Summary
This report provides insight into injuries that occur during a period of hospitalisation – referred to as hospital-onset injuries. This report complements existing reporting on hospital-acquired complications required by the Australian Commission on Safety and Quality in Health Care – such as pressure injuries, medication complications, and neonatal birth trauma – which are already routinely monitored. See Hospital-acquired complications - Hospitals and ‘Safety and quality of health systems’ data tables available from Admitted patient care - Hospitals.
The average annual rate of hospital-onset injury from 2015–16 to 2024–25 was 55 per 10,000 separations (1 in 182 separations). From 2015–16 to 2019–20, the hospital-onset injury rate fell from 64 to 50 per 10,000 separations and has remained stable up to 2024–25.
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Hospital-onset injury rates varied according to health service and clinical characteristics, and population groups
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The rate was highest for patient groups with longer hospitalisations, such as:
- those receiving sub-acute and non-acute care types (164 per 10,000 separations in 2024–25)
- patients who took leave days (389 per 10,000 in 2024–25).
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The rate was lower for hospitals located in Remote and very remote areas – 34 and 32 per 10,000 separations in 2024–25, respectively.
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The rate has been similar for First Nations and non-Indigenous Australians since 2017–18.
In 2024–25, the rate was 55 and 54 per 10,000 separations for Indigenous and non-Indigenous populations, respectively.
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Falls were the most common cause of hospital-onset injury
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Falls make up about half of all hospital-onset injuries each year. In 2024–25:
- 55% of fall-related injuries were open wounds or superficial injuries
- 9% were fractures and 3% intracranial injuries.
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The likelihood of sustaining fractures or open wounds from falls increased with age.
Younger individuals more often experienced superficial injuries.
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Admitted patients with hospital-onset injury had worse outcomes than those without
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Patients with hospital-onset injuries had a median length of stay 11 days longer than those without hospital-onset injuries.
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Patients with hospital-onset injuries were about 5 times as likely to require ICU admission and had higher rates of statistical discharge, acute hospital transfer, discharge to residential aged care, or in-hospital death than those without injury.
While hospital-onset injuries were associated with poorer outcomes, the findings highlight the importance of considering other risk factors – such as age and medical complexity – when assessing the impact of hospital-onset injuries on patient results. Patients who experience hospital-onset injuries may already have underlying risk factors that predispose them to poorer outcomes independent of the injury.