations were completed within 7 hours and 29 minutes, and 50% were completed within 2 hours 58 minutes
• 90% of patients who were subsequently admitted spent more time in the ED (11 hours 43 minutes) than patients who were not admitted (5 hours 30 minutes)
• 70% of patients had their care completed within 4 hours
• for patients subsequently admitted to the same hospital, about half (47%) of ED presentations were completed within 4 hours
• for patients not subsequently admitted, 80% of ED presentations were completed within 4 hours.

After a specialist clinical assessment, the treating doctor places the patient on an elective surgery waiting list. Elective surgery activity is measured by the number of additions to and removals from public hospital elective surgery waiting lists, and the number of patients admitted for their awaited procedure.

Explore the data

This data visualisation below presents information on additions, removals and admissions in 2018–19 and changes between 2014–15 and 2018–19.

Information is also presented by:

• Indigenous status
• Type of hospital (peer group)

National trends

Additions

• In 2018–19, 893,000 patients were added to elective surgery waiting lists in Australia, this represented 2.5% growth, on average, per year between 2014–15 and 2018–19.

Removals

• 886,400 patients were removed from public hospital elective surgery waiting lists in 2018–19.
• Most patients (86%) were removed from waiting lists were admitted for their awaited procedure.
• 14% were removed from waiting lists for other reasons (for example, the surgery was no longer required, they were treated elsewhere, transferred to another hospital’s waiting list, were unable to be contacted, or died).

Between 2014–15 and 2018–19, the total number of removals from public hospital elective surgery waiting lists increased by an average of 2.3% each year.

Admissions

• In 2018–19, there were 758,100 admissions from public hospital elective surgery waiting lists, 99% of which were elective admissions.
• Between 2014–15 and 2018–19, admissions increased by 2.1% per year on average.
• Principal referral and women’s and children’s hospitals and Public acute group A hospitals accounted for three‑quarters of these admissions (41% and 34%, respectively).
• In 2018–19, 3.8% of admissions from public hospital elective surgery waiting lists (28,600) were reported for people of Aboriginal and Torres Strait Islander origin who represent about 3.3% of the Australian population. 

The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery. This section presents information on the type of elective surgery provided, by surgical speciality in 2018–19 and changes between 2014–15 and 2018–19.

Information on 11 categories of surgical speciality is presented. The ‘other’ category contains data for surgeons whose speciality was not one of the 11 specified categories. From 1 July 2016, surgical speciality was revised to include Paediatric surgery.

Explore the data

The data visualisation below presents elective surgery waiting list additions, removals and admissions by state and territory between 2014–15 and 2018–19.

National trends

In 2018–19:

• Around 21% of patients were admitted for General surgery (on abdominal organs, including endocrine surgery and breast surgery).
• About 14% were admitted for Orthopaedic surgery (on bones, joints, ligaments and tendons, including knee and hip replacements) and Urological surgery (on organs of the urinary system such as bladder, urethra and kidneys).

Changes over time

Between 2014–15 and 2018–19:

• Admissions from elective surgery waiting lists increased for 9 of the 11 surgical specialities.
• The procedures with the greatest average annual increase were Plastic and reconstructive surgery, Urological surgery (increasing by 5.4% per year on average) and Urological surgery (4.6%).
• There was an average annual decrease in admissions for Cardiothoracic surgery (1.2%) and General surgery (0.2%).

The intended surgical procedure describes the type of elective surgery provided by public hospitals.

Explore the data

In the data visualisations below, you can explore admissions from elective surgery waiting lists by:

• The list of 15 indicator procedures between 2014–15 and 2018–19.
• Intended surgical procedure, by type of hospital (peer group) and over time between 2014–15 and 2018–19. Waiting times are presented at national, state and territory, LHN, and hospital level.

National trends

In 2018–19:

• 35% of admissions were for one of the 15 indicator procedures.
• Cataract extraction was the most commonly reported intended surgical procedure with about 72,300 patients admitted, followed by Cystoscopy (63,000).

Changes over time

Between 2014–15 and 2018–19:

• Admissions from elective surgery waiting lists increased for 11 of the 15 indicator procedures.
• The indicator procedures with the greatest average annual increases were Myringotomy (7.2%) and Cystoscopy (6.9%).
• Admissions decreased for Cholecystectomy (gall bladder surgery) by 0.2% per year on average, Coronary artery bypass graft surgery (5.9%), Myringoplasty (2.8%) and Varicose veins treatment (0.8%).

Between 2017–18 and 2018–19:

• There were relatively large increases in admissions for Cataract extraction (2.9%) and Prostatectomy (2.1%).

The length of time waited by patients on public hospital elective surgery waiting lists before being admitted for surgery between 2014–15 and 2018–19. Waiting times for elective surgery can vary depending on:

• State and territory
• Type of hospital (peer group)
• Clinical urgency category

Explore the data

In the data visualisation below, you can explore waiting times for elective surgery by peer group and clinical urgency category.

National trends

In 2018–19:

• the overall time within which 50% of patients were admitted (median waiting time) was 41 days, and the time within which 90% of patients were admitted was 279 days
• about 2.1% of patients waited more than 365 days for their surgery
• the 50th percentile (median) waiting time waiting time for patients admitted from waiting lists for Principal referral and women’s and children’s hospitals (35 days) was shorter than for smaller hospitals Public acute group A hospitals and Public acute group B hospitals (43 days and 50 days, respectively).

Changes over time

50th percentile (median) waiting time

Between 2014–15 and 2018–19, the waiting time of 50% of patients:

• increased overall from 35 days to 41 days
• increased for all public hospital peer groups.

90th percentile waiting time

Between 2014–15 and 2018–19, the 90th percentile waiting time:

• increased overall from 253 days to 279 days
• decreased in Victoria (177 days to 146 days)  and Tasmania (424 days to 343 days)
• increased for Queensland, Western Australia, South Australia, and the Australian Capital Territory, and remained stable in New South Wales.

Patients who waited more than 365 days

Between 2014–15 and 2018–19, the proportion of patients who waited more than 365 days to be admitted:

• fluctuated between 1.8% to 2.1%
• decreased in Public group A and increased in Principal referral, Women’s and children’s hospitals and Public group B.

Waiting times by clinical urgency category

When a patient is placed on the public hospital elective surgery waiting list, a clinical assessment is made of the urgency within which they require elective surgery (the clinically recommended time). The proportion of patients seen within the recommended time is the percentage of patients removed from elective surgery waiting lists who were admitted for surgery within the clinically recommended time for each clinical urgency category.

The ‘overdue wait’ is the amount of time spent waiting while overdue—that is, after 30, 90 or 365 days for clinical urgency categories 1, 2 and 3, respectively. The average overdue wait time (in days) is calculated for patients who were still waiting for their elective surgery as at 30 June 2018, who were ready for care, and who had waited beyond the recommended time.

Due to the lack of comparability of clinical urgency categories between states and territories, these data are presented for each state and territory separately.

National trends

In 2018–19:

• for New South Wales, 97% of patients were admitted within the clinically recommended time
• for Victoria, it was 91%
• for Queensland; 94%
• for Western Australia; 88%
• for South Australia; 88%
• for Tasmania; 60%
• for the Australian Capital Territory; 83%
• for the Northern Territory; 92%.

The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery.

Explore the data

In the data visualisation below, you can explore elective surgery waiting times by surgical speciality for 2018–19 and between 2014–15 and 2018–19. Waiting times are presented at national, state and territory, LHN, and hospital level.

National trends

In 2018–19:

• Otolaryngology, head and neck surgery had the highest median waiting time (84 days)
• Cardiothoracic surgery had the lowest 90th percentile waiting time (79 days)
• Otolaryngology, head and neck surgery and Orthopaedic surgery had the highest proportion of patients who waited more than 365 days to be admitted (6.5% and 4.0% respectively).

Changes over time

Between 2014–15 and 2018–19:

• the surgical speciality with the lowest waiting time for 50% of patients was Cardiothoracic surgery, ranging between 16 and 19 days
• median waiting times increased for Otolaryngology, head and neck surgery, Neurosurgery, Ophthalmology surgery and Orthopaedic surgery
• the largest increase in median waiting time was for Orthopaedic surgery from—64 days in 2014–15 to 77 days in 2018–19.

Waiting list statistics for intended surgical procedures can indicate performance in particular areas of elective surgery. Information on the types of elective surgery provided by public hospitals is shown by the intended surgical procedure, for selected procedures only.

Explore the data

In the data visualisations below, you can explore elective surgery waiting times by:

• the list of 15 indicator procedures between 2014–15 and 2018–19
• intended surgical procedure, by type of hospital (peer group) and over time between 2014–15 and 2018–19. Waiting times are presented at national, state and territory, LHN, and hospital level.

National trends

In 2018–19, for the top 25 intended procedures:

• Breast lump excision and/or biopsy had the shortest median and 90th percentile waiting times across all states and territories. The median waiting time ranged from 14 days in Victoria to 49 days in Australian Capital Territory, and the 90th percentile waiting time varied from 31 days in South Australia to 350 days in Australian Capital Territory
• Septoplasty (to fix a deviated nasal septum) had the highest median waiting time in 2018–19 (241 days), ranging from 49 days in Australian Capital Territory to 328 days in the New South Wales.

Changes over time

Between 2014–15 and 2018–19, for the 15 indicator procedures:

• Coronary artery bypass graft surgery consistently had the lowest median waiting time (17 days), 90th percentile waiting time (75 days) and proportion of patients who waited more than 365 days for surgery (0.4%)
• Septoplasty (to fix a deviated nasal septum) consistently had the highest median waiting time (ranging between 209 and 248 days)
• Myringoplasty/tympanoplasty (eardrum procedures) had the highest 90th percentile waiting time and proportion of patients who waited more than 365 days for surgery (394 days and 16.3%, respectively)
• the median waiting time for Haemorrhoidectomy (haemorrhoid surgery) decreased from 56 to 49 days, with the remainder of median waiting times remaining relatively stable.

Between 2017–18 and 2018–19:

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