Report on Government Services 2019

Part E, Chapter 12

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