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Report on Government Services 2017

Volume E, Chapter 12

Public hospitals

This chapter reports on the performance of governments in providing public hospitals, with a focus on acute care services.

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  • Key Facts
  • Indicator Framework
  • Indicator Results
  • Indigenous Data

Total recurrent expenditure on public hospitals (excluding depreciation) was $55.0 billion in 2014-15. In 2014-15, government real recurrent expenditure on public hospitals was $2321 per person for Australia, up from $1851 in 2010-11.

Funding for public hospitals comes from a number of sources. The Australian, State and Territory governments contributed 90.8 per cent of funding for public hospital services in 2014‑15, with non-government sources contributing 9.2 per cent.

In 2014-15, Australia had 698 public hospitals. Although 68.9 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 14.3 per cent of total available beds.

There were approximately 6.0 million separations from public (non-psychiatric) hospitals in 2014-15. Nationally, this translates into 239.8 separations per 1000 people. Acute separations accounted for the majority of separations from public hospitals.

A total of 33.8 million individual service events were provided to non-admitted patients in public hospitals in 2014-15. There were 7.4 million presentations to emergency departments in 2014-15.

Public hospitals aim to alleviate or manage illness and the effects of injury and rehabilitate where necessary by providing universal access to acute, non and sub-acute care along with emergency, outpatient and community care that is:

  • timely, affordable and accessible
  • appropriate and responsive to the needs of individuals and communities
  • high quality and safe
  • well co-ordinated to ensure continuity of care where more than one service type, and/or ongoing service provision is required
  • sustainable in terms of workforce, infrastructure, innovation and capacity to respond to emerging needs.

Governments aim for public hospital services to meet these objectives in an equitable and efficient manner.

The performance indicator framework provides information on equity, efficiency and effectiveness, and distinguishes the outputs and outcomes of public hospitals. The performance indicator framework shows which data are complete and comparable in the 2017 Report.

Indicator framework

An overview of the Public hospitals performance indicator results are presented. Information to assist the interpretation of these data can be found in the indicator interpretation boxes in the Public hospitals chapter and attachment tables.

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Effectiveness — Access indicators

Emergency department waiting times

Emergency department waiting times by triage category — proportion of patients seen on time, 2015-16 (%)

Most recent data for this measure are neither comparable or complete
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 100 100 100 100 100 100 na 100 100
Emergency 82 78 74 77 70 80 na 63 77
Urgent 76 71 61 53 56 59 na 53 67
Semi-urgent 80 72 74 67 70 64 na 60 74
Non-urgent 94 89 94 93 92 87 na 89 93
Total 81 74 70 65 66 66 na 61 74
Source: Attachment table 12A.13

Length of stay for emergency department care, proportion of patients staying for four hours or less, 2015‑16

Most recent data for this measure are neither comparable or complete
 NSWVicQldWASATasACTNTAust
% 74.8 71.2 75.2 76.0 66.0 66.3 na 63.6 73.2
Source: Attachment table 12A.18

Waiting times for admitted patient services

Overall elective surgery waiting times, 2015-16 (days waited)

Most recent data for this measure are neither comparable or complete
 NSWVicQldWASATasACTNTAust
50th percentile 55 30 29 30 40 72 na 29 37
90th percentile 328 174 163 161 233 452 na 229 260
Source: Attachment table 12A.19

Presentations to emergency departments with a length of stay of 4 hours or less ending in admission, public hospitals (per cent), 2015-16

Most recent data for this measure are neither comparable or complete
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 52 57 59 66 59 58 na 46 57
Emergency 45 53 56 58 45 34 na 28 50
Urgent 41 51 55 48 40 24 na 25 47
Semi-urgent 46 55 58 50 47 28 na 28 50
Non-urgent 66 65 65 60 67 48 na 36 64
Total 44 53 56 51 44 28 na 27 49
Source: Attachment table 12A.32

Effectiveness — Quality — Safety indicators

Accreditation

Proportion of accredited public hospitals, 30 June 2015

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 98 91 95 94 90 61 100 100 93
Source: Attachment table 12A.33

Adverse events in public hospitals

Selected healthcare-associated infections in acute care hospitals, per 10 000 patient days, 2015-16

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
rate 0.7 0.7 0.7 0.9 0.7 0.9 0.8 0.6 0.7
Source: Attachment table 12A.34

Adverse events treated in hospitals, per 100 separations, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 6.8 6.6 6.4 7.1 7.5 8.0 7.3 3.5 6.7
Source: Attachment table 12A.35

Falls resulting in patient harm in public hospitals, per 1000 separations, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 5.6 3.6 3.7 5.0 5.0 6.9 4.5 1.8 4.5
Source: Attachment table 12A.36

Sentinel events

Adverse events occurring due to hospital system and process deficiencies that result in death of, or serious harm to, a patient, 2014-15

Most recent data for this measure are not comparable but are complete, subject to caveats. Data are available in tables 12A.37–45.

Effectiveness — Quality — Responsiveness indicators

Patient satisfaction

Proportion (%) of persons who went to an emergency department in the last 12 months reporting that:

ED doctors, specialists or nurses always or often listened carefully to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 86.2 86.7 87.5 90.0 84.5 84.4 81.5 90.9 87.0
Nurses 87.8 91.2 91.9 91.2 87.3 91.8 #88.4 88.9 90.3

ED doctors, specialists or nurses always or often showed respect to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 88.6 88.6 88.9 88.7 86.4 85.7 81.8 92.0 88.3
Nurses 89.5 92.2 93.6 91.4 87.1 91.8 #86.8 88.9 91.5

ED doctors, specialists or nurses always or often spent enough time with them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 81.6 83.9 86.2 86.7 80.6 83.7 74.8 90.3 83.6
Nurses 84.5 87.4 90.2 90.4 82.6 89.2 #79.0 89.1 87.1
Proportion (%) of persons who were admitted to hospital in the last 12 months reporting that:

Hospital doctors, specialists or nurses always or often listened carefully to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 92.3 93.0 92.8 93.2 90.1 89.9 #85.1 #91.9 92.2
Nurses 90.7 92.1 93.5 94.3 88.7 90.7 85.5 88.9 92.0

Hospital doctors, specialists or nurses always or often showed respect to them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 91.3 92.9 93.2 94.1 92.3 90.6 87.5 93.9 92.5
Nurses 90.3 94.2 93.6 94.3 90.9 93.3 86.7 88.8 92.6

Hospital doctors, specialists or nurses always or often spent enough time with them, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Doctors/specialists 88.3 90.0 90.8 89.3 86.7 84.6 81.0 #87.5 88.9
Nurses 89.7 90.3 92.2 91.0 86.8 89.6 85.7 89.4 90.2

Source: Attachment tables 12A.46–49

Effectiveness — Quality — Continuity indicators

Selected unplanned hospital readmission rates

Rate at which patients unexpectedly return to hospital within 28 days for further treatment of the same condition (per 1000 separations), 2014-15

Most recent data for this measure are not comparable but are complete, subject to caveats
Surgical procedure prior to separation NSWVicQldWASATasACTNTAust
Knee replacement 19.4 19.4 36.3 28.1 18.6 18.3 7.0 np 22.7
Hip replacement 16.9 16.1 23.5 16.7 7.1 21.6 8.5 np 17.1
Tonsillectomy and adenoidectomy 31.7 26.0 49.5 41.3 53.9 34.9 31.3 105.0 35.7
Hysterectomy 28.6 28.4 40.9 38.6 25.5 27.5 78.3 np 31.6
Prostatectomy 23.0 23.4 33.0 12.6 13.0 np np 24.3
Cataract surgery 2.5 2.9 5.1 3.1 2.5 4.1 0.9 10.1 3.1
Appendicectomy 20.5 19.8 23.9 35.1 26.7 36.5 14.3 37.7 22.0

Source: Attachment table 12A.50

Efficiency — Sustainability indicators

Workforce sustainability

Nursing workforce by age group (per cent), 2015

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 15.8 18.1 16.0 16.9 14.6 13.6 16.7 18.1 16.5
30–39 20.7 21.7 21.0 21.2 19.8 16.6 23.7 27.1 21.0
40–49 23.2 24.1 26.0 24.9 24.7 24.0 25.0 21.9 24.3
50–59 27.2 24.9 26.3 25.9 29.4 33.2 24.2 22.7 26.5
60+ 13.1 11.2 10.8 11.1 11.4 12.6 10.4 10.3 11.6
Source: Attachment table 12A.53

Medical practitioner workforce by age group (per cent), 2015

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 9.1 10.5 9.6 10.1 9.5 9.6 8.2 10.9 9.7
30–39 26.2 28.5 28.7 30.0 27.2 23.2 27.7 36.9 27.8
40–49 24.4 23.4 25.9 25.8 24.4 25.5 25.3 23.6 24.6
50–59 20.4 20.2 20.8 19.5 21.0 23.1 22.5 16.3 20.4
60+ 20.0 17.4 15.0 14.5 17.8 18.6 16.3 12.4 17.4
Source: Attachment table 12A.55

Efficiency indicators

Cost per admitted patient separation

Recurrent cost per weighted separation, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 4 943 4 442 4 897 6 124 5 708 5 165 6 637 6 734 5 025
Source: Attachment table 12A.56

Capital cost per weighted separation, 2014-15

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 901 867 548 1 120 763 765 1 075 608 818

Source: Attachment table 12A.57

Recurrent cost per non-admitted patient

Average cost per non-admitted acute emergency department presentation, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 377 392 531 577 500 398 578 497 449
Source: Attachment table 12A.60

Average cost per non-admitted service event, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 205 273 340 315 364 243 242 445 272

Source: Attachment table 12A.61

Notes

These data and caveats for these data are available in chapter 12 and attachment 12A.

# Proportion has a margin of error >10 percentage points which should be considered when using this information.

na Not available. – Nil or rounded to zero. np Not published.

Indigenous public hospitals data
Table number Table title
Table 12A.15 Patients treated within national benchmarks for emergency department waiting time, by Indigenous status, by State and Territory
Table 12A.20 Waiting times for elective surgery in public hospitals, by Indigenous status and procedure, by State and Territory (days)
Table 12A.36 Separations for falls resulting in patient harm in hospitals, per 1000 separations, 2014-15
Table 12A.51 Unplanned hospital readmission rates, by Indigenous status, hospital peer group, remoteness and SEIFA IRSD quintiles, 2014-15