Impact of COVID–19 on hospital care

The COVID-19 pandemic has had a profound impact on hospital activity generally. Since February 2020, a range of social, economic, business and trravel restrictions have been in place to prevent and reduce the spread of coronavirus (COVID-19) and maintain adequate capacity of the healthcare system to deal with the pandemic. These initiatives have varied in terms of their geographic reach (i.e. whether they applied nationally, by state/territory or on a more local level) and have varied over time.

Over this period, a number of initiatives impacted on the provision of healthcare services and reduced the flow of patients seeking in-hospital care, including:

  • patients being re-directed to other healthcare services if they had symptoms consistent with COVID-19 or had been a close contact of someone who had been infected
  • establishment of new modes of delivering healthcare services (e.g. telehealth services and 'virtual' care models) that could re-direct patients seeking non-urgent care
  • changes in patient behaviours, including changes in healthcare seeking behaviours
  • restricted activities that might reduce risks for some kinds of healthcare issues, such as injuries that could result in an emergency admission to hospital.

In addition, following a decision by National Cabinet, restrictions were applied to selected elective surgeries from 26 March 2020 to ensure that the hospital system maintained adequate capacity to deal with the COVID-19 pandemic. Under these restrictions, only Category 1 and exceptional Category 2 procedures could be undertaken. These restrictions were gradually eased from 29 April 2020 onwards, although further restrictions applied in some areas in later periods as part of the response to further COVID-19 outbreaks. Outbreaks also affected the ability of some services to operate, for example, by limiting the availability of healthcare staff to provide services.

Impacts of COVID-19 on emergency department activity

Emergency department activity in 2019–20 and 2020–21 was influenced by COVID-19 restrictions and the changes affecting health care provision commencing in February 2020. Also, during 2020–21, some jurisdictions operated COVID-19 fever clinics within emergency departments. Comparatively large increases in ED activity observed between 2019–20 and 2020–21 in some jurisdictions may be driven, in part, by this additional activity.

Compared with 2018–19, in 2019–20 the number of ED presentations decreased by 1.4%—in contrast to the 4.2% increase seen between 2017–18 and 2018–19. In the following year (2020–21) the number of presentations increased by 6.9% compared to 2019–20.

More information on the impacts of COVID on emergency department activity in 2019–20 and 2020-21 is available here Emergency department care activity - Australian Institute of Health and Welfare (aihw.gov.au)

Impact of COVID-19 on admitted patient activity in 2019–20

Australia’s hospital system has played a significant role in managing and treating people with the coronavirus virus (COVID-19). Between January to June in 2020, there were over 2,600 hospitalisations involving a COVID-19 diagnosis.

Compared with 2018–19, in 2019–20 the number of hospitalisations decreased by 2.8%, in contrast to the 2.6% increase seen between 2017–18 and 2018–19. The decrease in hospitalisations was greatest for private hospitals (4.5%), which undertake a high proportion of elective surgeries, compared to public hospitals (1.7%).

More information about the impact of COVID-19 on hospital activity and hospitalisations involving COVID-19 can be found here Admitted patient activity - Australian Institute of Health and Welfare (aihw.gov.au)

Impact of COVID-19 on elective surgery activity

As a result of the restrictions on elective surgery introduced in early 2020, overall, there was an 8.3% decrease in elective admissions involving surgery in public hospitals and a 5.7% decrease in private hospitals between 2018–19 and 2019–20.

In addition, there was a 9.2% decrease in admissions from elective surgery waiting lists between 2018–19 and 2019–20.

Delays to elective surgery resulted in a subsequent increase in waiting times for most intended procedures between 2019–20 and 2020–21. The greatest increases in median waiting times occurred for Tonsillectomy (123 day increase over 2019–20), Varicose vein treatment (94 day increase over 2019–20) and Total knee replacement (85 day increase over 2019–20).

The proportion of patients waiting more than 365 days for their elective surgery also increased between 2019–20 and 2020–21 from 2.8% to 7.6% with the greatest increase for Total knee replacement (11% to 32%) and Septoplasty (18% to 36%).

The proportion of patients who waited longer than 365 days to be admitted was 7.6% in 2020–21, up from 2.8% in the previous year.

More information about the impact of COVID-19 on public hospital elective surgery activity is available in the Elective surgery activity area of the MyHospitals website.

Where to go for more information

Emergency department care activity - Australian Institute of Health and Welfare

Admitted patient activity - Australian Institute of Health and Welfare

Elective surgery activity - Australian Institute of Health and Welfare