Hospitalisations
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64%
of ear or hearing related hospitalisations among First Nations people were for children aged 0–14 in 2021–23.
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71%
of ear or hearing related hospitalisations among First Nations people were for middle ear infections.
People who are hospitalised with an ear or hearing condition as the main diagnosis generally have more severe ear disease or are admitted to hospital for ear or hearing related surgery or medical procedure.
About the data
The data in this section come from the AIHW National Hospital Morbidity Database (NHMD).
Information about hospitalisations is a count of hospital separations, not patients. The number of separations is a commonly used measure of the utilisation of hospital services.
A hospital separation is an episode of care for a patient admitted to hospital. It can be a total hospital stay that ends in the patient’s discharge from hospital, transfer to another hospital or medical facility, or death; or part of a hospital stay that begins or ends with a change in the type of care provided.
Information is presented for hospitalisations where the main diagnosis is an ear or hearing related condition. This includes diseases of the outer, middle, and inner ear, hearing loss, and other ear conditions, as listed in the International Classification of Disease (ICD10, 11th edition, Australian modification) under Diseases of the ear and mastoid process (codes H60–H95).
It can be difficult to determine whether changes in hospitalisation rates represent a situation that is improving or getting worse. Increasing rates of hospitalisation may indicate that a health condition is becoming more prevalent in the population, or that access to hospital services is increasing, or a combination of both factors.
Most common diagnoses of ear or hearing related hospitalisations
From July 2021 to June 2023, there were over 7,100 hospitalisations of First Nations people where the main diagnosis was a disease of the ear and mastoid process (4.0 per 1,000 population).
Middle ear disease was the main diagnosis for around 7 in 10 of these hospitalisations among First Nations people (around 5,100 hospitalisations) (data table 3.2b).
Hospitalisation rates were highest among young First Nations children overall, largely attributable to high rates of middle ear disease in these age groups (Figure TREATMENT 7).
Figure TREATMENT 7: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, First Nations people, by diagnosis and age, 2021–23
Column chart shows ear related hospitalisation rate of First Nations people highest for middle ear disease in children, inner ear disease for over 55s.
| Diagnosis | 0–4 | 5–9 | 10–14 | 15–34 | 35–54 | 55–74 | 75 and over | Total |
|---|---|---|---|---|---|---|---|---|
| Middle ear diseases | 11 | 6.9 | 2.7 | 0.8 | 0.9 | 1.1 | 0.4 | 2.8 |
| Inner ear diseases | 0 | 0 | 0 | 0.1 | 0.5 | 1.3 | 3.2 | 0.3 |
| Outer ear infections | 0.2 | 0.1 | 0.1 | 0.3 | 0.4 | 0.6 | 0.2 | 0.3 |
| Hearing loss | 0.8 | 0.6 | 0.2 | 0.1 | 0.2 | 0.4 | 0.2 | 0.3 |
- Any diagnosis identifies ear and hearing-related hospitalisations using both principal diagnosis and additional diagnosis.
- To calculate rates for the First Nations population, projections (medium series) based on the 2021 Census have been used (ABS 2011-to-2031).
- 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.
- Based on ICD-10-AM (11th edition) codes: Otitis externa (H60), Disease of the middle ear and mastoid (H65-H75), Diseases of the inner ear (H80-H83), Hearing loss (H90-H91), Diseases of the ear and mastoid process (H60-H95).
- Data for 'Diseases of the ear and mastoid process' also includes 'Other disorders of the external ear' (H61 and H62) and 'Other disorders of ear' (H92-H95).
Source: AIHW analysis of National Hospital Morbidity Database; and ABS population estimates and projections for rate calculations.
Among First Nations people, rates of hospitalisations due to middle ear and outer ear conditions were higher than among non-Indigenous people. Hospitalisation rates for conditions of the inner ear and hearing loss were similar for First Nations people and non-Indigenous Australians (Figure TREATMENT 8).
Figure TREATMENT 8: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, by diagnosis and Indigenous status, 2021–23
Column chart shows ear related hospitalisation rate for middle ear disease and outer ear infection higher for First Nations than non-Indigenous people.
| Diagnosis | First Nations | Non-Indigenous |
|---|---|---|
| Middle ear diseases | 2.1 | 1.3 |
| Inner ear diseases | 0.6 | 0.6 |
| Outer ear infections | 0.3 | 0.1 |
| Hearing loss | 0.3 | 0.3 |
- 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.
- Principal diagnosis code used unless specified otherwise.
- 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.
- Based on ICD-10-AM (11th edition) codes: Otitis externa (H60), Other disorders of the external ear (H61-H62), Disease of the middle ear and mastoid (H65-H75), Diseases of the inner ear (H80-H83), Hearing loss (H90-H91), Other disorders of ear (excluding hearing loss) (H92-H95).
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, around 64% of all ear or hearing related hospitalisations among First Nations people (4,600 hospitalisations) were for children aged 0–14. Middle ear disease was the main diagnosis for 9 in 10 ear or hearing related hospitalisations among First Nations children aged 0–14 (4,000 hospitalisations) (data table 3.2b).
Rates of ear or hearing related hospitalisations were higher among young First Nations children than older First Nations people, similar to the age patterns for emergency department visits.
Among First Nations children aged 0–4 there were 12.4 ear or related hospitalisations per 1,000 population (around 2,500), the highest rate of any age group (data table 3.2b).
Ear or hearing related hospitalisation rates for First Nations boys aged 1–6 were 1.3 to 1.7 times higher than rates for girls of the same age (Figure TREATMENT 9).
Figure TREATMENT 9: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, First Nations people, by sex and age, 2021–23
Column chart shows rate of ear related hospitalisations of First Nations people higher for boys than girls, higher for adult females than males.
| Age | Males | Females |
|---|---|---|
| 0 | 5.4 | 4 |
| 1 | 17.4 | 12.2 |
| 2 | 18.7 | 10.9 |
| 3 | 13.8 | 9.9 |
| 4 | 13.3 | 9.6 |
| 5 | 11 | 8.8 |
| 6 | 8.7 | 6.5 |
| 7 | 6.7 | 7.3 |
| 8 | 5.7 | 4.5 |
| 9 | 4.2 | 5.1 |
| 10 | 4 | 4.4 |
| 11 | 3.1 | 2.8 |
| 12 | 3 | 2.8 |
| 13 | 2.4 | 1.7 |
| 14 | 1.7 | 1.5 |
| 15–19 | 1.1 | 1.4 |
| 20–24 | 0.7 | 1.3 |
| 25–29 | 1.3 | 1.9 |
| 30–34 | 0.9 | 2.2 |
| 35–39 | 1 | 2 |
| 40–44 | 1.4 | 2.1 |
| 45–49 | 1.6 | 2.2 |
| 50–54 | 2.4 | 2.4 |
| 55–59 | 2.2 | 3.4 |
| 60–64 | 2.6 | 5.4 |
| 65–69 | 2.4 | 3.7 |
| 70–74 | 3.6 | 3.6 |
| 75 and over | 3 | 4.7 |
- 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.
- 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, rates of ear or hearing related hospitalisations among First Nations people were:
- lower among those living in Major cities (3.4 per 1,000 population), Inner regional areas (3.2 per 1,000) and Outer regional areas (3.0 per 1,000),
- higher in Remote areas (5.3 per 1,000) and Very remote areas (4.9 per 1,000) (data table 3.2e).
Similar to the patterns for emergency department visits, rates of ear or hearing related hospitalisations were higher among First Nations children aged 0–14 than First Nations people aged 15 and over across remoteness areas. Again, these differences were greatest in Remote and Very remote areas (Figure TREATMENT 10).
Figure TREATMENT 10: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, First Nations people, by age and remoteness, 2021–23
Column chart shows ear related hospitalisation rates of First Nations people are highest for those 0–14 and those 55 and over, across remoteness areas.
| Remoteness area | 0–14 | 15–34 | 35–54 | 55 and over |
|---|---|---|---|---|
| Major cities | 6.6 | 1.2 | 1.8 | 3.7 |
| Inner regional | 6.2 | 1.2 | 1.3 | 3 |
| Outer regional | 5.7 | 1.2 | 1.8 | 2.6 |
| Remote | 10.4 | 2.2 | 2.6 | 6.1 |
| Very Remote | 10.9 | 2.1 | 2.9 | 3.2 |
- 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.
- Principal diagnosis code used unless specified otherwise.
- 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
Nationally, there were 4.0 hospitalisations where the main diagnosis was ear related per 1,000 First Nations people in 2021–23.
Rates of hospitalisations where the main diagnosis was ear related among First Nations people ranged from 2.0 per 1,000 population in Tasmania to 4.5 per 1,000 population in Western Australia (Table 3.2d).
Rates of hospitalisations where the main diagnosis was ear related were higher among First Nations children aged 0–14 than among older First Nations across all states and territories in 2021–23.
Rates of hospitalisations where the main diagnosis was ear related among First Nations children aged 0–14 ranged from 3.5 per 1,000 population in Tasmania to 10.7 per 1,000 population in Western Australia (Figure TREATMENT 11).
Figure TREATMENT 11: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, First Nations people, by age and state/territory, 2021–23
Column chart shows high rates of ear related hospitalisation rates among those 0–14, particularly in WA, SA and NT.
| State/territory | 0–14 | 15–34 | 35–54 | 55 and over |
|---|---|---|---|---|
| NSW/ACT | 5.9 | 0.8 | 1.3 | 2.3 |
| Vic. | 5.6 | 1.3 | 1.2 | 2.6 |
| Qld | 7.4 | 1.7 | 2.7 | 5.6 |
| WA | 10.7 | 1.2 | 1.8 | 2.9 |
| SA | 8.5 | 1.6 | 1.5 | 3.2 |
| Tas. | 3.5 | 1 | 1.1 | 2.2 |
| NT | 6.8 | 2.4 | 3 | 4 |
- 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.
- Principal diagnosis code used unless specified otherwise.
- 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 hospitalisations where the main diagnosis was ear related of First Nations people in 2021–23 ranged from 2.0 per 1,000 population in Tasmania to 10.0 per 1,000 population in West Kimberley (Figure TREATMENT 12).
Figure TREATMENT 12: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, by Indigenous region (IREG), July 2021 to June 2023
Source: AIHW analysis of National Hospital Morbidity Database; and AIHW population modelling using ABS population estimates and projections.
Over time
The rates of hospitalisations where the main diagnosis was ear related among First Nations people increased from 3.7 per 1,000 population in 2012–13 to 4.5 per 1,000 in 2017–18, then generally decreased over the following years before rising to 4.4 per 1,000 in 2022–23 (data table 3.2f).
First Nations children aged 0–4 had the highest rate of hospitalisations where the main diagnosis was ear related per 1,000 population across age groups. The rate increased from 9.5 per 1,000 in 2012–13 to 13.0 per 1,000 in 2018–19, before rising to 14.1 per 1,000 in 2022–23 following pandemic-era declines.
Similarly, the rate of hospitalisations where the main diagnosis was ear related among First Nations children aged 5–9 peaked at 10.0 per 1,000 in 2017–18 before decreasing during the pandemic, then rising to 9.1 per 1,000 in 2022–23.
From 2012–13 to 2022–23, there was relatively little change in the rate of hospitalisations where the main diagnosis was ear related among First Nations adults aged 15–34 or 35–54. However, the rate among First Nations people aged 55 and over increased steadily over this period, from 2.3 per 1,000 in 2012–13 to 4.2 per 1,000 in 2022–23 (Figure TREATMENT 13).
Figure TREATMENT 13: Hospitalisations for main diagnosis of diseases of the ear and mastoid process, 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.