Skip to Content

Report on Government Services 2016

Chapter 11, Volume E

Public hospitals

The Public hospitals chapter (chapter 11) reports on the performance of governments in providing public hospitals, with a focus on acute care services. It also reports separately on a significant component of the services provided by public hospitals - maternity services.

Download the chapter

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

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

Public hospitals

Total recurrent expenditure on public hospitals (excluding depreciation) was $44.4 billion in 2013-14. In 2013-14, government real recurrent expenditure on public hospitals was $1905 per person for Australia, up from $1692 in 2009-10 (in 2013-14 dollars).

Funding for public hospitals comes from a number of sources. The Australian, State and Territory governments contributed 91.0 per cent of funding for public hospital services in 2013 14, with non-government sources contributing 9.0 per cent.

Non-government sources include health insurance funds, individuals, workers' compensation and compulsory third-party motor vehicle insurers.

In 2013-14, Australia had 747 public hospitals. Although 72 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 15 per cent of total available beds.

There were approximately 5.7 million separations from public (non-psychiatric) hospitals in 2013-14. Nationally, this translates into 234.0 separations per 1000 people. Acute separations accounted for 95.3 per cent of separations from public hospitals. Of the total number of separations in public (non-psychiatric) hospitals, 51.4 per cent were for same day patients.

A total of 46.5 million individual occasions of service were provided to non-admitted patients in public acute hospitals in 2013-14.

Public hospitals services aim to provide acute and specialist services that are:

  • safe and of high quality
  • appropriate and responsive to individual needs
  • affordable, timely and accessible
  • equitably and efficiently delivered.

Maternity services

Maternity services accounted for 8.3 per cent of total acute separations in public hospitals and 10.6 per cent of the total cost of all acute separations in public hospitals in 2013-14.

In Australian public hospitals in 2013-14, vaginal deliveries accounted for a substantial proportion of the separations for pregnancy, childbirth and the puerperium (41.1 per cent). The cost of vaginal deliveries was $780.5 million in 2013-14.

Maternity services aim to provide acute and specialist services that are:

  • safe and of high quality
  • appropriate and responsive to individual needs
  • affordable, timely and accessible
  • equitably and efficiently delivered.

Public hospitals

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 2016 Report.

Public hospitals indicator framework

Maternity services

The performance indicator framework provides information on equity, efficiency and effectiveness, and distinguishes the outputs and outcomes of maternity services. The performance indicator framework shows which data are complete and comparable in the 2016 Report.

maternity services indicator framework

Public hospitals

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.

Expand allCollapse all

Effectiveness — Access indicators

Emergency department waiting times

Emergency department waiting times by triage category — proportion of patients seen on time (per cent), 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
Triage category NSW Vic Qld WA SA Tas ACT NT Aust
Resuscitation 100 100 99 100 100 100 100 100 100
Emergency 82 80 77 83 69 83 78 62 79
Urgent 76 73 64 57 57 64 48 54 68
Semi-urgent 81 73 74 69 69 67 53 59 74
Non-urgent 95 89 93 93 89 89 86 88 92
Total 81 75 71 68 66 70 59 60 74
Source: Attachment table 11A.14

Length of stay for emergency department care, proportion of patients staying for four hours or less, 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 74.9 69.9 76.7 78.7 63.8 66.6 63.1 62.1 73.2
Source: Attachment table 11A.19

Emergency department waiting time to commencement of clinical care (minutes), 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
50th percentile 15 19 20 25 20 25 37 31 18
90th percentile 78 97 93 99 113 107 147 130 93
Source: Attachment table 11A.20

Waiting times for admitted patient services

Overall elective surgery waiting times, 2014-15 (days waited)

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
50th percentile 54 29 27 29 37 55 45 32 35
90th percentile 330 177 147 148 210 424 245 217 253
Source: Attachment table 11A.21

Presentations to emergency departments with a length of stay of 4 hours or less ending in admission, public hospitals (per cent), 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
Triage category NSW Vic Qld WA SA Tas ACT NT Aust
Resuscitation 51 56 59 68 54 58 57 46 56
Emergency 43 49 56 60 37 35 46 24 48
Urgent 40 48 56 52 34 26 31 21 45
Semi-urgent 45 51 60 53 40 28 35 22 48
Non-urgent 65 64 66 63 58 45 42 29 63
Total 43 49 57 55 37 29 36 23 47
Source: Attachment table 11A.44

Length of stay of emergency department presentations ending in admission — Time waited at 50th percentile by triage category (hours:minutes), 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Resuscitation 3:59 3:45 3:37 3:04 3:36 3:24 3:27 4:28 3:45
Emergency 4:39 4:03 3:49 3:38 5:11 5:28 4:24 7:17 4:11
Urgent 4:58 4:14 3:52 3:58 5:31 6:24 5:51 7:22 4:26
Semi-urgent 4:32 3:59 3:44 3:56 4:52 6:12 5:22 6:54 4:11
Non-urgent 3:18 3:24 3:20 3:37 3:12 4:25 4:36 6:32 3:26
Total 4:43 4:05 3:50 3:53 5:12 6:05 5:21 7:08 4:16
Source: Attachment table 11A.45

Effectiveness — Appropriateness indicators

Separation rates for selected procedures

Separation rates for selected procedures in public hospitals, per 1000 people (age standardised), 2013-14

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Cataract extraction 8.3 8.7 9.6 10.6 8.0 10.4 7.4 9.1 8.9
Cholecystectomy 2.2 2.3 2.4 2.0 2.1 2.4 2.5 1.7 2.2
Coronary angioplasty 1.5 1.5 1.5 1.4 1.2 1.2 3.2 0.3 1.5
Coronary artery bypass graft 0.5 0.5 0.6 0.4 0.6 0.3 0.7 .. 0.5
Cystoscopy 3.9 6.1 5.5 7.8 6.0 4.8 5.8 3.1 5.4
Haemorrhoidectomy 2.7 1.8 1.5 1.2 1.5 1.9 1.0 1.9 1.9
Hip replacement 1.4 1.7 1.4 1.7 1.7 1.9 2.3 0.7 1.6
Hysterectomy 2.1 2.3 2.7 3.8 1.8 2.7 3.8 0.8 2.4
Inguinal herniorrhaphy 2.0 2.1 2.1 2.1 2.0 2.1 2.4 1.7 2.1
Knee replacement 1.9 1.7 2.0 2.2 2.1 1.6 2.4 0.8 1.9
Myringotomy 1.4 1.7 1.4 2.0 2.6 1.2 2.3 0.7 1.6
Prostatectomy 2.5 2.8 2.7 2.9 1.9 2.6 8.1 0.2 2.6
Septoplasty 1.2 1.3 0.9 1.0 1.4 0.5 1.2 0.5 1.1
Tonsillectomy 2.3 2.6 2.3 2.8 2.8 1.8 4.0 1.2 2.5
Varicose veins, stripping and ligation 0.6 0.7 0.5 0.6 0.6 0.4 1.0 0.5 0.6
Source: Attachment table 11A.46

Effectiveness — Quality — Safety 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), 2013-14

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
Surgical procedure prior to separation NSW Vic Qld WA SA Tas ACT NT Aust
Knee replacement 21.4 21.2 31.3 34.4 18.5 33.8 30.6 np 23.7
Hip replacement 18.1 16.3 19.3 24.8 20.9 14.9 18.4 17.8
Tonsillectomy and adenoidectomy 28.5 30.1 43.4 45.4 35.7 35.3 27.3 58.5 33.0
Hysterectomy 28.6 26.0 34.8 37.3 30.9 8.4 64.1 np 29.8
Prostatectomy 25.8 19.8 30.4 29.6 29.3 30.5 np np 25.5
Cataract surgery 2.7 3.7 4.3 2.1 1.7 2.1 9.3 3.1
Appendicectomy 18.3 20.3 19.7 32.9 25.7 19.1 30.2 34.9 20.3
Source: Attachment table 11A.47

Accreditation

Selected healthcare-associated infections in acute care hospitals, per 10 000 patient days, 2014-15

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 92.9 100.0 91.1 100.0 98.8 17.4 100.0 100.0 93.2
Source: Attachment table 11A.49

Adverse events in public hospitals

Selected healthcare-associated infections in acute care hospitals, per 10 000 patient days, 2014-15

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
rate 0.8 0.7 0.8 0.8 0.8 0.8 0.8 0.7 0.8
Source: Attachment table 11A.50

Adverse events treated in hospitals, per 100 separations, 2013-14

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Rate 6.4 7.0 6.4 7.0 7.3 8.4 7.3 3.7 6.7
Source: Attachment table 11A.51

Falls resulting in patient harm in public hospitals, per 1000 separations, 2013-14

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Rate 5.1 3.4 3.4 4.5 4.9 6.5 3.8 1.8 4.2
Source: Attachment table 11A.52

Efficiency sustainability indicators

Workforce sustainability

Nursing workforce by age group (per cent), 2014

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
<30 15.8 18.0 15.3 16.4 14.5 13.1 16.7 17.2 16.2
30-39 20.2 20.9 20.7 20.8 19.3 15.9 22.3 26.6 20.5
40-49 23.5 24.7 26.7 25.3 25.2 25.5 25.2 22.8 24.9
50-59 28.3 25.6 26.8 26.5 30.4 33.9 25.7 23.8 27.3
60+ 12.3 10.7 10.4 11.0 10.7 11.6 10.1 9.7 11.1
Source: Attachment table 11A.54

Medical practitioner workforce by age group (per cent), 2014

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
<30 9.1 10.6 9.8 10.4 9.8 9.7 9.8 10.6 9.8
30-39 26.2 28.5 28.5 29.2 27.6 24.5 26.8 37.3 27.8
40-49 24.3 23.4 25.8 25.7 24.5 25.8 24.4 22.2 24.5
50-59 20.8 20.6 20.9 19.5 20.5 22.5 23.1 16.8 20.7
60+ 19.5 16.9 15.0 15.2 17.6 17.5 15.8 13.1 17.2
Source: Attachment table 11A.56

Efficiency indicators

Cost per casemix adjusted separation

Recurrent cost per casemix-adjusted separation, 2013-14

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
$ 4788 4228 4783 5624 5402 4942 6664 6840 4836
Source: Attachment table 11A.57

Total cost per casemix-adjusted separation, 2013-14

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
$ 738 819 614 554 710 668 907 548 709
Source: Attachment table 11A.58

Relative stay index, 2013-14

Acute care patient days divided by expected number of acute care patient days, adjusted for casemix

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Total 1.03 0.92 0.86 0.97 1.05 0.99 1.08 1.14 0.97
Source: Attachment table 11A.59

Recurrent cost per non-admitted occasion of service, 2013-14

Most recent data for this measure are neither comparable nor complete (chapter 11) Data are available in attachment tables 11A.61-11A.65

Outcome indicators

Patient satisfaction, 2014-15

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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 86.9 83.7 83.9 88.8 84.4 87.4 86.8 85.5 85.2
Nurses 90.5 91.2 88.6 92.6 88.2 91.2 91.8 91.2 90.4

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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 90.1 86.1 86.6 89.5 86.4 88.1 89.3 88.2 87.7
Nurses 90.8 90.3 88.7 92.7 88.6 93.7 94.8 91.2 90.7

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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 85.0 80.9 81.2 83.7 80.4 82.5 82.0 87.1 82.4
Nurses 87.6 85.9 84.4 90.7 85.1 88.5 89.4 91.5 86.8
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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 92.0 88.8 88.8 88.9 89.1 88.8 88.1 94.3 89.9
Nurses 92.9 89.6 90.0 90.7 89.9 91.8 91.6 94.7 90.8

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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 92.5 90.7 90.2 90.5 91.1 90.1 88.5 90.5 91.0
Nurses 93.7 91.1 90.3 90.7 90.3 92.7 90.1 94.7 91.9

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

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Doctors / specialists 89.6 84.9 86.4 87.0 88.2 84.5 83.3 90.2 87.2
Nurses 90.0 88.6 87.7 85.9 86.4 90.3 88.4 93.1 88.6
Source: Attachment tables 11A.69-76

Sentinel events, 2012-13

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

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11) Data are available in tables 11A.77-11A.85

Maternity services

An overview of the Maternity services 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.

Expand allCollapse all

Effectiveness — Appropriateness indicators

Caesareans and inductions for selected primiparae

Proportion (%) of births for selected primiparae that were caesareans / inductions, public hospitals, 2014

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Caesareans 23.5 25.1 22.6 25.0 28.4 24.1 22.4 29.7 24.3
Inductions 40.4 38.6 31.1 37.6 41.0 50.1 30.4 41.7 37.9
Source: Attachment table 11A.90

Instrumental vaginal births

Proportion of births for women giving birth for the first time that were instrumental vaginal births, 2013

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 22.9 29.1 22.4 29.6 24.2 23.0 28.4 19.4 25.3
Source: Attachment table 11A.99

Vaginal birth after caesarean section, 2013

Proportion (%) of multiparous mothers who have had a previous caesarean, whose current method of birth was either an instrumental or non-instrumental vaginal birth, 2013

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Non-instrumental 12.5 10.2 12.8 9.7 12.7 13.2 14.1 19.1 11.8
Instrumental 3.7 4.1 2.7 3.6 3.5 3.1 5.5 3.4 3.6
Source: Attachment table 11A.100

Effectiveness — Quality — Safety indicators

Perineal status after vaginal birth

Proportion of women with third or fourth degree lacerations to the perineum following vaginal birth, 2013

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
% 2.0 1.9 2.2 1.6 2.3 1.8 4.4 2.0 2.0
Source: Attachment table 11A.101

Efficiency indicators

Recurrent cost per maternity separation

Recurrent cost per maternity separation without catastrophic or severe complications and comorbidities (dollars), public hospitals, 2013-14.

Most recent data for this measure are not comparable but are complete (subject to caveats) (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
$/Caesarean 8279 10 241 9874 8803 13 458 9921 15 932 11 425 9811
$/Vaginal delivery 5930 6512 6167 5315 8291 5655 12 703 6214 6423
Source: Attachment table 11A.102

Mother's average length of stay

Average length of stay for selected maternity AR-DGs, public hospitals (days), 2013-14

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
O01C Caesarean delivery 3.6 3.5 3.2 3.5 3.7 3.6 3.5 4.2 3.5
O60C Vaginal delivery 2.3 2.2 1.9 2.2 2.1 2.3 1.8 2.8 2.2
Source: Attachment table 11A.103

Outcome indicators

Baby's Apgar score at 5 minutes

Proportion of live births with an Apgar score of less than 4, at 5 minutes, by birthweight category, 2014

Most recent data for this indicator are neither comparable nor complete (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
<1500g 14.5 18.2 18.2 5.8 9.0 18.8 13.2 25.5 15.1
1500-1999g 0.8 0.7 1.4 0.3 2.1 1.7 0.9
2000-2499g 0.4 0.3 0.6 0.5 0.3 0.5 0.4 0.5 0.4
2500g+ 0.2 0.2 0.2 0.2 0.1 0.1 0.5 0.3 0.2
Source: Attachment table 11A.104

Perinatal death rate

Perineal death rate per 1000 total births, 2013

Most recent data for this measure are comparable and complete, subject to caveats (chapter 11)
  NSW Vic Qld WA SA Tas ACT NT Aust
Fetal deaths 5.6 6.0 5.9 5.9 3.8 7.2 5.2 9.5 5.7
Neonatal deaths 2.6 2.1 3.2 1.6 2.3 2.3 1.8 4.9 2.5
Perinatal deaths 8.1 8.2 9.1 7.5 6.1 9.5 7.0 14.4 8.2
Source: Attachment tables 11A.105-108

Legend

Nil or rounded to zero.

.. Not applicable.

np Not published.

Performance indicator data for Aboriginal and Torres Strait Islander people in this chapter are available in the attachment tables listed below. Contextual data and further supporting information can be found in the chapter.

Indigenous public hospitals data
Table number Table title
Table 11A.16 Patients treated within national benchmarks for emergency department waiting time, by Indigenous status, by State and Territory
Table 11A.23 Waiting times for elective surgery in public hospitals, by Indigenous status and procedure, by State and Territory (days)
Table 11A.48 Selected unplanned hospital readmission rates, by Indigenous status, hospital peer group, remoteness and SEIFA IRSD quintiles, 2013-14
Table 11A.52 Separations for falls resulting in patient harm in hospitals, per 1000 separations, 2013-14
Table 11A.109 Perinatal, neonatal and fetal deaths