Health service and clinical characteristics
Health service characteristics
The rate of hospital-onset injuries (excluding complications and sequelae) varied with health service characteristics (Figure 2).
Higher hospital-onset injury rates observed in certain patient groups – such as those receiving non-acute and sub-acute care, and those who take leave days – are likely linked to their longer length of stay. Length of stay can increase the risk of injury and may itself be prolonged if a patient experiences an adverse event in hospital (see Outcomes of hospital-onset injury).
Figure 2: Hospital-onset injury rates by health service characteristics, 2015–16 to 2024–25
A series of line graphs showing hospital-onset injury separations per 10,000 separations from 2015-16 to 2024-25, stratified by 9 health care characteristics: same day admission or overnight stay, length of stay in weeks, hospital in the home care, leave days, urgency of admission, hospital sector, care type, patient funding status, hospital remoteness. The graphs show higher injury rates associated with longer hospital stays, and for certain care types.
| Year | Same day | Overnight |
|---|---|---|
| 2015-16 | 6 | 124 |
| 2016-17 | 7 | 133 |
| 2017-18 | 6 | 113 |
| 2018-19 | 6 | 113 |
| 2019-20 | 6 | 100 |
| 2020-21 | 5 | 102 |
| 2021-22 | 5 | 104 |
| 2022-23 | 5 | 104 |
| 2023-24 | 5 | 108 |
| 2024-25 | 6 | 110 |
| Year | Less than 1 week | 1-2 weeks | 2-3 weeks | 3-4 weeks | 4-8 weeks | 8-12 weeks | More than 12 weeks |
|---|---|---|---|---|---|---|---|
| 2015-16 | 27 | 257 | 435 | 588 | 800 | 1201 | 1547 |
| 2016-17 | 29 | 280 | 473 | 627 | 857 | 1217 | 1714 |
| 2017-18 | 23 | 239 | 428 | 573 | 798 | 1213 | 1587 |
| 2018-19 | 23 | 238 | 434 | 565 | 771 | 1171 | 1646 |
| 2019-20 | 19 | 207 | 370 | 499 | 714 | 1054 | 1494 |
| 2020-21 | 19 | 214 | 397 | 550 | 766 | 1148 | 1545 |
| 2021-22 | 18 | 197 | 394 | 543 | 764 | 1221 | 1625 |
| 2022-23 | 17 | 202 | 374 | 522 | 756 | 1170 | 1649 |
| 2023-24 | 18 | 216 | 398 | 547 | 791 | 1207 | 1741 |
| 2024-25 | 19 | 214 | 411 | 559 | 823 | 1277 | 1797 |
| Year | No hospital in the home days | Had hospital in the home days |
|---|---|---|
| 2015-16 | 64 | 89 |
| 2016-17 | 67 | 102 |
| 2017-18 | 57 | 78 |
| 2018-19 | 57 | 84 |
| 2019-20 | 50 | 68 |
| 2020-21 | 49 | 86 |
| 2021-22 | 51 | 54 |
| 2022-23 | 49 | 81 |
| 2023-24 | 51 | 102 |
| 2024-25 | 52 | 103 |
| Year | No leave days | Had leave days |
|---|---|---|
| 2015-16 | 62 | 402 |
| 2016-17 | 66 | 459 |
| 2017-18 | 55 | 440 |
| 2018-19 | 55 | 421 |
| 2019-20 | 49 | 381 |
| 2020-21 | 49 | 391 |
| 2021-22 | 50 | 344 |
| 2022-23 | 49 | 370 |
| 2023-24 | 51 | 388 |
| 2024-25 | 52 | 389 |
| Year | Elective | Emergency |
|---|---|---|
| 2015-16 | 49 | 82 |
| 2016-17 | 52 | 87 |
| 2017-18 | 39 | 78 |
| 2018-19 | 38 | 79 |
| 2019-20 | 32 | 70 |
| 2020-21 | 30 | 74 |
| 2021-22 | 29 | 79 |
| 2022-23 | 27 | 79 |
| 2023-24 | 29 | 79 |
| 2024-25 | 30 | 80 |
| Year | Public (excluding psychiatric day hospitals) | Public psychiatric | Public -all | Private (excluding free-standing day hospital facilities) | Private free-standing day hospital facilitiy | Private - all |
|---|---|---|---|---|---|---|
| 2015-16 | 81 | 281 | 82 | 49 | 3 | 40 |
| 2016-17 | 86 | 416 | 87 | 50 | 3 | 41 |
| 2017-18 | 75 | 302 | 76 | 39 | 1 | 32 |
| 2018-19 | 76 | 392 | 76 | 37 | 1 | 31 |
| 2019-20 | 66 | 309 | 67 | 33 | 1 | 27 |
| 2020-21 | 67 | 333 | 68 | 33 | 1 | 27 |
| 2021-22 | 69 | 347 | 70 | 33 | 1 | 27 |
| 2022-23 | 70 | 330 | 70 | 30 | 1 | 24 |
| 2023-24 | 71 | 421 | 71 | 31 | 1 | 26 |
| 2024-25 | 73 | 372 | 74 | 31 | 1 | 25 |
| Year | Acute care | Rehabilitation care | Palliative care | Geriatric evaluation and management | Psychogeriatric care | Maintenance care | Newborn (qualified) | Newborn (qualified/unqualified) | Mental health care |
|---|---|---|---|---|---|---|---|---|---|
| 2015-16 | 55 | 109 | 206 | 482 | 249 | 332 | 40 | 14 | 141 |
| 2016-17 | 58 | 112 | 212 | 464 | 186 | 271 | 43 | 33 | 158 |
| 2017-18 | 47 | 110 | 205 | 431 | 197 | 217 | 64 | 27 | 149 |
| 2018-19 | 47 | 110 | 199 | 412 | 196 | 311 | 55 | 24 | 141 |
| 2019-20 | 40 | 109 | 173 | 389 | 251 | 291 | 44 | 16 | 134 |
| 2020-21 | 39 | 108 | 170 | 412 | 317 | 313 | 39 | 14 | 147 |
| 2021-22 | 40 | 124 | 159 | 397 | 302 | 216 | 36 | 20 | 149 |
| 2022-23 | 39 | 109 | 154 | 422 | 312 | 359 | 40 | 24 | 132 |
| 2023-24 | 41 | 102 | 163 | 440 | 335 | 390 | 41 | 18 | 140 |
| 2024-25 | 42 | 99 | 152 | 485 | 351 | 422 | 45 | 29 | 142 |
| Year | Department of Veterans Affairs | Motor vehicle third party personal claim | Private health insurance | Public patients | Self-funded | Workers compensation |
|---|---|---|---|---|---|---|
| 2015-16 | 120 | 76 | 50 | 79 | 16 | 33 |
| 2016-17 | 122 | 90 | 52 | 84 | 18 | 37 |
| 2017-18 | 102 | 73 | 43 | 72 | 14 | 28 |
| 2018-19 | 102 | 75 | 42 | 72 | 14 | 28 |
| 2019-20 | 91 | 76 | 38 | 63 | 11 | 25 |
| 2020-21 | 89 | 72 | 37 | 63 | 11 | 23 |
| 2021-22 | 93 | 73 | 37 | 65 | 8 | 21 |
| 2022-23 | 86 | 92 | 35 | 65 | 9 | 20 |
| 2023-24 | 77 | 76 | 37 | 67 | 9 | 22 |
| 2024-25 | 83 | 76 | 37 | 69 | 9 | 20 |
| Year | Major cities | Inner regional | Outer regional | Remote | Very remote |
|---|---|---|---|---|---|
| 2015-16 | 65 | 59 | 60 | 41 | 21 |
| 2016-17 | 70 | 62 | 63 | 44 | 16 |
| 2017-18 | 58 | 55 | 57 | 38 | 23 |
| 2018-19 | 58 | 54 | 59 | 36 | 29 |
| 2019-20 | 51 | 48 | 50 | 34 | 21 |
| 2020-21 | 50 | 50 | 49 | 38 | 29 |
| 2021-22 | 51 | 52 | 51 | 34 | 23 |
| 2022-23 | 49 | 53 | 53 | 34 | 20 |
| 2023-24 | 51 | 54 | 53 | 35 | 22 |
| 2024-25 | 53 | 55 | 53 | 34 | 32 |
Notes:
- Hospital-onset injuries exclude diagnosis codes T80-T88 Complications of surgical and medical care and T90-T98 Sequelae of injuries, of poisoning and of other external causes.
- Analysis excludes care types 7.3, 9, 10, and separations for same day chemotherapy or haemodialysis
- The length of stay of an overnight patient is calculated by subtracting the date the patient is admitted from the date of separation and deducting days the patient was on leave. A same-day patient is allocated a length of stay of 1 day. See METEOR identifier 269982
- Overnight stay is where the patient stayed one or more nights
- Hospital in the home care is the provision of care to hospital admitted patients in their place of residence as a substitute for hospital accommodation. Place of residence may be permanent or temporary. See METEOR identifier 327308
- Care type is the overall nature of care delivered, derived from other service characteristics. See METEOR identifier 711010
- Remoteness areas are classified using the ABS 2011 Australian Statistical Geography Standard (ASGS) for years 2015-16 and 2016-17, Edition 2 (2016) for years 2019-20 to 2021-22 and Edition 3 (2021) from 2022-23 onwards.
Downloadable data tables are available on Data. See Tables S2-S10.
Source:
AIHW analysis of the National Hospital Morbidity Database
|
Data source overview
The hospital-onset injury rate was:
- Higher with increasing length of stay: in 2024–25 the hospital-onset injury rate increased from 19 per 10,000 separations for those admitted for less than 1 week to 1,797 per 10,000 separations for more than 12 weeks admission (excluding leave days).
- Up to twice as high for separations that included hospital in the home care: in 2024–25, the rate for episodes that involved hospital in the home care compared to those without was 103 and 52 per 10,000 separations, respectively.
- Up to 8 times as high for separations that involved leave days: in 2024–25, the injury rate was 389 per 10,000 separations with leave days and 52 per 10,000 separations without leave days. On average, hospital-onset injuries were recorded for 1 in 25 separations involving leave days, compared to 1 in 187 without leave between 2015–16 and 2024–25.
- Highest for public psychiatric hospitals: in 2024–25, the injury rate was 372 per 10,000 separations in psychiatric hospitals compared with 71 per 10,000 in other public hospitals and 26 per 10,000 for private hospitals. The hospital-onset injury rate was also higher than average for very small hospitals, at 127 per 10,000 separations in 2024–25.
- Higher for patients receiving non-acute and sub-acute care (164 per 10,000 separations in 2024–25) compared with acute care (42 per 10,000). The injury rate for several care types was above the national rate (53 per 10,000), including Geriatric evaluation and management care (485 per 10,000 separations in 2024–25), Maintenance care (422 per 10,000) Psychogeriatric care (351 per 10,000), Palliative care (152 per 10,000), Mental health care (142 per 10,000) and Rehabilitation care (99 per 10,000).
- Highest for hospitalisations funded by the Department of Veterans Affairs, and Motor vehicle third party personal claim (83 and 76 per 10,000 separations in 2024-25). The rate for Department of Veterans Affairs has fallen from 120 per 10,000 separations since 2015–16. The rate for hospitalisations funded through Workers' compensation was generally low (20 per 10,000 in 2024–25).
- Lowest for hospitals located in Very remote and Remote areas: in 2024–25, hospitals in Very Remote and Remote areas had rates of 32 and 34 per 10,000 separations, respectively. Major cities, Inner regional, and Outer regional areas were close to the national average of 53 per 10,000 separations. The rate has declined since 2015–16 for all areas, except for Very remote areas where the rate has fluctuated and increased from 21 to 32 per 10,000 separations over the 10-year period.
Principal diagnosis
The hospital-onset injury rate has remained stable between 2015–16 and 2024–25 for most principal diagnosis groups (Figure 3).
Figure 3: Hospital-onset injury rates by principal diagnosis chapter (top 10), 2015–16 to 2024–25
Line graph showing hospital-onset injury rates for principal diagnosis chapters from 2015-16 to 2024-25, measured as number per 10,000 separations. Each coloured line represents a diagnosis category with notable trends including the highest rate in all years for mental and behavioural disorders and a steady decrease for circulatory diseases, with detailed legend identifying the 10 diagnosis chapters with the highest rates for 2024-25.
| Year | A00-B99 Infectious & parasitic | C00-D48 Neoplasms | E00-E89 Endocrine, nutritional & metabolic | F00-F99 Mental & behavioural | G00-G99 Nervous system | I00-I99 Circulatory system | J00-J99 Respiratory system | M00-M99 Musculoskeletal & connective tissue | S00-T98 Injury & poisoning | Z00-Z99 Factors influencing health status |
|---|---|---|---|---|---|---|---|---|---|---|
| 2015-16 | 74 | 96 | 72 | 136 | 47 | 132 | 68 | 68 | 83 | 35 |
| 2016-17 | 81 | 99 | 76 | 147 | 51 | 132 | 75 | 73 | 88 | 43 |
| 2017-18 | 81 | 78 | 61 | 141 | 44 | 111 | 72 | 57 | 79 | 42 |
| 2018-19 | 77 | 76 | 59 | 139 | 46 | 115 | 67 | 59 | 80 | 48 |
| 2019-20 | 72 | 61 | 53 | 135 | 44 | 93 | 65 | 50 | 71 | 49 |
| 2020-21 | 83 | 58 | 56 | 150 | 46 | 93 | 66 | 51 | 70 | 47 |
| 2021-22 | 61 | 54 | 54 | 158 | 47 | 96 | 75 | 52 | 76 | 50 |
| 2022-23 | 73 | 50 | 51 | 146 | 45 | 96 | 68 | 51 | 76 | 54 |
| 2023-24 | 75 | 53 | 54 | 156 | 46 | 94 | 65 | 51 | 76 | 65 |
| 2024-25 | 73 | 52 | 52 | 159 | 46 | 95 | 71 | 50 | 78 | 82 |
- Hospital-onset injuries exclude diagnosis codes T80-T88 Complications of surgical and medical care and Y90-Y98 Sequelae of injuries, of poisoning and of other external causes.
- Analysis excludes care types 7.3, 9, 10, and separations for same day chemotherapy or haemodialysis.
- The 10 principal diagnosis chapters with the highest hospital-onset injury rates in 2024–25.
Downloadable data tables are available on Data. See Table S11.
Source:
AIHW analysis of the National Hospital Morbidity Database
|
Data source overview
The hospital-onset injury rate:
- Was highest in all years for Mental and behavioural disorders, and gradually increased from 136 to 159 per 10,000 separations between 2015–16 and 2024–25.
- Declined from 132 to 93 per 10,000 separations between 2015–16 and 2019–20 for Circulatory diseases and has remained stable through to 2024–25.
- Increased from 54 to 82 per 10,000 separations for Factors influencing health status between 2022–23 and 2024–25.
In 2024–25, hospital-onset injury rates for several principal diagnoses exceeded the national average (53 per 10,000 separations), such as Mental and behavioural disorders (159), Circulatory diseases (95), Injury and poisoning (78), Infectious and parasitic (73), Respiratory diseases (71), and Factors influencing health status (82).
Hospital-onset injury rates for separations classified under Codes for special purposes were also high – 128 per 10,000 separations for 2024–25. These codes largely include the emergency use codes related to COVID-19 and supplementary codes for chronic endocrine, nutritional and metabolic diseases.