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