Australian Hospital Statistics 2000-01 is the eighth of the Australian Institute of Health and Welfare's annual summary reports describing the characteristics and activity of Australia's hospitals.
Hospitals and beds
- There were 726 public acute hospitals and 23 public psychiatric hospitals in Australia in 2000-01. In 1999-00, there were 509 private hospitals, 207 free-standing day hospital facilities and 302 other private hospitals (Table 2.1).
- Public acute hospitals had 50,113 beds in 2000-01, about the same as in 1999-00 (50,188). Private hospitals had 25,246 beds in 1999-00, about the same as in 1998-99 (25,206).
Patient numbers and lengths of stay
- The number of admissions to hospitals in Australia continues to increase from year to year. There was a total of 6.14 million separations in 2000-01, an increase of 4.1% compared to 1999-00 (Table 2.3).
- Between 1999-00 and 2000-01, separations from public acute hospitals decreased by 0.1% to 3.85 million, and from private hospitals increased by 12.1% to 2.27 million. The private hospitals' share of overall patient separations was 37.0% in 2000-01.
- The number of separations per 1,000 population fell by 1.8% (to 194 per 1,000) for public hospitals, and rose by 9.9% (to 112 per 1,000) for private hospitals.
- Numbers of patient days in public acute hospitals decreased by 0.5% compared with 1999-00, to 15.01 million. Private hospital patient days increased by 5.9%, to 6.74 million and were 30.0 % of all patient days.
- The number of patient days per 1,000 population fell by 5.2% (to 759 per 1,000) for public hospitals, and rose by 3.8% (to 320 per 1,000) for private hospitals.
- The average length of stay in hospitals decreased in 2000-01, to 3.7 days from 3.8 days in 1999-00, following the overall pattern of decline shown in previous years. Private hospital stays averaged 3.0 days compared with 3.9 days in public acute hospitals. For patients staying at least one night, average lengths of stay were 6.4 days in public acute hospitals and 5.7 days in private hospitals.
- The proportion of separations that were same day was 50.8% overall (compared with 49.2% in 1999-00 and 44.7% in 1996-97), 46.2% in public acute hospitals and 58.5% in private hospitals.
Public hospital staff and expenditure
- The 82,476 nurses made up 45.1% of total full time equivalent staff of public hospitals. Salaried medical officers comprised 9.5% of the staff, diagnostic and allied health professionals comprised 13.0%, and 15.2% were administrative and clerical staff (Table 3.4).
- Total recurrent expenditure of public hospitals in Australia in 2000-01, excluding depreciation, was $15,545 million, or about $806 per person. Salaries and wages totaled $9,722 million, 62.5% of the total (Table 3.5).
Hospital performance indicators
- Nationally, the cost per casemix-adjusted separation in public hospitals was $2,834. This performance indicator 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. Nursing salaries ($752) and medical labour ($525) were large components of the cost (Table 4.1).
- Queensland reported the lowest cost per casemix-adjusted separation ($2,675) and the Australian Capital Territory reported the highest ($3,397).
- The cost per casemix-adjusted separation varied by the peer group of the hospital. Large metropolitan hospitals had a cost of $2,667, for example, and Remote acute hospitals had a cost of $3,168 (Table 4.2).
- Nationally, 76% of public hospitals were accredited in 2000-01, and 91% of all public hospital beds were in accredited public hospitals (Table 4.5). In the private sector, 72% of hospitals were accredited in 1999-00, and 92% of all private hospital beds were in accredited private hospitals.
- The median waiting time for elective surgery in public hospitals in 2000-01 was 27 days, and 90% of patients had been admitted for their surgery within 202 days (Table 5.1). Patients who waited over 365 days made up 4.4% of the total.
- Median waiting times ranged from 11 days for cardio-thoracic surgery to 52 days for opthalmological surgery (Table 5.3), and from 16 days for coronary artery bypass graft to 114 days for total knee replacement (Table 5.6).
Public and private patients
- Public patients accounted for 3.45 million separations in 2000-01 (56.2% of the total), a decrease of 0.4% compared to 1999-00. Most were in public hospitals, but 2.9% were in private hospitals, compared with 2.3% in 1999-00 (Table 6.5).
- Private patients (other than Department of Veterans' Affairs and compensable patients) accounted for 2.19 million separations in 2000-01 (35.6% of the total), an increase of 9.6% compared to 1999-00. The proportion of these in public hospitals was 14.8%, compared with 14.9% in 1999-00.
Age, sex and Aboriginal and Torres Strait Islander status
- Australians aged over 65 years, comprising 12.3% of the total population, accounted for 33.1% of total hospital separations and 48.0% of patient days. The average length of stay for these patients was 5.3 days, compared with 3.7 days for all patients (Tables 7.1 and 7.4).
- Females accounted for 53.6% of separations in 2000-01 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.
- The highest numbers of separations in the public sector were for Diseases of the digestive system, followed by Injury and poisoning and certain other consequences of external causes and Pregnancy, childbirth and the puerperium. The highest numbers of patient days were reported for ental and behavioural disorders and Diseases of the circulatory system (Figures 8.2 and 8.3).
- In the private sector, Diseases of the digestive system had the largest number of separations, followed by Neoplasms and Diseases of the musculoskeletal system and connective tissue. Neoplasms, Diseases of the digestive system, Diseases of the musculoskeletal system and connective tissue and Diseases of the circulatory system accounted for the highest numbers of patient days.
- For 4.8 million separations (78.8% of the total), there was an operation or other procedure reported. In public hospitals, 72.6% of separations were reported with a procedure, as were 89.2% of private sector separations (Tables 9.1 and 9.2).
- In public hospitals, procedures on the urinary system (including haemodialysis) and the digestive system were the most common. In private hospitals, procedures on the digestive system were the most common, followed by procedures on the musculoskeletal system (Figure 9.2).
External causes of injury and poisoning
- External causes of injury and poisoning included falls. They were reported for 129,125 public sector separations and 33,322 private sector separations, and most commonly for patients in the 5 to 14 years age group and the over 65 years age group (Figure 10.1).
- In public hospitals, Admit for renal dialysis was the most common AR-DRG, with 13.0% of acute separations (487,350, Table 11.5), 20,700 more than in 1999-00 (Table 11.17). Other leading AR-DRGs included Chemotherapy with 3.0% (112,218 separations, 4,411 fewer than in 1999-00), vaginal delivery without complicating diagnosis with 2.8% (104,857 separations, 6,254 fewer than in 1999-00) and Other colonoscopy, same day, with 1.6% (61,610 separations, 483 more than in 1999-00).
- The corresponding top AR-DRGs in the private sector were Other colonoscopy, sameday with 7.3% of separations (160,569, 24,668 more than in 1999-00), Chemotherapy with 5.1% (111,807 separations, 21,295 more than in 1999-00) Other gastroscopy for non-major digestive disease, sameday with 4.9% (108,063 separations, 12,965 more than in 1999-00), and Admit for renal dialysis, with 3.8% (84,553 separations, 22,099 more than in 1999-00) (Tables 11.6 and 11.17).