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Report on Government Services 2018

Part 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 $61.4 billion in 2015-16, with the Australian, State and Territory governments funding 91.8 per cent (non-government sources funded the remaining 8.2 per cent).

In 2015-16, government real recurrent expenditure on public hospitals was $2551 per person for Australia, up from $2366 in 2014-15.

In 2015-16, Australia had 701 public hospitals – 3 more than 2014-15. Although 68.8 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 14.0 per cent of total available beds.

There were approximately 6.3 million separations from public (non-psychiatric) hospitals in 2015-16. Nationally, this translates into 246.9 separations per 1000 people. Acute separations accounted for the majority of separations from public hospitals.

A total of 32.3 million individual service events were provided to non-admitted patients in public hospitals in 2015-16.

There were 7.5 million presentations to emergency departments in 2015-16.

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

  • timely and accessible to all
  • appropriate and responsive to the needs of individuals throughout their lifespan 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.

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 2018 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, 2016-17 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 100 100 100 100 100 100 99 100 100
Emergency 81 77 72 80 67 75 77 66 77
Urgent 76 70 60 50 52 57 50 55 66
Semi-urgent 81 73 74 65 69 65 63 58 74
Non-urgent 94 89 94 92 92 89 91 88 92
Total 81 73 69 64 64 65 62 61 73
Source: Attachment table 12A.13

Length of stay for emergency department care, proportion of patients staying for four hours or less, 2016‑17

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 75.0 71.0 73.0 74.0 64.0 65.0 73.0 64.0 72.0
Source: Attachment table 12A.18

Waiting times for admitted patient services

Overall elective surgery waiting times, 2016-17 (days waited)

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
50th percentile 54 30 32 34 39 45 46 28 38
90th percentile 327 162 211 185 237 313 279 202 258
Source: Attachment table 12A.19

Presentations to emergency departments with a length of stay of 4 hours or less ending in admission, public hospitals, 2016-17 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 50 59 57 65 59 51 65 48 56
Emergency 44 55 55 56 44 31 57 33 50
Urgent 41 53 54 45 38 22 46 31 47
Semi-urgent 48 57 57 48 46 26 55 32 51
Non-urgent 67 68 67 58 70 41 61 33 64
Total 44 55 55 49 43 26 51 32 49
Source: Attachment table 12A.32

Effectiveness — Quality — Safety indicators

Adverse events in public hospitals

Selected healthcare-associated infections in acute care hospitals, 2016-17 (per 10 000 patient days)

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 0.7 0.8 0.8 0.7 0.8 0.9 0.9 1.0 0.8
Source: Attachment table 12A.34

Adverse events treated in hospitals, 2015-16 (per 100 separations)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 6.8 6.2 6.4 7.2 7.3 8.0 7.3 3.4 6.6
Source: Attachment table 12A.35

Falls resulting in patient harm in public hospitals, 2015-16 (per 1000 separations)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 5.8 3.4 3.9 5.0 5.4 6.7 5.0 1.7 4.6
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, 2015-16

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 (per cent) of persons who went to an emergency department in the last 12 months reporting that in 2016-17:

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
ED doctors, specialists or nurses always or often listened carefully to them
Doctors/ specialists 84.0 88.5 87.1 86.9 86.7 87.8 83.4 93.8 86.3
Nurses 90.1 91.4 90.1 92.8 88.8 90.7 89.1 93.8 90.5
ED doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 86.4 90.1 87.8 91.1 89.3 86.8 #89.2 95.4 88.6
Nurses 90.8 93.3 91.5 93.7 89.4 93.7 88.7 97.4 91.8
ED doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 82.3 85.0 83.1 87.1 84.4 86.0 #84.0 93.8 83.9
Nurses 85.9 91.2 89.6 92.1 84.9 87.9 #86.5 91.8 88.6
Proportion (per cent) of persons who were admitted to hospital in the last 12 months reporting that:
Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Hospital doctors, specialists or nurses always or often listened carefully to them
Doctors/ specialists 90.6 90.2 92.6 92.5 90.5 91.7 #92.2 87.6 91.3
Nurses 93.2 92.6 94.2 96.4 90.0 91.8 87.8 92.5 93.6
Hospital doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 92.8 92.5 94.0 92.8 92.6 92.2 91.0 87.6 93.1
Nurses 94.1 93.1 95.3 96.8 91.2 94.4 89.6 92.5 94.2
Hospital doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 88.8 86.9 89.9 90.5 90.3 87.6 90.7 88.2 88.7
Nurses 91.6 89.0 93.5 94.2 88.8 90.1 86.3 93.8 91.4
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, 2015-16 (per 1000 separations)

Most recent data for this measure are not comparable but are complete, subject to caveats
Surgical procedure prior to separation NSWVicQldWASATasACTNTAust
Knee replacement 19.5 19.3 31.4 23.3 27.5 36.4 9.4 55.6 23.1
Hip replacement 17.3 19.1 20.0 21.9 20.9 39.0 23.8 19.2
Tonsillectomy and adenoidectomy 27.1 23.9 56.7 53.7 52.3 46.0 30.6 85.7 34.7
Hysterectomy 38.3 25.9 35.0 42.9 33.6 36.3 48.8 51.5 33.4
Prostatectomy 23.6 20.7 42.3 40.4 29.2 10.5 27.8 37.0 26.5
Cataract surgery 2.7 2.8 4.6 1.6 2.6 8.8 2.0 6.6 3.2
Appendicectomy 18.8 19.3 20.2 32.5 34.1 35.0 12.2 43.3 20.9
Source: Attachment table 12A.50

Effectiveness — Sustainability indicators

Workforce sustainability

Nursing workforce by age group, 2016 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 years 16.0 18.4 16.7 16.7 14.6 13.9 17.2 18.1 16.7
30–39 years 21.7 22.6 21.4 22.2 20.5 17.6 24.7 26.8 21.8
40–49 years 22.8 23.4 25.5 24.6 24.3 22.9 24.8 21.1 23.9
50–59 years 25.9 24.1 25.5 25.1 28.7 32.1 22.9 22.8 25.5
60+ years 13.6 11.5 10.9 11.4 12.0 13.5 10.4 11.2 12.0
Source: Attachment table 12A.53

Medical practitioner workforce by age group, 2016 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 years 9.5 10.7 10.4 9.8 9.4 9.6 8.6 9.5 10.0
30–39 years 26.2 28.5 28.8 30.4 27.0 24.3 26.9 38.0 27.9
40–49 years 24.2 23.8 25.6 25.6 24.3 24.7 25.3 23.2 24.6
50–59 years 19.8 19.6 20.2 19.4 21.2 22.4 21.9 16.0 19.9
60+ years 20.2 17.5 14.9 14.8 18.1 19.0 17.3 13.3 17.6
Source: Attachment table 12A.55

Efficiency indicators

Cost per admitted patient separation

Recurrent cost per weighted separation, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 5 060 4 707 5 086 6 355 5 737 5 157 6 347 6 698 5 199
Source: Attachment table 12A.56

Capital cost per weighted separation, 2015-16

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 947 1 041 742 1 036 860 723 1 018 1 105 927
Source: Attachment table 12A.57

Recurrent cost per non-admitted patient

Average cost per non-admitted acute emergency department presentation, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 533 408 539 619 529 416 578 513 515
Source: Attachment table 12A.60

Average cost per non-admitted service event, 2015-16

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 223 332 348 353 415 324 280 627 303
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.

– Nil or rounded to zero. 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.

Aboriginal and Torres Strait Islander 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, 2015-16
Table 12A.51 Unplanned hospital readmission rates, by Indigenous status, hospital peer group, remoteness and SEIFA IRSD quintiles, 2015-16