Highlights

Australian Hospital Statistics 1999–00 is the seventh Australian Institute of Health and Welfare annual summary reports describing the characteristics and activity of Australia’s hospitals. It summarises 1999–00 data reported to the Institute’s National Public Hospital Establishments Database and National Hospital Morbidity Database.

Hospital performance indicators

  • Nationally, the cost per casemix-adjusted separation in public hospitals was $2,728. This figure is a measure of the average cost of providing care for an admitted patient, adjusted for the relative complexity of the patient’s condition and hospital services provided. Non- medical labour ($1,454) and medical labour ($502) were large components of the cost.
  • Victoria reported the lowest cost per casemix-adjusted separation ($2,529) and the Northern Territory reported the highest ($3,444). Principal referral and specialist women’s and children’s hospitals had an average cost per casemix-adjusted separation of $2,831. For small rural acute care hospitals, the average cost was $2,604.
  • There was considerable variation between the States and Territories in separation rates for some procedures. For example, coronary artery bypass grafts were reported for New South Wales residents at a rate 25% higher, and for Western Australian residents at a rate 27% lower, than the rates for the other jurisdictions combined.
  • The average length of stay for 9 of the top 10 overnight stay AR-DRGs was higher in private hospitals compared with public hospitals. For example, for O60D Vaginal delivery without complicating diagnosis, it was 3.1 days in public hospitals and 4.8 days in private hospitals.

Hospitals, beds, staff and expenditure

  • There were 724 public acute hospitals and 24 public psychiatric hospitals in Australia in 1999–00. Numbers of hospitals can vary from year to year, often because of changes in administrative arrangements. A more useful indicator of the quantum of hospital services is the number of available beds. In 1999–00 there were 52,947 public hospital beds, a decline from the 53,885 beds reported in the previous year.
  • Nurses made up 45.1% of total full time equivalent staff of public hospitals, with salaried medical officers comprising 9.5%.
  • Total recurrent expenditure of public hospitals in Australia in 1999–00, excluding depreciation, was $14,350 million, or about $753 per person. Salaries and wages totaled $8,935 million, 62% of the total.

Patient numbers and lengths of stay

  • The number of admissions to public and private hospitals continues to increase. There was a total of 5.9 million separations in 1999–00, an increase of 2.8% compared with 1998–99.
  • Between 1998–99 and 1999–00, separations from public acute hospitals increased by 0.4% to 3.9 million. From private hospitals, they increased by about 6.8% (adjusted for changes in coverage of the data collection) to 2.0 million. The private hospitals’ share of overall patient separations was 34.3% in 1999–00, compared with 32.7% in 1998–99.
  • Patient days in public acute hospitals increased by 0.6% compared with 1998–99, to 15.1 million. Private hospital patient days increased by 5.1%, to 6.4 million, 28.1% of the total.
  • The average length of stay in private hospitals decreased in 1999–00, to 3.1 days from 3.2 days in 1998–99, following the overall pattern of decline shown in previous years. The average length of stay in 1999–00 was the same as in 1998–99 in public acute hospitals (3.9 days) and for non-same day separations in all hospitals combined (6.6 days).
  • The proportion of separations that were same day was 49.2% overall (compared with 47.9% in 1998–99), 45.8% in public acute hospitals and 56.2% in private hospitals.

Patient characteristics

Public and private patients

  • Public patients accounted for 3.5 million separations in 1999–00 (58.9% of the total), an increase of 1.5% compared with 1998–99. Most were in public hospitals, but 2.3% were in private hospitals, compared with 1.6% in 1998–99.
  • Private patients accounted for 2.0 million separations in 1999–00 (33.8% of the total), an increase of 6.1% compared with 1998–99. The proportion of these in public hospitals was 14.9%, compared with 17.0% in 1998–99.

Age, sex and Aboriginal and Torres Strait Islander status

  • Australians aged over 65 years, comprising 12% of the total population, accounted for 32.5% of total hospital separations and 47.7% of patient days. The average length of stay for these patients was 5.6 days, compared with 3.8 days for all patients.
  • Females accounted for 53.7% of separations in 1999–00 although they comprised 50.2% of the population. There were more separations for females than males in all age groups from 15 to 54 years (which include child-bearing ages for women) and in the 75 years and over age groups, in which women outnumber men in the population.
  • Aboriginal and Torres Strait Islander peoples had twice as many separations per 1,000 population of other persons, after allowing for age structure. This is likely to be an underestimate because the identification of Aboriginal and Torres Strait Islanders as patients is incomplete.

Diagnoses, procedures, external causes and AR-DRGs

  • Commonly reported principal diagnoses in both the public and private sectors included dialysis, rehabilitation, chemotherapy for cancer, angina pectoris, cataract, abdominal and pelvic pain, pain in throat and chest, and gastro-oesophageal reflux disease.
  • For 78.2% of separations, there was an operation or other procedure reported. In public hospitals, allied health interventions and procedures on the urinary system were the most commonly reported. In private hospitals, procedures on the digestive system were the most common, followed by allied health interventions.
  • Falls were commonly reported external causes of injury for both the public and private sectors, as were exposures to mechanical forces and transport accidents.
  • L61Z Admit for renal dialysis was the most commonly reported AR-DRG in the public sector, (12.1% of public hospital separations) and G44C Other colonoscopy, same day was the leading AR-DRG in the private sector (6.7% of separations). Other high volume AR- DRGs included R63Z Chemotherapy and O60D Vaginal delivery without complicating diagnosis.