Key concepts

Overnight admitted mental health-related care
Key concept Description
Average length of stay Average length of stay is the average number of patient days for admitted patient separations.
Care type

The care type defines the overall nature of a clinical service provided to an admitted patient during an episode of care (admitted care), or the type of service provided by the hospital for boarders or posthumous organ procurement (other care).

Mental health related

A separation is classified as mental health-related for the purposes of this report if:

  • it had a mental health-related principal diagnosis, which, for admitted patient care in this report, is defined as a principal diagnosis that is either:
    • a diagnosis that falls within the section on Mental and behavioural disorders (Chapter 5) in the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM) (codes F00–F99), or
    • a number of other selected diagnoses (see the technical information) for a full list of applicable diagnoses), and/or
  • it included any specialised psychiatric care.
Overnight admitted patient care

For this report overnight admitted patient separations refers to those separations when a patient undergoes a hospital’s formal admission process, completes an episode of care, is in hospital for more than one day and ‘separates’ from the hospital. Same-day separations are reported separately in the Admitted patient care – same-day care section of this report.

Patient day

Patient day means the occupancy of a hospital bed (or chair in the case of some same day patients) by an admitted patient for all or part of a day. The length of stay for an overnight patient is calculated by subtracting the date the patient was 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. Patient day statistics can be used to provide information on hospital activity that, unlike separation statistics, account for differences in length of stay. The patient day data presented in this report include days within hospital stays that occurred before 1 July provided that the separation from hospital occurred during the relevant reporting period (that is, the financial year period). This has little or no impact in private and public acute hospitals, where separations are relatively brief, throughput is relatively high and the patient days that occurred in the previous year are expected to be approximately balanced by the patient days not included in the counts because they are associated with patients yet to separate from the hospital and therefore yet to be reported. However, some public psychiatric hospitals provide very long stays for a small number of patients and, as a result, would have comparatively large numbers of patient days recorded that occurred before the relevant reporting period and may not be balanced by patient days associated with patients yet to separate from the hospital.  

Principal diagnosis

The principal diagnosis is the diagnosis established after study to be chiefly responsible for occasioning the patient’s episode of admitted patient care.

Procedure

Procedure refers to a clinical intervention that is surgical in nature, carries an anaesthetic risk, requires specialised training and/or requires special facilities or services available only in an acute care setting. Procedures therefore encompass surgical procedures and non-surgical investigative and therapeutic procedures, such as X-rays. Patient support interventions that are neither investigative nor therapeutic (such as anaesthesia) are also included.

Procedures are grouped together in blocks (Procedure blocks) based on the area of the body, health professional or intervention involved.

Psychiatric care days

Psychiatric care days are the number of days or part days the person received care as an admitted patient in a designated psychiatric unit or ward. 

Separation

Separation is the term used to refer to the episode of admitted patient care, which can be a total hospital stay (from admission to discharge, transfer or death) or a portion of a hospital stay beginning or ending in a change of type of care (for example, from acute care to rehabilitation). ‘Separation’ also means the process by which an admitted patient completes an episode of care by being discharged, dying, transferring to another hospital or changing type of care. Each record includes information on patient length of stay. A same-day separation occurs when a patient is admitted and separated from the hospital on the same date. An overnight separation occurs when a patient is admitted to and separated from the hospital on different dates. The numbers of separations and patient days can be a less reliable measure of the activity for establishments such as public psychiatric hospitals, and for patients receiving care other than acute care, for which more variable lengths of stay are reported.

Specialised psychiatric care

A separation is classified as having specialised psychiatric care if the patient was reported as having one or more days in a specialised psychiatric unit or ward.

Without specialised psychiatric care

A separation is classified as without specialised psychiatric care if the patient did not receive any days of care in a specialised psychiatric unit or ward. Despite this, these separations are classified as mental health related because the reported principal diagnosis for the separation is either one that falls within the Mental and behavioural disorders chapter (Chapter 5) in the ICD-10-AM classification (codes F00–F99) or is one of a number of other selected diagnoses (technical information).


Alternative text for figures for Overnight admitted mental health-related care section

Figure ON.1

Stacked bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations with specialised psychiatric care for all states and territories by type of hospital. The highest rate was for public acute hospitals (44.7) followed by private hospitals (17.5) and public psychiatric hospitals (5.1). Separations per 10,000 population for public acute hospitals: NSW 45.3; Vic 40.6; Qld 50.0; WA 39.7; SA 52.3; Tas 38.5; ACT 47.9; NT 36.1. Refer to Table ON.4. Back to figure ON.1

Figure ON.2

Vertical bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations with specialised psychiatric care by age-group, sex, indigenous status, remoteness and SEIFA. Persons by age group: <15 years 5.5; 15-24 years 94.0; 25-34 years 97.6; 35-44 years 108.2; 45-54 years 87.4; 55-64 years 62.2; 65 years and older 42.1. Persons by sex: males 64.9; females 69.6. Persons by indigenous status: Indigenous 147.5; Non-Indigenous 64.4. Persons by remoteness: major cities 68.3; inner regional 65.6; outer regional 56.6; remote and very remote 37.2. Persons by SEIFA: quintile one 73.0; quintile two 70.9; quintile three 63.7; quintile four 65.3; quintile five 57.7. (Refer to Table ON.6). Back to figure ON.2

Figure ON.3

Horizontal bar chart showing the percent of overnight admitted mental health-related separations with specialised psychiatric care for the 5 most frequently reported principal diagnoses for all hospital types: Schizophrenia (F20) 14.7%; Depressive episode (F32) 14.4%; Reaction to severe stress and adjustment disorders (F43) 10.0%; Bipolar affective disorder (F31) 8.8%; Mental and behavioural disorders due to other psychoactive substance use (F11-19) 7.9 %. Refer to Table ON.7. Back to figure ON.3

Figure ON.4

Vertical bar chart showing the proportion of overnight admitted mental health-related separations with specialised psychiatric care by legal status and hospital type. More than a third (36.6%) of all these separations were involuntary. By hospital type: Public acute 44.8% involuntary; Public psychiatric 50.5% involuntary; and Private 0.7% involuntary. Refer to Table ON.5. Back to figure ON.4

Figure ON.5

Vertical bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations without specialised psychiatric care for all states and territories. The aggregate rate for all public hospitals was 35.4 and private hospitals 4.0. Public hospitals by state or territory: NSW 39.7; Vic 31.6; Qld 30.5; WA 34.4; SA 45.5; Tas 25.9; ACT 33.8; NT 53.3. Refer to Table ON.12. Back to figure ON.5

Figure ON.6

Vertical bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations without specialised psychiatric care by age-group, sex, indigenous status, remoteness and SEIFA. Persons by age group: <15 years 12.3; 15-24 years 29.3; 25-34 years 34.1; 35-44 years 40.6; 45-54 years 35.7; 55-64 years 28.4; 65 years and older 92.1. Persons by sex: males 38.2; females 39.0. Persons by indigenous status: indigenous 126.0; non-indigenous 34.2. Persons by remoteness: major cities 36.1; inner regional 36.0; outer regional 49.9; remote and very remote 74.1. Persons by SEIFA: quintile one 47.8; quintile two 42.3; quintile three 37.3; quintile four 32.4; quintile five 30.4. Refer to Table ON.13. Back to figure ONN.6

Figure ON.7

Horizontal bar chart showing the percent of overnight admitted mental health-related separations without specialised psychiatric care for the 5 most frequently reported principal diagnoses. The 5 most common principal diagnoses for all hospital types: Mental and behavioural disorders due to use of alcohol (F10) 21.1%; Other organic mental disorders (F04-09) 18.0%; Mental and behavioural disorders due to other psychoactive substance use (F11-19) 8.6%; Dementia (F00-03) 8.5%; Depressive episode (F32) 6.9%. Refer to Table ON.14. Back to figure ON.7