Hospitals are very diverse in location, size and the services provided. In 2017–18, there were 693 public hospitals in Australia. The most recent data from 2016–17 show that there were 657 private hospitals (including day hospital facilities) (ABS 2018).
During 2017–18, a total of $74.0 billion was spent on Australia’s public and private hospitals with $30.8 billion (42%) of this funded by state and territory governments and $26.5 billion (36%) by the Australian Government. The remaining $16.7 billion (23%) came from non-government sources. Spending per person increased by an average of 2.1% per year between 2013–14 and 2017–18 after adjusting for inflation (2.2% for public hospital care and 2.0% for private). See Health expenditure.
Both public and private hospital sectors provide services for admitted and non-admitted patients (outpatient clinics and emergency department care).
Admitted patient services, or hospitalisations, are provided when a patient is formally admitted to a hospital. Hospitalisations can either be on the same day or involve a stay in hospital of 1 or more nights. A hospitalisation may be for medical, surgical, or other acute care, childbirth, mental health care, subacute care (for example rehabilitation or palliative care) or non-acute care (for example, maintenance care for a person suffering limitations due to a health condition). Some admitted patient services can also be provided via ‘hospital-in-the-home’ programs, where patients receive admitted care in a combination of in and outside the hospital settings.
In 2017–18, there were 62,000 beds in public hospitals in Australia. The number of hospital beds increased by 1.3% per year between 2013–14 and 2017–18. This trend coincided with a decrease in the average length of stay over time (an average of 2.2% decline per year), meaning fewer beds are used to support more episodes of care. The number of public hospital beds per 1,000 population was relatively stable between 2013–14 and 2017–18, ranging between 2.5 and 2.6 beds per 1,000 population.
The most recent data, from 2016–17, show that there were 34,000 hospital beds in private hospitals (including day hospital facilities)—a rate of 1.4 beds per 1,000 population, up from 1.3 beds per 1,000 population in 2012–13 (ABS 2018). The average decrease per year in the average length of stay over this period was 1.2%.
In 2018–19, there were 11.5 million hospitalisations—6.9 million in public hospitals and 4.6 million in private hospitals. Between 2014–15 and 2018–19, the total number of hospitalisations increased by an average of 3.3%—faster than the average population growth of 1.6% over the same period. Hospitalisations increased by an average of 3.7% each year in public hospitals and 2.6% in private hospitals.
In 2018–19, 33% of all hospitalisations were for patients who were admitted and discharged on the same day in a public hospital and 27% were for 1 or more nights in a public hospital. Same-day hospitalisations in private hospitals accounted for 29% of all hospitalisations, and 11% of hospitalisations were overnight or longer in a private hospital.
The average length of stay in hospital is decreasing; between 2014–15 and 2018–19, the average length of stay in hospital decreased from 2.8 days to 2.7 days. The average length of stay in hospital was longer in public hospitals, at 3.0 days, and was 2.2 days in private hospitals in 2018–19. This difference in average length of stay is influenced by the differing patient characteristics, illnesses and procedures in public and private hospitals as well as differing administrative and clinical practices.
Why do people go to hospital?
The reason that a patient was admitted to hospital can be described in various ways, including the mode and urgency of admission, the type of care required or the principal diagnosis. The principal diagnosis is the diagnosis established after study (for example, at the completion of the hospitalisation) to be chiefly responsible for the episode of admitted patient care. Diagnoses are categorised using the International Statistical Classification of Diseases and Related Health problems, 10th Revision, Australian Modification (ICD-10-AM).
Overall, the most common reason a patient is admitted to hospital is for Other factors influencing health status. Other factors influencing health status includes examinations, investigations, observation, evaluation, screening, immunisation and other health management. The most common reason for admission to hospital varies with age and sex. The visualisation below presents the 5 most common reasons for a stay in hospital for males and females by age group, according to the patients’ principal diagnosis (Figure 1).
In 2018–19:
- patients aged under 5 often stayed in hospital for Respiratory system issues and Perinatal period conditions following birth
- patients aged 5–14 primarily stayed in hospital for Injury and poisoning, and Digestive system diseases. Males aged 15–24 also stayed in hospital for the same reasons, whereas females of this age group mostly stayed for pregnancy and childbirth-related reasons, as well as Digestive system diseases
- similar to the age group before them, females aged 25–44 predominantly stayed in hospital for pregnancy and childbirth, whereas males of that age stayed in hospital for Other factors influencing health status
- patients aged 45–64 stayed in hospital for Other factors influencing health status and Digestive system diseases
- male patients aged 65 and over primarily came to hospital for Other factors influencing health status and Neoplasms (cancer). Female patients aged 65 and over primarily came to hospital for Other factors influencing health status and Musculoskeletal system diseases.