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	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
%	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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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

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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
<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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
<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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$	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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$	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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$	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
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Aust
$	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