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Report on Government Services 2019

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

Expenditure on public hospitals (excluding depreciation) was around $63.8 billion in 2016-17, with the Australian, State and Territory governments funding 91.6 per cent (non-government sources funded the remaining 8.4 per cent).

Nationally, in 2016-17, government expenditure on public hospitals was equivalent to $2606 per person, similar to 2015-16 ($2603) in real terms.

In 2016-17, there were 695 public hospitals in Australia – 3 fewer than 2015-16. Although 68.1 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 13.4 per cent of total available beds.

There were approximately 6.6 million separations from public (non-psychiatric) hospitals in 2016-17. Nationally, this is equivalent to 254.2 separations per 1000 people. Acute care separations accounted for the majority of separations from public hospitals.

A total of 35.5 million individual service events were provided to non-admitted patients in public hospitals in 2016-17.

There were 7.8 million presentations to emergency departments in 2016-17.

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 2019 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, 2017-18 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 100 100 100 100 100 100 100 100 100
Emergency 81 76 72 81 63 71 77 63 76
Urgent 76 68 59 50 48 56 37 49 64
Semi-urgent 80 72 73 65 66 66 48 56 73
Non-urgent 94 89 93 92 89 89 81 87 92
Total 80 72 68 64 60 66 49 57 72
Source: Attachment table 12A.13

Length of stay for emergency department care, proportion of patients staying for four hours or less, 2017‑18

Most recent data for this measure are not comparable but are complete, subject to caveats
NSWVicQldWASATasACTNTAust
% 73.5 69.2 72.1 75.7 60.8 64.4 64.0 62.7 71.1
Source: Attachment table 12A.18

Waiting times for admitted patient services

Overall elective surgery waiting times, 2017-18 (days waited)

Most recent data for this measure are not comparable but are complete, subject to caveats
NSWVicQldWASATasACTNTAust
50th percentile 55 29 40 39 42 42 54 23 40
90th percentile 327 150 279 199 262 238 344 160 268
Source: Attachment table 12A.19

Elective surgery waiting times by clinical urgency category, 2017-18 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats.

Data are available in tables 12A.24-31.

Presentations to emergency departments with a length of stay of 4 hours or less ending in admission, public hospitals, 2017-18 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 49 57 55 68 56 50 61 45 55
Emergency 43 53 56 60 45 33 50 32 50
Urgent 41 51 54 50 36 25 36 30 46
Semi-urgent 46 55 57 53 44 28 40 31 50
Non-urgent 66 67 68 60 60 43 46 44 64
Total 43 53 55 54 41 28 40 31 49
Source: Attachment table 12A.32

Elective surgery waiting list turn over

The number of people removed from elective surgery waiting lists, divided by the number of people added to public hospital elective surgery waiting lists, multiplied by 100, 2016-17

Most recent data for this measure are not comparable but are complete, subject to caveats
NSWVicQldWASATasACTNTAust
Additions (no.) 251 641 222 271 176 812 101 428 67 550 21 180 15 571 9 910 866 363
Removals (no.) 222 893 196 086 143 447 86 747 58 655 19 187 12 826 8 250 748 091
Turn over (%) 88.6 88.2 81.1 85.5 86.8 90.6 82.4 83.2 86.3
Source: Attachment table 12A.33

Effectiveness — Quality — Safety indicators

Adverse events in public hospitals

Selected healthcare-associated infections in acute care hospitals, 2017-18 (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 0.6 0.8 0.8 0.9 0.8 0.4 0.7
Source: Attachment table 12A.35

Adverse events treated in hospitals, 2016-17 (per 100 separations)

Most recent data for this measure are comparable and complete, subject to caveats
NSWVicQldWASATasACTNTAust
Rate 7.0 6.1 6.5 7.3 7.6 8.3 7.0 3.6 6.6
Source: Attachment table 12A.36

Falls resulting in patient harm in public hospitals, 2016-17 (per 1000 separations)

Most recent data for this measure are comparable and complete, subject to caveats
NSWVicQldWASATasACTNTAust
Rate 6.2 3.8 4.2 5.4 5.9 7.6 4.5 1.7 4.9
Source: Attachment table 12A.37

Sentinel events

Adverse events occurring due to hospital system and process deficiencies that result in death of, or serious harm to, a patient, 2016-17

Most recent data for this measure are not comparable but are complete, subject to caveats .

Data are available in tables 12A.38–46.

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 2017-18:

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 84.7 86.1 89.4 86.4 85.9 86.6 81.1 84.6 86.3
Nurses 88.5 92.2 91.9 89.4 90.6 92.0 89.5 92.1 90.4
ED doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 87.4 87.9 90.3 87.8 89.4 88.7 88.3 85.8 88.6
Nurses 88.7 91.8 93.6 90.5 91.8 92.3 92.6 92.1 91.0
ED doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 82.5 83.2 86.1 80.5 84.1 82.8 77.5 78.5 83.5
Nurses 86.8 87.7 88.8 88.4 87.6 89.7 88.4 93.0 87.8
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 90.7 92.2 91.8 90.0 91.3 90.3 90.5 86.5 91.2
Nurses 91.4 91.6 91.6 91.7 93.1 94.5 89.9 94.1 92.1
Hospital doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 93.0 92.5 91.7 92.0 93.2 90.2 89.4 86.5 92.5
Nurses 92.7 93.2 92.8 91.7 96.1 94.1 94.5 93.5 92.9
Hospital doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 88.2 87.8 88.4 85.7 91.5 86.8 77.1 84.3 88.0
Nurses 89.5 89.4 90.0 90.6 90.4 92.3 85.5 95.1 90.1
Source: Attachment tables 12A.47–50

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, 2016-17 (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 20.5 19.4 32.6 19.6 24.3 44.9 3.6 45.5 23.2
Hip replacement 16.1 16.9 27.3 16.8 13.6 39.9 4.0 33.3 18.6
Tonsillectomy and adenoidectomy 35.8 28.1 58.9 57.2 42.7 56.6 31.7 104.7 39.8
Hysterectomy 27.9 29.1 45.7 30.8 27.5 46.0 25.4 57.1 33.1
Prostatectomy 24.8 17.0 31.6 23.9 14.0 11.2 30.0 93.8 22.5
Cataract surgery 2.7 2.4 5.7 1.7 3.7 4.3 2.9 5.1 3.1
Appendicectomy 24.4 19.6 23.5 27.9 24.0 29.9 23.3 50.4 23.3
Source: Attachment table 12A.51

Effectiveness — Sustainability indicators

Workforce sustainability

Nursing workforce by age group, 2017 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
NSWVicQldWASATasACTNTAust
<30 years 16.4 18.6 17.2 16.4 14.3 14.3 17.2 18.0 17.0
30–39 years 22.8 23.8 22.2 23.2 21.5 18.1 27.1 27.4 22.9
40–49 years 22.4 22.7 24.8 24.0 23.7 22.1 23.9 20.2 23.2
50–59 years 24.3 23.1 24.7 24.6 27.9 31.1 21.3 22.7 24.5
60+ years 14.0 11.8 11.1 11.8 12.5 14.4 10.4 11.7 12.4
Source: Attachment table 12A.54

Medical practitioner workforce by age group, 2017 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
NSWVicQldWASATasACTNTAust
<30 years 9.1 10.5 9.6 10.1 9.5 9.6 8.3 10.9 9.7
30–39 years 26.2 28.5 28.6 30.0 27.2 23.2 27.7 37.0 27.8
40–49 years 24.4 23.4 25.9 25.9 24.5 25.6 25.3 23.5 24.6
50–59 years 20.4 20.2 20.8 19.5 21.0 23.0 22.5 16.4 20.4
60+ years 20.0 17.4 15.1 14.6 17.8 18.6 16.2 12.2 17.4
Source: Attachment table 12A.56

Efficiency indicators

Cost per admitted patient separation

Recurrent cost per weighted separation, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 4 870 4 613 4 941 6 280 5 420 5 138 5 598 6 321 5 020
Source: Attachment table 12A.57

Capital cost per weighted separation, 2016-17

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 971 944 1 042 1 081 704 685 1 045 1 032 966
Source: Attachment table 12A.58

Recurrent cost per non-admitted patient

Average cost per non-admitted acute emergency department presentation, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 538 429 507 619 526 469 540 557 515
Source: Attachment table 12A.59

Average cost per non-admitted service event, 2016-17

Most recent data for this measure are comparable and complete, subject to caveats
NSWVicQldWASATasACTNTAust
$ 216 341 324 350 401 297 281 496 297
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.37 Separations for falls resulting in patient harm in hospitals, per 1000 separations, 2016-17
Table 12A.52 Unplanned hospital readmission rates, by Indigenous status, hospital peer group, remoteness and SEIFA IRSD quintiles, 2016-17