Hospital procedures
-
77%
of all ear or hearing related hospital procedures for First Nations people in 2021–23 were for children aged 0–14.
Hospital procedures include surgical procedures and non-surgical investigations and therapies. The information presented in this section relate to procedures requiring admission to hospital and excludes procedures performed where people are not admitted to hospital, that is, outpatient procedures.
Many ear and hearing related hospital procedures requiring hospital admissions are performed to address medical conditions caused by repeated ear infections.
Among the most common ear and hearing related procedures are:
- a procedure called a myringotomy, which is a surgical incision in the eardrum to relieve pressure or drain fluid, and may include inserting a small tube called a grommet to allow air to ventilate the middle ear and stop fluid building up again
- other application, insertion or removal procedures' including the removal of myringotomy tubes
- an operation called a myringoplasty to repair a hole in the eardrum, often caused by middle ear infection or from grommet insertion
About the data
The data in this section come from the AIHW National Hospital Morbidity Database (NHMD).
Information is presented for procedures on the ear and mastoid process (ACHI procedure block codes 300–334). Common procedures include Myringotomy (ACHI procedure block code 309); Application, insertion or removal procedures on eardrum or middle ear (ACHI procedure block code 308); and Myringoplasty (ACHI procedure block 313). For this report, procedure codes 41632-02 and 41632-03 (Insertion of myringotomy tube, unilateral and bilateral), which are usually included under procedure block code 308, have been excluded from block code 308 and included under procedure block code 309 (Myringotomy).
Overview
In 2021–23, about 8,800 in-hospital ear or hearing related procedures were performed for First Nations patients (4.4 per 1,000 population). The most common procedure was surgical eardrum incision (myringotomy) with or without insertion of ear ventilation tubes (grommets), which accounted for around 57% of the procedures performed (about 5,000 procedures, 2.5 per 1,000 population) (Figure TREATMENT 14).
First Nations children aged 0–14 accounted for 77% (6,800) of all ear or hearing related hospital procedures for First Nations people, at a rate of 10 per 1,000 population.
Figure TREATMENT 14: Ear or hearing related hospital procedures, by Indigenous status, 2021–23
Bar chart shows rates of common ear related hospital procedures were higher for First Nations people than non-Indigenous Australians.
| Per 1,000 (ASR) | First Nations | Non-Indigenous |
|---|---|---|
| Surgical eardrum incision | 1.7 | 1.5 |
| Other application, insertion or removal | 0.4 | 0.3 |
| Surgical repair of hole in eardrum | 0.3 | 0.1 |
| Middle ear examination | 0.2 | 0.1 |
- To calculate rates for the First Nations population, projections (medium series) based on the 2021 Census have been used (ABS 2011-to-2031). Rates for non-Indigenous Australians are calculated using total population estimates based on the 2021 Census (ABS 2022) and subtracting the projections for First Nations people.
- Data exclude separations for Newborns without qualified days, Hospital boarders and Posthumous organ procurement.
- Data exclude hospitalisations in WA with a contracted patient status of 'Inter-hospital contracted patient to private sector hospital', to adjust for separations recorded on both sides of contractual care arrangements.
ASR = age-standardised rate
Source: AIHW analysis of National Hospital Morbidity Database; and ABS population estimates and projections for rate calculations.
Age and sex
In 2021–23:
- the highest ear or hearing related procedure rates for First Nations children were at age 2 for boys (27 per 1,000 population) and age 4 for girls (18 per 1,000 population).
- ear or hearing related procedure rates for First Nations boys aged 1–6 were 1.2 to 1.7 times as high as those for girls of the same age (Figure TREATMENT 15).
Figure TREATMENT 15: Ear or hearing related hospital procedures, First Nations people, by sex and age, 2021–23
Column chart shows ear related hospital procedure rates for First Nations people highest among young children and higher for boys than girls.
| Age | Males | Females |
|---|---|---|
| 0 | 2.6 | 1.3 |
| 1 | 19.8 | 13.1 |
| 2 | 27.3 | 16.3 |
| 3 | 24.3 | 17 |
| 4 | 22.6 | 17.5 |
| 5 | 18.6 | 14.9 |
| 6 | 13.8 | 11.8 |
| 7 | 10.3 | 10.9 |
| 8 | 8.1 | 7.9 |
| 9 | 6.3 | 8.5 |
| 10 | 5.2 | 6.2 |
| 11 | 5.3 | 4.5 |
| 12 | 4.1 | 4 |
| 13 | 3.9 | 2.2 |
| 14 | 2.8 | 2.4 |
| 15–19 | 1.7 | 1.5 |
| 20–24 | 0.8 | 1 |
| 25–29 | 1.5 | 1.5 |
| 30–34 | 1.1 | 1.8 |
| 35–39 | 1.2 | 1.4 |
| 40–44 | 1.7 | 1.7 |
| 45–49 | 1.3 | 1.6 |
| 50–54 | 1.9 | 1.3 |
| 55–59 | 1.5 | 2.2 |
| 60–64 | 2 | 2 |
| 65–69 | 1.5 | 1.2 |
| 70–74 | 2 | 1.8 |
| 75 and over | 2.2 | 1.6 |
- To calculate rates for the First Nations population, projections (medium series) based on the 2021 Census have been used (ABS 2011-to-2031). Rates for non-Indigenous Australians are calculated using total population estimates based on the 2021 Census (ABS 2022) and subtracting the projections for First Nations people.
- Data exclude separations for Newborns without qualified days, Hospital boarders and Posthumous organ procurement.
- Data exclude hospitalisations in WA with a contracted patient status of 'Inter-hospital contracted patient to private sector hospital', to adjust for separations recorded on both sides of contractual care arrangements.
Source: AIHW analysis of National Hospital Morbidity Database; and ABS population estimates and projections for rate calculations.
Remoteness
In 2021–23, the rate of ear or hearing related procedures among First Nations people was highest for those living in Remote areas (4.8 per 1,000 population) and lowest in Outer regional areas (3.7 per 1,000 population) (Figure TREATMENT 16).
Figure TREATMENT 16: Ear or hearing related hospital procedures, First Nations people, by age and remoteness, 2021–23
Column chart shows ear related hospital procedure rates for First Nations people higher for those 0–14 than other age groups across remoteness areas.
| Remoteness area | 0–14 | 15–34 | 35–54 | 55 and over |
|---|---|---|---|---|
| Major cities | 10.5 | 1.3 | 1.6 | 2.2 |
| Inner regional | 10 | 1.3 | 1.3 | 1.6 |
| Outer regional | 8.8 | 1.2 | 1.2 | 1.2 |
| Remote | 11.7 | 1.9 | 2 | 1.9 |
| Very remote | 11.5 | 2 | 2 | 1.9 |
- Rates are calculated using population denominators modelled by the AIHW using ABS population estimates and projections (medium series).
- Data exclude separations for Newborns without qualified days, Hospital boarders and Posthumous organ procurement.
- Data exclude hospitalisations in WA with a contracted patient status of 'Inter-hospital contracted patient to private sector hospital', to adjust for separations recorded on both sides of contractual care arrangements.
Source: AIHW analysis of National Hospital Morbidity Database; and AIHW population modelling using ABS population estimates and projections.
State and territory
In 2021–23, the rate of ear or hearing related hospital procedures ranged from 3.0 per 1,000 population in Tasmania to 5.7 per 1,000 population in Western Australia (Figure TREATMENT 17).
Figure TREATMENT 17: Ear or hearing related hospital procedures, First Nations people, by age and state/territory, 2021–23
Column chart shows ear related hospital procedure rates for First Nations people higher for those 0–14 than older people across states and territories.
| State/territory | 0–14 | 15–34 | 35–54 | 55 and over |
|---|---|---|---|---|
| NSW/ACT | 9.3 | 1.2 | 1.3 | 1.6 |
| Vic. | 8.5 | 0.8 | 0.9 | 1.1 |
| Qld | 11.1 | 1.6 | 2 | 2.5 |
| WA | 14.9 | 1.4 | 1.4 | 1.8 |
| SA | 13.1 | 1.7 | 1.8 | 1.1 |
| Tas. | 6.7 | 1.3 | 1.3 | 1.4 |
| NT | 6.5 | 1.8 | 1.7 | 1.6 |
- To calculate rates for the First Nations population, projections (medium series) based on the 2021 Census have been used (ABS 2011-to-2031). Rates for non-Indigenous Australians are calculated using total population estimates based on the 2021 Census (ABS 2022) and subtracting the projections for First Nations people.
- Data exclude separations for Newborns without qualified days, Hospital boarders and Posthumous organ procurement.
- Data exclude hospitalisations in WA with a contracted patient status of 'Inter-hospital contracted patient to private sector hospital', to adjust for separations recorded on both sides of contractual care arrangements.
Source: AIHW analysis of National Hospital Morbidity Database; and ABS population estimates and projections for rate calculations.
Indigenous region
Across Indigenous regions, the rate of ear or hearing related hospital procedures among First Nations people in 2021–23 ranged from 1.7 per 1,000 population in Tennant Creek to 10.4 per 1,000 population in West Kimberley (Figure TREATMENT 18).
Figure TREATMENT 18: Ear or hearing related hospital procedures, First Nations people, by Indigenous region (IREG), July 2021 to June 2023
Source: AIHW analysis of National Hospital Morbidity Database; AIHW modelling using ABS population estimates and projections for rate calculations.
Over time
Rates of ear or hearing related procedures among First Nations children aged 0–6 peaked around 2017–18 and 2018–19, and following pandemic-era declines, increased again in 2022-23. Since 2013–14, rates have risen overall among First Nations children aged 0–6, while remaining relatively constant for non-Indigenous children in the same age group (Figure TREATMENT 19).
Figure TREATMENT 19: Ear or hearing related hospital procedures, by Indigenous status and age, 2014–15 to 2022–23
Source: AIHW analysis of National Hospital Morbidity Database; and ABS population estimates and projections for rate calculations.