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Report on Government Services 2020

PART E, SECTION 12: RELEASED ON 31 JANUARY 2020

12 Public hospitals

This section 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 $67.2 billion in 2017-18, with the Australian, State and Territory governments funding 91 per cent (non-government sources funded the remaining 9 per cent).

Nationally, in 2017-18, government expenditure on public hospitals was equivalent to $2706 per person, an increase on 2016-17 ($2673) in real terms.

In 2017-18, there were 693 public hospitals in Australia – 2 fewer than 2016-17. Although 68.3 per cent of hospitals had 50 or fewer beds, these smaller hospitals represented only 13.1 per cent of total available beds.

There were approximately 6.7 million separations from public (non-psychiatric) hospitals in 2017-18. Nationally, this is equivalent to 253.9 separations per 1000 people. Acute care separations accounted for the majority of separations from public hospitals (94.0 per cent).

A total of 37.7 million individual service events were provided to non-admitted patients in public hospitals in 2017-18.

There were 8.0 million presentations to emergency departments in 2017-18.

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 coordinated 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 this 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 section and data 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, 2018-19 (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 79 75 72 78 60 72 74 67 75
Urgent 74 66 61 48 46 56 32 54 63
Semi-urgent 79 72 75 64 65 64 47 65 73
Non-urgent 93 89 93 91 89 85 83 92 91
Total 78 71 69 63 58 64 46 64 71
Source: Data table 12A.13

Length of stay for emergency department care, proportion of patients staying for four hours or less, 2018‑19

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
% 71.7 67.5 70.2 74.9 59.4 62.0 59.5 66.8 69.6
Source: Data table 12A.18

Waiting times for admitted patient services

Overall elective surgery waiting times, 2018-19 (days waited)

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
50th percentile 56 28 41 40 41 57 48 29 41
90th percentile 330 146 282 220 277 343 322 229 279
Source: Data table 12A.19

Elective surgery waiting times by clinical urgency category, 2018-19 (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, 2018-19 (per cent)

Most recent data for this measure are not comparable but are complete, subject to caveats
Triage category NSWVicQldWASATasACTNTAust
Resuscitation 47 55 54 66 54 52 50 42 53
Emergency 42 52 55 57 45 33 42 36 49
Urgent 38 50 52 47 35 25 31 34 44
Semi-urgent 44 52 55 50 43 26 35 37 48
Non-urgent 64 65 66 59 61 39 43 46 62
Total 41 51 53 51 40 27 35 35 47
Source: Data 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, 2018-19

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Additions (no.) 263 338 230 043 177 414 103 472 70 112 22 157 16 355 10 140 893 031
Removals (no.) 229 851 198 517 142 358 88 673 58 835 17 858 14 017 8 027 758 136
Turn over (%) 87.3 86.3 80.2 85.7 83.9 80.6 85.7 79.2 84.9
Source: Data table 12A.33

Effectiveness — Quality — Safety indicators

Adverse events in public hospitals

Selected healthcare-associated infections in public hospitals, 2018-19 (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 0.8 0.6 0.8 0.8 0.5 0.7
Source: Data table 12A.35

Adverse events treated in hospitals, 2017-18 (per 100 separations)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 7.1 5.6 6.3 7.3 7.4 8.3 6.6 3.7 6.5
Source: Data table 12A.36

Falls resulting in patient harm in public hospitals, 2017-18 (per 1000 separations)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
Rate 6.3 3.5 4.2 6.5 5.4 7.5 1.7 4.6 4.9
Source: Data table 12A.37

Sentinel events

Adverse events occurring due to hospital system and process deficiencies that result in the death of, or serious harm to, a patient, 2017-18

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 2018-19:

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 86.5 ± 2.6 87.5 ± 2.7 86.3 ± 2.3 89.1 ± 3.7 87.4 ± 2.4 82.5 ± 2.1 88.6 ± 3.9 85.0 ± 10.2 86.9 ± 1.6
Nurses 92.4 ± 3.2 91.5 ± 2.3 94.1 ± 3.2 91.6 ± 3.1 91.7 ± 1.4 90.0 ± 2.4 88.3 ± 5.1 91.9 ± 6.8 92.1 ± 1.6
ED doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 90.1 ± 1.3 90.4 ± 0.4 89.4 ± 2.0 88.8 ± 3.0 89.2 ± 3.4 86.1 ± 2.2 85.5 ± 4.7 87.6 ± 8.6 89.4 ± 1.3
Nurses 93.1 ± 2.5 92.6 ± 1.2 95.6 ± 2.1 91.9 ± 2.3 92.0 ± 2.0 91.9 ± 2.5 88.7 ± 6.4 93.2 ± 6.9 93.2 ± 1.5
ED doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 84.4 ± 2.8 83.4 ± 3.3 85.1 ± 3.1 85.2 ± 4.4 83.3 ± 3.2 77.4 ± 4.0 79.7 ± 6.1 87.8 ± 9.4 84.0 ± 1.9
Nurses 89.7 ± 3.1 85.8 ± 1.7 91.8 ± 2.8 90.3 ± 3.1 88.5 ± 2.4 84.7 ± 3.7 83.6 ± 6.7 89.6 ± 7.6 89.0 ± 1.5
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 90.4 ± 3.0 93.7 ± 3.5 93.9 ± 2.5 91.0 ± 5.1 90.2 ± 4.4 90.9 ± 1.1 91.3 ± 6.4 89.2 ± 5.3 91.9 ± 2.0
Nurses 90.5 ± 1.9 94.7 ± 2.2 94.6 ± 2.6 93.5 ± 2.5 94.2 ± 2.1 94.5 ± 1.6 86.2 ± 9.5 87.1 ± 6.3 93.0 ± 1.1
Hospital doctors, specialists or nurses always or often showed respect to them
Doctors/ specialists 91.2 ± 2.9 93.6 ± 2.9 93.9 ± 3.0 90.9 ± 4.3 93.1 ± 4.3 90.6 ± 1.2 89.2 ± 7.1 87.4 ± 5.9 92.4 ± 1.9
Nurses 92.1 ± 1.8 95.4 ± 1.9 95.3 ± 2.9 94.3 ± 0.9 94.5 ± 2.9 95.0 ± 1.3 89.1 ± 6.2 90.1 ± 5.0 93.9 ± 1.2
Hospital doctors, specialists or nurses always or often spent enough time with them
Doctors/ specialists 87.5 ± 2.2 88.6 ± 3.3 91.5 ± 2.4 87.9 ± 4.7 88.8 ± 4.8 88.1 ± 3.2 85.1 ± 6.3 88.8 ± 6.3 88.7 ± 1.9
Nurses 88.3 ± 2.3 91.5 ± 2.7 93.5 ± 2.2 91.7 ± 2.7 91.7 ± 4.1 91.7 ± 2.8 85.0 ± 8.8 88.0 ± 5.8 91.0 ± 1.8
Source: Data 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, 2017-18 (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 21.3 26.6 32.8 22.8 29.1 54.8 6.9 25.9
Hip replacement 18.4 21.0 29.8 22.5 16.9 18.9 3.9 35.7 20.9
Tonsillectomy and adenoidectomy 36.0 28.1 60.0 63.3 39.1 56.7 28.6 83.7 39.1
Hysterectomy 27.8 22.0 32.6 36.7 43.2 31.1 49.2 98.4 29.2
Prostatectomy 34.6 24.5 51.8 29.3 31.5 39.1 48.6 88.9 35.0
Cataract surgery 3.2 2.4 5.4 2.4 3.1 3.1 0.9 5.9 3.1
Appendicectomy 20.4 16.6 21.7 23.8 25.2 22.4 34.4 41.1 20.7
Source: Data table 12A.51

Effectiveness — Sustainability indicators

Workforce sustainability

Nursing workforce by age group, 2018 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 years 17.8 19.8 17.6 16.8 14.5 15.8 17.5 17.4 17.9
30–39 years 23.1 23.5 22.0 22.1 20.9 17.7 27.5 26.6 22.7
40–49 years 22.4 22.5 24.8 24.3 23.6 21.4 24.4 21.0 23.2
50–59 years 23.5 22.9 25.0 25.1 28.2 31.2 21.3 22.5 24.3
60+ years 13.2 11.3 10.7 11.6 12.8 13.9 9.3 12.6 11.9
Source: Data table 12A.54

Medical practitioner workforce by age group, 2018 (per cent)

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
<30 years 11.1 12.1 11.7 10.8 11.2 10.8 10.6 13.0 11.4
30–39 years 28.0 30.0 29.2 29.8 28.0 25.3 28.0 35.7 29.0
40–49 years 23.6 23.7 26.0 26.0 24.4 25.0 26.8 24.0 24.6
50–59 years 19.8 19.0 20.0 19.6 20.9 22.5 20.3 14.9 19.7
60+ years 17.5 15.3 13.1 13.8 15.6 16.3 14.4 12.4 15.4
Source: Data table 12A.56

Efficiency indicators

Cost per admitted patient separation

Recurrent cost per weighted separation, 2017-18

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 4 537 4 518 4 574 5 504 5 365 5 042 5 056 5 962 4 726
Source: Data table 12A.57

Capital cost per weighted separation, 2017-18

Most recent data for this measure are not comparable but are complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 979 984 1 218 1 223 1 492 719 1 191 1 046 1 089
Source: Data table 12A.58

Recurrent cost per non-admitted patient

Average cost per non-admitted acute emergency department presentation, 2017-18

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 552 468 548 628 617 380 516 517 541
Source: Data table 12A.59

Average cost per non-admitted service event, 2017-18

Most recent data for this measure are comparable and complete, subject to caveats
 NSWVicQldWASATasACTNTAust
$ 248 310 327 323 451 280 270 504 304
Source: Data table 12A.61

Notes

These data and caveats for these data are available in section 12 and relevant data tables.

# 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 section are available in the data tables listed below. Contextual data and further supporting information can be found in the section.

Public hospitals data disaggregated for Aboriginal and Torres Strait Islander people
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
Table 12A.52 Unplanned hospital readmission rates, by Indigenous status, hospital peer group, remoteness and SEIFA IRSD quintiles