Hospitals are an important part of Australia’s health landscape, providing services to many Australians each year. A summary measure of their significant role is the amount that is spent on them—an estimated 40% of recurrent health expenditure per year.
Public hospitals are very diverse in size and the types of services they provide. Smaller hospitals, with less than 10 beds, are mostly located in regional and remote areas. Larger principal hospitals, with an average of about 650 beds, are mostly located in major cities and provide a broad range of general and specialist services. While only about 30 of the almost 700 public hospitals are principal referral hospitals, they account for more than one-third of total hospitalisations in public hospitals each year.
Hospitals provide a range of services for admitted and non-admitted patients. Admitted patient services are provided in both public and private hospitals and include medical, surgical and other services for both emergency and elective admissions. They include acute care, mental health care, maternity services, subacute and non-acute care. Non-admitted patient services are mostly located in public hospitals and include emergency department services and outpatient clinics.
Admitted patient services, or ‘hospitalisations’, are provided either on the same day (60%) or involve an overnight stay of one or more nights in hospital.
The admitted patient services provided in hospital can also be described in terms of the broad categories of care. The majority of hospitalisations are for acute care, that is, care focused on curing a condition, alleviating symptoms or managing childbirth. Acute care includes medical (care not involving a procedure), surgical (involving an operating room procedure), childbirth, specialist mental health and other acute care (non-surgical procedures, such as endoscopy). Subacute and non-acute care includes rehabilitation, palliative care, geriatric evaluation and management, psychogeriatric care and maintenance care.
Medical care accounted for more than two-thirds of hospitalisations in public hospitals and around one-third in private hospitals. Surgical care comprises the highest proportion of care in private hospitals (around 36%), compared with less than 20% in public hospitals. About 3% of hospitalisations in public hospitals and 7% in private hospitals were for subacute and non-acute care.
The 3 main reasons people are admitted to hospitals are for dialysis for kidney failure, for care related to cancer (including chemotherapy), and for care related to the digestive system (for example, hernias, gallstones, appendicitis).
About one-quarter of hospitalisations involve surgery, which can be either emergency or elective (non-emergency). The 3 most common reasons for an emergency admission involving surgery are appendicitis, hip fracture and heart attack. The 3 most common reasons for an elective admission involving surgery are cataracts, malignant skin lesions and
in vitro fertilisation procedures.
Public hospitals employed about 300,000 full-time equivalent staff and private hospitals about 64,000. Nurses are the largest occupational group in both sectors.
The AIHW continues to work with stakeholders to improve the national statistical information on hospitals and its relevance to contemporary public policy debate on hospital service delivery. The AIHW’s Australian hospital statistics series of reports presents the latest analyses and trend information from the Institute’s national hospitals databases.
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