Sports injury in Australia

Data sources

The AIHW operates under strict privacy policies outlined in Section 29 of the Australian Institute of Health and Welfare Act 1987 (AIHW Act). Section 29 requires that confidentiality of data relating to persons (living and deceased) and organisations be maintained. The Privacy Act governs confidentiality of information about living individuals. The AIHW is committed to reporting that maximises the value of information released for users while being statistically reliable and meeting legislative requirements described in the AIHW Act and the Privacy Act.

Hospitalisations

Hospitalisations data are sourced from the Australian Institute of Health and Welfare's (AIHW) National Hospital Morbidity Database (NHMD). The NHMD is a compilation of episode-level records from admitted patient morbidity data collection systems (APC NMDS) in Australian public and private hospitals. It includes episodes of care for admitted patients in all public and private acute and psychiatric hospitals, free standing day hospital facilities and alcohol and drug treatment centres in Australia. Hospitals operated by the Australian Defence Force, corrections authorities and in Australia's offshore territories may also be included. Hospitals specialising in dental, ophthalmic aids and other specialised acute medical or surgical care are included. Data quality statements for the NHMD are available on the AIHW Hospitals site. For more information about data contained in the NHMD refer to the AIHW Hospitals technical notes.

Population data

Population data are used for demographic analyses and as the denominator in calculating rates. All population level calculations are based on the estimated resident population (ERP) calculated as at the midpoint of each financial year. For example, for the reporting period 2024–25, the denominator population is the June 2024 ERP + the June 2025 ERP, divided by 2. This is used as the denominator for age specific/crude and age standardised rates.

The ERP at 30 June 2001 is used as the standardising population throughout the report (ABS 2003).

All general populations data are sourced from the Australian Bureau of Statistics (ABS) National, state and territory population (ABS 2025).

Sport and physical recreation participation data

Sport and physical activity participation data is sourced from the AusPlay survey led by the Australian Sports Commission (ASC). This national online survey reaches an annual target sample size of 40,000 adults aged 15 and over who have been living in Australia for at least 12 months. Those respondents with children aged 0–14 are also invited to provide participation data for one child. The annual target sample size of children aged 0–14 is approximately 8,800.

AusPlay survey respondents answer a broad range of questions about their participation in sports and physical recreation in the 12 months prior to interview, including how active they are and tracking their participation behaviours. A respondent needs only to have participated once in the previous 12 months to be counted as a participant.

The sample data is projected to population estimates using a statistical technique called Random Iterative Method (RIM) Weighting. As survey estimates are based on a sample, rather than the full population, they have associated sample error. One measure of sample error is the relative margin of error (RMOE). Survey estimates with a RMOE between 50% and 100% should be used with caution. Survey estimates with a RMOE greater than 100% are considered too unreliable to use.

In July 2023, AusPlay moved from phone to online data collection causing a break in AusPlay time series. Analyses using AusPlay data from 2023–24 onwards cannot be directly compared with analyses using historical 2015–23 AusPlay data.

This report uses AusPlay data between 1 July 2024 to 30 June 2025 for adults aged 15 and over. Due to the change in AusPlay’s data collection methodology, previous reports using AusPlay data from 2015–23 cannot be compared to analyses in this report.

Injury hospitalisations

A diagnosis of injury is defined as ICD-10-AM codes in the range S00–T75 or T79, using ‘Chapter 19 Injury, poisoning and certain other consequences of external causes’. A primary diagnosis of injury is when one of the specified codes is the first diagnosis code reported, while an additional diagnosis of injury is when one of the specified codes is reported but not as the first diagnosis.

A person may have more than one incident of injury resulting in hospitalisation in a financial year and each case of hospitalisation will be counted separately in this report. This is because we are counting incidents of injury resulting in hospitalisation, rather than the number of people who were hospitalised, in a given financial year. If a single incident led to an admission in more than one hospital, the incident has only been counted once. Therefore, counts of injury cases will be lower than the count of hospital records indicating injuries.

Inclusion criteria

• Records with the maximal snapshot ID in any database where the date of separation falls between 1 July 2024 to 30 June 2025.
• NHMD records with a principal diagnosis in the ICD 10 AM range S00–T75 or T79, using ‘Chapter 19 Injury, poisoning and certain other consequences of external causes’.
• NHMD records with an activity code in the ICD 10 AM sports activity range U50–U71. For records where the first recorded activity code is Leisure activity, not elsewhere classified (U72) or While working for income (U73), then the second recorded activity code is considered.
• NHMD records with a separation date between 1 July 2024 to 30 June 2025.

Exclusion criteria

• Records were excluded where the AIHW ‘standard analysis’ flag was absent, i.e. care type was newborn with unqualified days only (7.3), organ procurement - posthumous (9), or hospital boarder (10).
• Injuries due to Complications of surgical and medical care (T80 – T88) and Sequelae of injuries, of poisoning and of other consequences of external causes (T90 – T98) are excluded.

Estimating index cases, not counting separations

Each record in the NHMD refers to a single episode of care in a hospital. Some injury incidents result in more than one episode of care and, therefore, more than one record.

To minimise the impact of overcounting where a person experienced multiple episodes of care relating to the same condition, the following criteria are applied to estimate incidents:

• Exclude records where admission mode is transfer from another hospital (1).
• Exclude records where admission mode is statistical admission (2) and care type is not acute (1, 7.1, 7.2).
• Exclude records where care involving use of rehabilitation procedures (Z50) appears as an additional diagnosis and care type is not acute (1, 7.1, 7.2).

Injury classifications from ICD-10-AM

Diagnosis, intervention, activity, place of occurrence and external cause data for 2024–25 were reported to the NHMD using classifications from the 12th edition of the International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM) (ACCD 2019a), incorporating the Australian classification of health interventions (ACHI).

In tables and figures, information on diagnoses, external causes, activity, place of occurrence and interventions are presented using the codes and abbreviated descriptions of the ICD-10-AM/ACHI. Full descriptions of the categories are available in ICD-10-AM/ACHI publications on the Independent Health and Aged Care Pricing Authority (IHACPA) website (IHPA 2022).

Where data are presented in a time series incorporating previous reporting periods, these have been coded according to the following editions of ICD 10 AM:

• 7th edition for 2010–11 to 2012–13 hospital data
• 8th edition for 2013–14 to 2014–15 hospital data
• 9th edition for 2015–16 to 2016–17 hospital data
• 10th edition for 2017–18 to 2018–19 hospital data
• 11th edition for 2019–20 to 2021–22 hospital data
• 12th edition for 2022–23 to 2024–25 hospital data.

Mapping AusPlay and ICD-10-AM sports categories

The categorisation of sports categories using ICD-10-AM codes are detailed in Table 1 (see AusPlay to ICD-10-AM mapping for Sports injury in Australia [XLSX 133kB]).

Categorising external causes of injury

The NHMD is structured so that the first listed external cause for a record relates to the first listed injury diagnosis (principal diagnosis). While multiple external causes may be recorded for a separation, we report only one cause for each injury, referred to as ‘nominal external cause’ in these notes. The following steps are followed to determine the nominal external cause for each injury hospitalisation:

1. The first reported external cause is taken to be the nominal external cause.
2. If the nominal external cause, as determined by step 1, is U90.0 (Healthcare associated Staphylococcus aureus bacteraemia) or a supplementary factor (Y90–Y98), then the second reported code is taken to be the nominal external cause.
3. If the nominal external cause, after steps 1 and 2, relates to complications of medical and surgical care (Y40–Y84), sequelae of external causes of morbidity and mortality (Y85–Y89), or a supplementary factor code (Y90–Y98), then the record is excluded.

The categorisation of external causes using ICD-10-AM codes are detailed in the Appendix tables to technical notes for Injury in Australia.

Categorising type and site of injury

Type of injury and body part injured are based on the patient’s principal diagnosis. Principal diagnosis is the diagnosis chiefly responsible for occasioning the episode of care for the patient as defined by ICD-10-AM codes. The principal diagnosis details the type of injury sustained such as fractures, dislocations, nerve injuries and burns, and the body part injured such as head, neck, ankle and foot.

To categorise injuries by type and body part injured, Injury in Australia’s principal diagnosis matrix has been applied (as outlined in the Appendix tables to technical notes for Injury in Australia).

The sum of injuries by body part may not equal the total number of hospitalised injury cases because some injuries are not described in terms of body region.

Analysis methods

The Australian ERP as of 30 June 2001 is used as the standardising population throughout the report. Age standardisation of rates enables valid comparison across years and/or jurisdictions without being affected by differences in age distributions.

Population based rates of injury tend to have similar values from one year to the next. Exceptions to this can occur (for example, due to a mass casualty disaster), but are unusual in Australian injury data. Some year on year variation and short run fluctuations are to be expected, so small changes in a rate over a short period do not provide a firm basis for asserting that a trend is present.

n.a. Note applicable

Timeseries

10-year time series rates may not match historically published rates due to changes in denominator data over time, jurisdictional updates in numerator data or retrospective refreshing of numerator or denominator data across different data sources.

Remoteness

Remoteness areas are based off the patient’s usual place of residence and are defined using the ABS’ Australian Statistical Geography Standard (ASGS) Remoteness Structure (ABS 2021). The ASGS Remoteness Structure 2016 categorises geographical areas in Australia into remoteness areas, described in detail on the ABS website which also includes detail of the nature of changes between the ASGS 2011 and ASGS 2016.

The remoteness classification is as follows: 

• Major cities – for example, Sydney, Melbourne, Brisbane, Adelaide, Perth, Canberra and Newcastle
• Inner regional – for example, Hobart, Launceston, Wagga Wagga, Bendigo and Murray Bridge
• Outer regional – for example, Darwin, Moree, Mildura, Cairns, Charters Towers, Whyalla and Albany 
• Remote – for example, Port Lincoln, Esperance, Queenstown and Alice Springs 
• Very remote – for example, Mount Isa, Cobar, Coober Pedy, Port Hedland, Tennant Creek and Norfolk Island.

Presentation of data

Persons totals include cases for which sex was not reported.

All age totals include cases where age was not reported.

Percentages, rates (crude/age-specific and age-standardised) are rounded to 1 decimal place. Percentages may not add up to 100.0 because of rounding. Both crude/age-specific rates and age-standardised rates are calculated per 100,000 population.

Aggregated injury hospitalisations data are presented in tables, graphs, or figures to avoid attribute disclosure and minimise risk of potentially re-identifying a person.

Data quality

A summary of data notes and data quality issues for the NHMD can be found in the Admitted Patient Care technical notes and appendices on the AIHW Hospitals site.

Missing or invalid data

In some cases, the data provided may include missing values (for example, the date/time of physical departure was not recorded), or invalid values (for example, if the time of physical departure was recorded as occurring before the time of hospitalisation).

Glossary

Age

Age in years of the patient at time of admission.

Crude rate

Also known as age-specific rate.

A rate limited to a particular age group. Numerator is the number of hospitalisations in that age group; the denominator is number of persons in that age group in the population.

Sex

We note that the ‘sex’ variable currently available for national hospitals reporting only comprises of 4 categories – male, female, intersex or indeterminate, and not stated/inadequately described – and is referring to the biological sex only. Work is underway to include more comprehensive coverage of sex and/or gender within future reporting.

For this report, the categories of intersex or indeterminate, and not stated/inadequately described have been grouped together to assist with data confidentiality. In addition, ‘boys’ is used to refer to children and adolescents with a biological sex of male, and ‘girls’ for a biological sex of female. Rates, based on the Australian population data held by the AIHW (sourced from the ABS), are currently only available for male and female sex categories.

External cause

External cause are the circumstances in which an injury or poisoning event has occurred. External causes are defined as ICD-10-AM codes in the range V00–Y36 or Y37.6, using ‘Chapter 20 External causes of morbidity and mortality’.

The categorisation of hospitalisation external causes using ICD-10-AM codes are detailed in Appendix tables to technical notes for Injury in Australia.

Place of occurrence

The first reported place of occurrence indicates where the person was at the time the injury or poisoning event occurred. Place of occurrence includes locations such as the home, residential institution, school, sports and athletic areas, street and highway, and trade and construction area. Place of occurrence is defined as ICD-10-AM codes in the range Y92, using ‘Chapter 20 External causes of morbidity and mortality’.

Activity

The first reported activity being undertaken by the patient when the principal diagnosis is injury or poisoning. It identifies the activity of the injured person at the time the injury event occurred. Activity includes categories such as football, fishing, canoeing, dancing, school-related recreational activities, hang gliding, horse racing, and leisure activity.

Activity is defined as ICD-10-AM codes in the range U50-U73, using ‘Chapter 20 External causes of morbidity and mortality’.

Type of injury

Injuries are damage to the body from an external force. Type of injury includes fracture, dislocation, nerve injury, burn, poisoning and toxic effect, soft-tissue injury, open wound, intracranial injury, superficial injury, amputation, crushing injury, internal organs, blood vessels, foreign object (through orifice), other specified and/or multiple injuries, and other unspecified and not reported.

Type of injury is determined by the patient’s principal diagnosis. An injury diagnosis is defined as ICD-10-AM codes in the range S00–T75 or T79, using ‘Chapter 19 Injury, poisoning and certain other consequences of external causes’.

Body part injured

The body part or ‘site of injury’ is the location of injury on the patient’s body. Body parts injured include head and neck, shoulder and upper limb, trunk (thorax, abdomen, lower back, lumbar spine and pelvis), wrist and hand, hip and lower limb (excluding ankle and foot), ankle and foot, and other, multiple and incompletely specified body regions.

Site of injury is determined by the patient’s principal diagnosis. An injury diagnosis is defined as ICD-10-AM codes in the range S00–T75 or T79, using ‘Chapter 19 Injury, poisoning and certain other consequences of external causes’.