Alcohol and other drug treatment services in Australia 2015–16

28 Jun 2017

Information on hospitalisations is taken from the National Hospital Morbidity Database (NHMD). This database includes almost all public hospitals that provided data for the NHMD in 2015–16. The exception was an early parenting centre in the Australian Capital Territory. The great majority of private hospitals also provided data, the exceptions being the private free-standing day hospital facilities in the Australian Capital Territory. Further information can be found in Admitted patient care 2015–16: Australian hospital statistics.

Number of drug-related separations

Drugs described in this section include legal, accessible drugs such as alcohol and tobacco, drugs that are available by prescription or over the counter, such as analgesics and antidepressants, and drugs that are generally not obtained through legal means, such as heroin and ecstasy. Therefore, a proportion of the separations reported here may result from harm arising from the therapeutic use of drugs, and the inclusion of therapeutic use in these data may mean the burden on the hospital system appears larger than expected.

In 2015–16:

• there were about 10.6 million separations in Australia’s public and private hospitals
• about 135,000 hospital separations with a drug-related principal diagnosis were reported in 2015–16 (Table 1), which represents 1% of all hospital separations, a similar proportion to previous years
• sedatives and hypnotics continued to account for the highest proportion of hospital separations with a drug-related principal diagnosis (58% of all such separations), with alcohol making up 87% of separations for sedatives and hypnotics
• on its own, alcohol accounted for 50% of all drug-related hospital separations
• of all separations with a drug-related principal diagnosis, 13% were for analgesics, with opioids (heroin, opium, morphine and methadone) accounting for half of this group (6.6% of all drug-related separations)
• stimulants and hallucinogens, including cannabis and cocaine, accounted for 17% of all separations where the principal diagnosis was drug-related
• overnight separations continued to be more common for drug-related treatment than same-day separations, accounting for 59% of all drug-related separations.

Definitions

A hospital separation refers to a completed episode of admitted hospital care ending with discharge, death, transfer or a portion of a hospital stay beginning or ending in a change to another type of care (for example, from acute care to rehabilitation). The hospital separations data do not include episodes of non-admitted patient care provided in outpatient clinics or emergency departments. Patients in these settings may be admitted subsequently, with the care provided to them as admitted patients being included in the NHMD.

Drug-related separations refer to hospital care with selected principal diagnoses (that is, the diagnosis established to be chiefly responsible for occasioning an episode of admitted patient care) of substance-use disorder or harm (all forms of harm, for example, accidental, intended or self-inflicted) due to selected substances (see Hospital separations data). Hospital separations where the diagnosis of drug-related harm or disorder is additional to the principal diagnosis such as problems related to certain chronic conditions caused by the use of drugs like tobacco and alcohol have been excluded.

Separations can be either same-day (where the patient is admitted and separated on the same day) or overnight (where the patient is admitted to hospital and separates on a different date).

Table 1: Hospital separations by drug-related principal diagnosis and duration, 2015–16

Note: Separations with a care type of ‘Newborn’ (without qualified days), and records for ‘Hospital boarders’ and ‘Posthumous organ procurement’ have been excluded.

Source: AIHW analysis of the NHMD 2015–16.

Trends in drug-related separations

The total number of drug-related hospital separations has increased from 110,060 in 2011–12 to 135,001 in 2015–16. At the same time, total hospital separations have increased, with drug-related hospital separations consistently making up about 1% of all hospital separations across this 5-year period.

Alcohol has consistently been the drug-related principal diagnosis with the highest number of hospital separations from 2011–12 to 2015–16, with the number of separations increasing from 61,913 to 68,239 in that time.

Table 2: Hospital separations by drug-related principal diagnosis, 2011–12 to 2015–16

Notes:
^(a) Crude rate is based on the Australian estimated resident population as at 31 December of the reference year.
Separations with a care type of ‘Newborn’ (without qualified days), and records for ‘Hospital boarders’ and ‘Posthumous organ procurement’ have been excluded.

Source: AIHW analysis of the National Hospital Morbidity Database 2015–16.

Hospital separations data

The hospital separation data included in this report were extracted from the AIHW National Hospital Morbidity Database using a selection of codes from the International statistical classification of diseases and related health problems, 10th revision, Australian modification 8th edition (ICD-10-AM) (NCCC 2012) (see Table 3).

Table 3: Relationship between the drug of concern and the ICD-10-AM codes

Note: Data for 2015–16 were reported to the NHMD using the ICD-10-AM.

References

NCCC (National Casemix and Classification Centre) 2012. International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM) (ACCD 2014), incorporating the Australian Classification of Health Interventions (ACHI) (ACCD 2015) and Australian Coding Standards (ACS), 9th edition. Wollongong: NCCC.