Understanding how the activity of hospitals is changing over time should be done through several perspectives. One key measure of activity is the number of hospitalisations. A hospitalisation can vary in length from a single day to months, hence another useful measure of activity is patient days. Patient days is the total number of days of care provided to patients. Beyond these measures of ‘output’, it is also important to understand the types of care being provided.
This section presents information on:
- the number of hospitalisations and how long patients stay in hospital
- the type of care provided.
This section also provides more detailed information on hospital care related to:
- diagnosis
- injury
- surgery and other services provided.
The main measure of admitted patient activity is the number of hospitalisations, or episodes of admitted patient care. As episodes can vary in length from ‘same-day’ to many days or weeks, another useful measure of activity is patient days. Patient days are the total number of days of care provided to patients – a measure of activity that accounts for variations in the length of stay.
Explore the data
In the visualisations below, you can explore information on hospitalisations, patient days and patient day rates for admitted patients between 2017–18 and 2021–22.
Hospitalisations and patient days
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
Hospital sector
These line graphs show the number of hospitalisations per 1,000 population, between 2017–18 and 2021–22. Data is presented by same day/overnight and hospital sector. National, state and territory data is available. In 2021–22, there were 253 same-day hospitalisations per 1,000 population and 153 overnight hospitalisations per 1,000 population.
Time series
This bar graph shows the number of hospitalisations between 2017–18 and 2021–22. Numbers and rates are presented by hospital sector and measure (average length of stay, overnight separations, patient days, same day separations and separations). National, state and territory data is available. In 2021–22, the average length of stay was 2.74 days compared with 2.70 days in 2017–18.
States and territories
This bar graph shows the number of hospitalisations per 1,000 population between 2017–18 and 2021–22. Data is presented by hospital sector. National, state and territory data is available. In 2021–22, the number of hospitalisations was 405 per 1,000 population compared with 419 hospitalisations in 2017–18.
Highlights
Hospitalisations
There were 11.6 million hospitalisations in 2021–22.
In 2021–22:
- hospitalisations decreased by 2.1% compared with 2020–21 – from 11.8 million to 11.6 million
- public acute hospitalisations decreased by 1.9% (7 million to 6.8 million)
- the smallest decrease was for private free-standing day hospitals (1.2%, 1.09 million to 1.07 million)
- overnight hospitalisations decreased by 2.2% (4.4 million to 4.3 million) and same-day hospitalisations decreased by 2.0% (7.4 million to 7.3 million).
Changes over time
Before the COVID-19 pandemic, nationally, from 2014–15 to 2018–19, hospital admissions increased by 3.3%, on average, each year and hospital admissions per 1,000 population increased by 1.1%, on average each year. However, due to the restrictions and measures put in place to manage and prevent COVID-19, hospitalisations in 2019–20 decreased by 2.8% and hospitalisations per 1,000 population decreased by 4.8%. Since then, admitted patient activity has failed to return to pre-COVID trend levels, with many states and territories experiencing outbreaks as well as workforce shortages that have impacted on system capacity and activity.
Patient days
There were 31.8 million days of patient care provided in 2021–22.
In 2021–22:
- public hospitals accounted for 68% of patient days of care (21.7 million)
- Private hospitals accounted for 32% of patient days (10.0 million).
Compared with 2020–21, in 2021–22:
- the number of patient days increased by 2.0% – from 31.2 million to 31.8 million patient days
- patient days increased by 4.0% in public hospitals and decreased by 2.3% in private hospitals
- patient days per 1,000 population increased from 1,077 to 1,088.
Over the five years to 2021–22:
- the number of patient days increased by 1.3%, on average, each year – from 30.2 million to 31.8 million patient days
- patient days increased, on average, each year by 1.9% in public hospitals and 0.2% in private hospitals
- patient days per 1,000 population decreased on average, each year by 0.5% - from 1,111 to 1,088 – consistent with longer term trends.
What other information is available?
More information about these data can be found in tables 2.1–2.7 in Admitted patient care 2021–22: How much activity was there?
Definitions of the terms used in this section are available in the Glossary.
Patient days
Patient days refers to the total number of days of patient care provided to admitted patients and excludes leave days.
Rates per 1,000 population
The population rates for patient day presented in this report (patient days per 1,000 population) are age standardised to eliminate the effect of differences in population age structures over periods of time or across geographic areas (for example, for states and territories).
In 2021–22, 671 public hospitals in Australia provided admitted patient care services.
Hospitals are grouped by the type of service provided. In 2021–22:
- 31 Principal referral hospitals accounted for the highest proportion of public hospital hospitalisations (38%, 2.6 million hospitalisations) and public hospital patient days (38%, 8.2 million patient days)
- 63 Public acute group A hospitals accounted for a further 34% of hospitalisations and 32% of patient days
- 109 Very small hospitals accounted for less than 0.5% of both hospitalisations and patient days, with an average length of stay of 11.3 days which was much longer than the average length of stay in Principal referral hospitals (3.2 days)
- 36 Subacute and non-acute hospitals accounted for 0.9% of hospitalisations and 3.5% of patient days, with an average length of stay of 12.9 days.
Public hospitals providing admitted patient care
The numbers of public and private hospitals in Australia can vary over time, reflecting the opening or closing of hospitals, the reclassification of hospitals as non‑hospital facilities (or vice-versa) and the amalgamation of existing hospitals.
The number of hospitals reported can be affected by jurisdictional variations in administrative and/or reporting arrangements and is not necessarily a measure of the number of physical hospital buildings or campuses.
This section presents information on the number of public hospitals reporting activity to the National Hospitals Morbidity Database (NHMD) 2021–22. The hospitals providing admitted patient care services is a smaller group of hospitals compared to the total number of public hospitals in Australia, published in the National Public Hospital Establishments Database.
Public hospitals peer groups
Hospital type (peer group) is a classification of public hospitals into groups of similar hospitals by the types of services provided.
Various types of public hospitals provide care to admitted patients including:
- Principal referral hospitals
- Public acute group A hospitals
- Very small hospitals, and
- Subacute and non-acute hospitals.
Data on public hospitals providing admitted patient care in Australia comes from the Admitted patient care 2021–22 publication, Table 2.12.
More information, Appendixes and caveat information, and data tables are available in the Info & downloads section.
Definitions of the terms used in this section are available in the Glossary.
Various types of care are provided to admitted patients. The care type describes the overall nature of a clinical service provided to an admitted patient during an episode of care. This is not the same as the diagnosis or condition that a person might attend hospital for. A single type of care can be used to manage many different conditions. Care type can be classified as:
- Acute care
- Newborn care
- Subacute and non-acute care—Rehabilitation care, Palliative care, Geriatric evaluation and management, Maintenance care and Psychogeriatric care
- Mental health care.
Explore the data
In the data visualisation below you can explore the number of hospitalisations by care type for public and private hospitals between 2017–18 and 2021–22, and by hospital, between 2012–13 to 2021–22.
Type of care
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
Hospital sector
This column graph shows the number of hospitalisations by care type and private/public between 2017–18 and 2021–22. National data is presented by public/private and care type (acute, geriatric evaluation and management, maintenance care, mental health care, newborn care, palliative care, psychogeriatric care and rehabilitation care). In 2021–22, there were 6,422,078 Acute care separations in public hospitals and 4,193,089 Acute care separations in private hospitals.
Hospitals and LHNs
This table explores on the number of hospital admissions between 2011–12 and 2021–22. Data is presented by measure (number of admissions and care type). Hospital-level data is available.
Highlights
In 2021–22, for the public and private sectors combined:
- 92% of hospitalisations were classified as episodes of Acute care
- 3.3% were classified as episodes of as Rehabilitation care
- 3.0% were classified as episodes of as Mental health care
- 0.5% were classified as episodes of as Newborn care (this only refers to situations where the newborn requires specific care – not all births.).
The proportions of hospitalisations for each care type varied by hospital sector. Public hospitals accounted for 60% of hospitalisations for Acute care, while private hospitals accounted for 81% of hospitalisations for Rehabilitation care.
Changes over time
Over the last five years, from 2017–18 to 2021–22, there has been an annual average increase for hospitalisations with Acute care by 0.7% in public hospitals and 1.8% in private hospitals.
Acute care
In 2021–22:
- around 9 in 10 hospitalisations in public (94%) and private hospitals (88%) were for Acute care
- the most common principal diagnosis reported for overnight acute hospitalisations was Single spontaneous delivery (3.1% of hospitalisations)
- almost 1 in 4 (24%) of same-day acute hospitalisations had a principal diagnosis of Care involving dialysis.
Changes over time
- Compared with 2020–21, in 2021–22, the number of hospitalisations with Acute care decreased by 2.1% for public hospitals and by 1.5% for private hospitals.
- Over the last five years, from 2017–18 to 2021–22, there has been an annual average increase for hospitalisations with Acute care by 0.7% in public hospitals and 1.8% in private hospitals.
Newborn care
Newborns receiving care may have both ‘qualified’ (where the baby requires specialised care) and ‘unqualified’ days (where routine care is provided as part of the care for the mother). Refer to ‘More information about the data’ section below for definitions on qualified and unqualified care.
In 2021–22:
- there were 81,800 hospitalisations for newborn care with at least one qualified day—the majority of these (85%) occurred in public hospitals
- 1 in 4 hospitalisations for newborn care had a principal diagnosis of Disorders related to short gestation and low birth weight, not elsewhere classified (24% of hospitalisations for qualified newborns) followed by Respiratory distress of newborn (13% of hospitalisations for qualified newborns)
- almost all (95%) hospitalisations for newborn care were Discharged home and less than 0.24% Died.
Changes over time
Compared with 2020–21, in 2021–22:
- hospitalisations for qualified newborns decreased by 0.7% in public hospitals and increased in private hospitals by 6.7%
- for unqualified newborns, hospitalisations decreased by 1.3% in public hospitals and increased by 5.9% in private hospitals.
Compared with 2017–18, in 2021–22:
- hospitalisations for qualified newborns increased by an annual average of 2.7% (from 62,400 to 69,400) in public hospitals and increased in private hospitals by 1.7% (11,600 to 12,400)
- for unqualified newborns, hospitalisations decreased by an annual average of 0.5% in public hospitals and increased by 3.8% in private hospitals. Victoria had the largest annual average increase over this period at 39.1% in private hospitals (from 2,000 hospitalisations to 7,600 hospitalisations).
Subacute and non-acute care
In 2021–22:
- less than 1 in 20 hospitalisations (4.7%) were for Subacute and non-acute care
- over the previous year, from 2020–21 to 2021–22, the number of hospitalisations for Subacute and non-acute care increased by 7.7% in public hospitals and decreased by 10% in private hospitals
- over the last five years, from 2017–18 to 2021–22, there has been an annual average increase of 1.6% for Subacute and non-acute care hospitalisations in public hospitals and an annual average decrease of 5.1% in private hospitals.
Rehabilitation care
In 2021–22:
- there were around 382,000 Rehabilitation care hospitalisations, with 4 in 5 (81%) occurring in private hospitals
- New South Wales and Queensland combined accounted for 4 in 5 (79%) Rehabilitation care hospitalisations – 56% in New South Wales and 23% in Queensland.
Changes over time
- Over the previous year, from 2020–21 to 2021–22, the number of Rehabilitation care hospitalisations decreased by 10.1% in public hospitals and 11.4% in private hospitals.
- Over the last five years, from 2017–18 to 2021–22, there has been an annual average decrease of 6.0% for Rehabilitation care hospitalisations in public hospitals and an annual average decrease of 4.6% in private hospitals.
Palliative care
In 2021–22:
- nearly 9 in 10 (86%) of the 51,300 Palliative care hospitalisations occurred in public hospitals
- 1 in 2 (49%) hospitalisations for Palliative care had a neoplasm-related (cancer-related) principal diagnosis, with Malignant neoplasm of bronchus and lung accounting for 8% of Palliative care hospitalisations.
Mental health care
In 2021–22:
- over 3 in 5 (62%) of the 353,000 Mental health care hospitalisations occurred in private hospitals
- females (as identified in the data) accounted for 60% of all Mental health care hospitalisations.
Changes over time
Over the previous year, from 2020–21 to 2021–22, the number of Mental health care hospitalisations in private hospitals decreased by 6.0% (from 232,000 to 218,000). However, over the last five years, from 2017–18 to 2021–22, there has been an annual average increase of 2.9%.
What other information is available?
More information on these data are available in the Admitted patient care 2021–22: What services were provided? data tables.
Definitions of the terms used in this section are available in the Glossary.
Acute care
An episode of Acute care for an admitted patient is one in which the principal clinical intent is to do one or more of the following:
- manage labour (obstetric)
- cure illness or provide definitive treatment of injury
- perform surgery
- relieve symptoms of illness or injury (excluding palliative care)
- reduce severity of illness or injury
- protect against exacerbation and/or complication of an illness and/or injury which could threaten life or normal functions
- perform diagnostic or therapeutic procedures
Rehabilitation care
Rehabilitation care is care in which the primary clinical purpose or treatment goal is improvement in the functioning of a patient with an impairment, activity limitation, or participation restriction due to a health condition.
Rehabilitation care is always:
- delivered under the management of or informed by a clinician with specialised expertise in rehabilitation
- evidenced by an individualised multidisciplinary management plan, which is documented in the patient’s medical record, which includes negotiated goals within specified time frames and formal assessment of functional ability.
Palliative care
Palliative care is defined as care in which the primary clinical purpose or treatment goal is optimisation of the quality of life of a patient with an active and advanced life-limiting illness. The patient will have complex physical, psychosocial and/or spiritual needs.
Palliative care is always:
- delivered under the management of or informed by a clinician with specialised expertise in palliative care
- evidenced by an individualised multidisciplinary assessment and management plan, which is documented in the patient's medical record that covers the physical, psychological, emotional, social and spiritual needs of the patient and negotiated goals.
Mental health care
Mental health care is defined in this publication as care in which the primary clinical purpose or treatment goal is improvement in the symptoms and/or psychosocial, environmental, and physical functioning related to a patient’s mental disorder.
Mental health care:
- is delivered under the management of, or regularly informed by, a clinician with specialised expertise in mental health
- is evidenced by an individualised formal mental health assessment and the implementation of a documented mental health plan
- may include significant psychosocial components, including family and carer support.
Mental health care differs from mental health-related care reported in AIHW Mental health services reports. A hospitalisation is classified as mental health-related if:
- it had a mental health-related principal diagnosis, which, for admitted patient care in this report, is defined as a principal diagnosis that is either:
- a diagnosis that falls within the section on Mental and behavioural disorders (Chapter 5) in the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD‑10‑AM) (codes F00–F99), or
- a number of other selected diagnoses (see the technical information for a full list of applicable diagnoses), and/or
- it included any specialised psychiatric care.
For 2021–22, mental health care refers to hospitalisations for which the care type was reported as Mental health. The care type Mental health was introduced from 1 July 2015. Prior to this, mental health admitted patient activity was assigned to one of the other care types.
‘Qualified’ newborn
A day is considered ‘qualified’ for health insurance benefits purposes when a newborn meet at least 1 of the following criteria:
- the newborn is the second or subsequent live born infant of a multiple birth, whose mother is currently an admitted patient
- the newborn is admitted to an intensive care facility in a hospital, being a facility approved by the Commonwealth Minister for the purpose of the provision of special care
- the newborn is admitted to or remains in hospital without its mother.
A newborn admission to hospital can occur at any time within the first 9 days of life, including at the time of birth.
‘Unqualified’ newborn
The reporting of unqualified newborns has changed over time and varies across jurisdictions. Prior to 2017–18, newborn episodes involving unqualified care were routinely excluded from national reporting on the basis that they did not meet admission criteria for all purposes. However, due to changes in Newborn care practices (such as, care being provided to unqualified newborns on the ward rather than in a special care nursery) stakeholders have expressed interest in the reporting of all newborn episodes, regardless of qualification status.
The principal diagnosis is the diagnosis established after study (for example, at the completion of the episode of care) to be chiefly responsible for causing the episode of admitted patient care. It is essentially the main reason someone needed to be admitted to hospital.
This section presents information on the numbers of hospitalisations by ICD-10-AM chapters, and the 20 most common detailed principal diagnoses (at the 3-character level) for public and private hospitals for 2021–22.
Highlights
- In 2021–22, over 1 in 4 (25%, 2.9 million) hospitalisations had a principal diagnosis of Factors influencing health status and contact with health services – which includes Care involving dialysis (around 1.7 million separations), radiotherapy or chemotherapy.
- Principal diagnoses tend to differ in terms of the proportion that are admitted to public versus private hospitals. For example, 85% of hospitalisations for Certain conditions originating in the perinatal period and 87% of hospitalisations for Certain infectious and parasitic diseases were provided in public hospitals. While in private hospitals, Diseases of the eye and adnexa, and Diseases of the musculoskeletal system and connective tissue, were 75% and 71% of hospitalisations respectively.
- 1 in 2 (47%) hospitalisations for Indigenous Australians had a principal diagnosis of Factors influencing health status and contact with health services (for more information relating to hospitalisations for Indigenous Australians see the Aboriginal and Torres Strait Islander Health Performance Framework).
Most common principal diagnoses
Same-day acute hospitalisations
In 2021–22:
- nearly 1 in 4 (24%, 1.7 million) same-day acute hospitalisations in both public and private hospitals were for Care involving dialysis and over 1 in 3 (35%) same-day acute hospitalisations in public hospitals were for this diagnosis
- same-day acute hospitalisations for Pain in throat and chest (93%) and Care involving dialysis (79%) were most likely to be provided by public hospitals
- same-day acute hospitalisations for Procreative management (96%), Embedded and impacted teeth (95%), Other retinal disorders (87%), and Benign neoplasm of colon, rectum, anus and anal canal (79%) were the most likely to be provided in private hospitals.
Overnight acute hospitalisations
In 2021–22:
- over 2 in 3 overnight acute hospitalisations were provided in public hospitals (2.7 million or 71%)
- the most common principal diagnosis reported for overnight acute hospitalisations was Single spontaneous delivery, which accounted for 3.6% of overnight acute separations in public hospitals and 1.9% in private hospitals
- public hospitals provided a majority of overnight acute hospitalisations for Viral infection of unspecified site (98%), Viral pneumonia, not elsewhere classified (96%) and Other chronic obstructive pulmonary disease (90%)
- private hospitals provided a majority of overnight acute hospitalisations for Gonarthrosis (arthrosis of the knee, 76%), Coxarthrosis (arthrosis of hip, 74%) and Sleep disorders (68%).
Changes over time
Over the last five years, from 2017–18 to 2021–22:
- Overnight acute hospitalisations with the principal diagnosis Sleep disorders decreased by 27,000, from 76,000 cases in 2017–18 down to 49,000 cases in 2021–22.
- Overnight acute hospitalisations with the principal diagnosis Other chronic obstructive pulmonary disease decreased by 19,000, from 64,000 cases in 2017–18 down to 45,000 cases in 2021–22.
What other information is available?
More information on these data are available in tables 4.6–4.11 in the Admitted patient care 2021–22: Why did people receive care? data tables.
Definitions of the terms used in this section are available in the Glossary.
Principal diagnosis
The principal diagnosis is the diagnosis established after study (for example, at the completion of the episode of care) to be chiefly responsible for causing the episode of admitted patient care. In some cases, the principal diagnosis is described in terms of a treatment for an ongoing condition (for example, Care involving dialysis). Diagnoses are recorded using the relevant version of the International statistical classification of diseases and related health problems, Australian modification (ICD-10-AM).
Data on hospitalisations involving a COVID-19 diagnosis are presented in the following visualisation and summarised in the sections below. It is presented by the demographic characteristics of patients, the types of comorbid chronic diseases that were treated as part of their in-hospital care, and the severity of illness patients experienced.
Hospitalisations with a COVID-19 diagnosis
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
Severity
This bar graph shows the number of COVID-19 separations involving ICU in 2021–22. Data is presented by age group, co-morbidity, Indigenous status, remoteness and socioeconomic status, sex and severity. In 2021–22, the age group with the highest number of COVID-19 hospitalisations was 25-34 years at 33,094 hospitalisations.
Age group and sex
This bar graph shows the number of COVID-19 separations by sex and age group in 2021–22. In 2021–22, the age group with the highest number of COVID-19 hospitalisations was females aged 25 to 34 years at 22,900 hospitalisations.
Average length of stay
This bar graph shows the average length of stay in days for hospitalisations involving a COVID-19 diagnosis in 2021–22. Data is also presented by average total hours in ICU and average total hours involving CVS. In 2021–22, the average length of stay in days for hospitalisations involving a COVID-19 diagnosis was 7 days.
In 2021–22, there were 263,400 hospitalisations involving a COVID-19 diagnosis and the average length of stay for these patients was 7 days.
Who received hospital care for a COVID-19 diagnosis?
In 2021–22:
- Almost 1 in 4 (23%) hospitalisations were for people 65 to 84 years of age and 7.5% were for people 85 years and above.
- Over 1 in 4 (26%) hospitalisations were for patients between 0 and 24 years of age.
Where did patients with a COVID-19 diagnosis live?
There were more hospitalisations involving a COVID-19 diagnosis for patients who lived in cities and in areas classified as being the most disadvantaged.
In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:
- Almost 9 in 10 hospitalisations (88%, or 232,600 hospitalisations) were for people living in Major cities and Inner regional areas combined.
- Less than 4% of hospitalisations were for patients who usually lived in Remote or Very Remote areas.
- Over 1 in 4 (27%) hospitalisations involving a COVID-19 diagnosis were for patients living in the lowest socioeconomic areas.
- 14% of hospitalisations were for patients living in the highest socioeconomic areas.
- 7.9% of hospitalisations involving a COVID-19 diagnosis were for people of Aboriginal and Torres Strait Islander origin.
Intensive care for hospitalisations involving COVID-19 diagnosis
Hospitalisations in which the person spent time in an Intensive care unit (ICU) and/or received continuous ventilatory support (CVS) are an indication that the patient required a higher level of acute care. During these hospitalisations, patients had at least one hour of ICU or CVS recorded, or a combination of both.
In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:
- 3.0% of hospitalisations involved a stay in ICU, during which patients received a median of 86 hours in ICU care.
- 1.3% involved CVS
- 2.0% of patients died in hospital.
Hospitalisations involving a COVID-19 diagnosis with a comorbid chronic condition
Patients who receive care during their hospitalisation may receive treatment for one or multiple conditions. Patients hospitalised with a COVID-19 diagnosis may have received care for another chronic condition, which is recorded as a primary diagnosis or an additional diagnosis. For this analysis, these diagnoses are referred to as ‘comorbid chronic conditions’.
In 2021–22, of the 263,000 hospitalisations involving a COVID-19 diagnosis:
- Over 7 in 10 (72%) hospitalisations recorded no comorbid chronic condition.
- Around 1 in 5 (19%) hospitalisations recorded one comorbid chronic condition.
- 9.3% of hospitalisations recorded two or more chronic comorbid conditions.
In 2021–22, hospitalisations involving a COVID-19 diagnosis for patients recorded with one or more comorbid chronic conditions were more likely to receive acute care in ICU and/or CVS.
Of the 24,600 hospitalisations with two or more recorded comorbid chronic conditions:
- 13% of hospitalisations involved time spent in ICU
- 5.9% involved CVS
- 11% died in hospital.
In comparison, hospitalisations involving no comorbid chronic conditions were less likely to involve time spent in ICU and/or CVS. Of the 189,000 hospitalisations with no recorded comorbid chronic conditions:
- 1.0% of hospitalisations involved time spent in ICU
- 0.3% involved CVS
- 0.4% died in hospital.
Patients who received treatment in ICU and/or CVS with a recorded comorbid condition
The most common comorbid conditions associated with COVID-19 hospitalisations were type 2 diabetes (12%; 31,600) and cardiovascular disease (11.6%; 30,500).
Of the 31,600 hospitalisations with a recorded comorbid diagnosis of type 2 diabetes:
- 7.6% of hospitalisations involved time spent in ICU
- 3.2% involved CVS
- 5.9% died in hospital.
Of the 30,500 hospitalisations with a recorded comorbid diagnosis of cardiovascular disease:
- 15% of hospitalisations involved time spent in ICU
- 7.7% involved CVS
- 9.6% died in hospital.
What other information is available on COVID‑19?
More information on these data are available in Admitted patient care 2021–22 hospitalisations with a COVID-19 diagnosis
To explore the influence of the COVID‑19 on other health data, further releases are available on the AIHW website under COVID‑19 resources.
Information on the total confirmed cases and active cases can be found on the Australian Government Department of Health website.
What other information is available on admitted patient care?
Data are also available on emergency department presentations by hospital or LHN in My local area.
Appendixes and caveat information for this data is available to download in the Info and downloads section.
Definitions of the terms used in this section are available in the Glossary.
Hospitalisations with a COVID-19 diagnosis
To accurately capture data about hospitalisations with a COVID-19 diagnosis, the states and territories utilised ICD-10-AM diagnoses to identify confirmed, suspected, and ruled-out COVID-19 under the advice of the Independent Hospital Pricing Authority (IHPA).
- Emergency use of U07.1 [COVID-19, virus identified] is assigned when COVID 19 has been confirmed by laboratory testing.
- Emergency use of U07.2 [COVID-19, virus not identified] is assigned when COVID-19 has been clinically diagnosed, but laboratory testing is inconclusive, not available or unspecified.
- Emergency use code U06.0 Emergency use of U06.0 [COVID-19, ruled out] is assigned when laboratory testing for COVID-19 produces a negative test result.
Hospitalisations that began on any day, from 1 July 2021 to 30 June 2022, were included in the analysis. Therefore, the data does not capture hospitalisations involving a COVID-19 diagnosis that were separated after 30 June.
Severity of illness is measured by a patient’s length of stay, whether hours in intensive care were recorded and how long patients received care in intensive care units (ICU) and/or continuous ventilatory support (CVS).
Comorbid conditions recorded in hospitalisations with a COVID-19 diagnosis
Selected comorbidity diagnoses were included in the analysis where a chronic condition was recorded in any diagnostic field, including primary diagnosis. These chronic conditions impacted on the patient’s care during their hospital stay, while other existing chronic conditions (which did not impact on their care) are not included in the analysis.
The selected comorbidity chronic conditions were chosen based on the available Australian Government advice on health factors that may impact upon a person’s risk of contracting the COVID-19 virus (Australian Government 2021). The following chronic conditions could be included in the analysis based on the available data:
- Neoplasm
- Immunocompromised
- Asthma
- Obesity
- Stroke
- Chronic liver disease
- Dementia
- Diabetes (type 1 and 2)
- Chronic kidney disease
- Chronic obstructive pulmonary disease (COPD)
- Cardiovascular disease
References
Australian Government 2021. Coronavirus (COVID-19) advice for people with chronic health conditions. Australian Department of Health. Viewed on 9 April 2021
This section presents information on the number of hospitalisations with the principal diagnosis Injury, poisoning and certain other consequences of external causes for public and private hospitals in 2021–22.
Highlights
In 2021–22:
- about 1 in 15 (6.8%, 783,000) hospitalisations had a principal diagnosis of Injury, poisoning and certain other consequences of external causes – the majority (77%) were treated in public hospitals
- almost half (47%, or 369,000 hospitalisations) of all injury hospitalisations had a principal diagnosis of Injuries to upper and lower limbs, and 17% (132,000 hospitalisations) had a principal diagnosis of Complications of medical and surgical care
- 2 in 5 injury hospitalisations were for Falls (39%, 302,000 hospitalisations)
- the rate of hospitalisation due to injury for Indigenous Australians was 53 per 1,000 population and the rate for other Australians was 27 per 1,000 population. For more information relating to hospitalisations for Indigenous population, see the Aboriginal and Torres Strait Islander Health Performance Framework website.
Changes over time
Compared to 2020–21, in 2021–22, hospitalisations due to Injury were lower by 59,000 – 841,000 in 2020–21 and 783,000 in 2021–22. However, the number in 2021–22 is the same as they were in 2017–18 (782,000).
What other information is available?
More information on these data are available in tables 4.6–4.13 in the Admitted patient care 2021–22: Why did people receive care? data tables.
More data on injury can be found on the Injury topic page.
Definitions of the terms used in this section are available in the Glossary.
Information on the Aboriginal and Torres Strait Islander Health Performance Framework can be found on the Aboriginal and Torres Strait Islander Health Performance Framework website.
External cause
An external cause is defined as the environmental event, circumstance or condition that was the cause of injury, poisoning or adverse event. Whenever a patient has a principal or additional diagnosis of an injury or poisoning, an external cause code should be recorded. External causes may also be required for other selected diagnoses. More than one external cause code may be reported for a separation, and the external causes presented may not relate to the principal diagnosis.
Injury and poisoning
Some hospitalisations for injury or poisoning may be considered potentially avoidable. It should be noted that the admitted patient care data provide only a partial picture of the overall burden of injury because the data do not include injuries that do not require admission to hospital: for example, that were not medically treated, were treated by general practitioners or were treated in emergency departments (without being admitted).
Surgery and other interventions
Interventions include surgical procedures, non-surgical investigative procedures, and therapeutic interventions. They require specialised training and/or require special facilities or services available only in an acute care setting. Types of interventions include:
- surgical procedures – operating room procedures
- non-surgical investigative and therapeutic procedures – such as X-rays, diagnostic testing, and dialysis
- patient support interventions that are neither investigative nor therapeutic – such as general anaesthesia, physiotherapy, and other allied health interventions
- physiological assessments undertaken by doctors, nurses, and allied health professionals
- manufacture and fitting of devices, aids, or equipment
- psychological therapies and skills training.
Impact of COVID-19 on elective surgery activity from 2019–20 to 2021–22
The COVID-19 pandemic has had a profound impact on hospital activity involving surgery. In 2019–20, a range of restrictions on elective surgery were introduced.
Under these restrictions, Category 1 and exceptional Category 2 elective surgery procedures continued unrestricted but the conduct of other procedures was limited nationally. These national restrictions were eased in 2020–21, however, states and territories and individual hospitals continued to closely manage elective surgery volumes; increasing activity where possible but also restricting it when COVID-19 outbreaks occurred.
This active management of elective surgery alongside the pandemic has resulted in considerable fluctuation in the activity conducted from year to year.
From 2019–20 to 2020–21:
- elective admissions involving surgery increased by 12.6% – higher for private hospitals (14.1%) compared with public hospitals (9.6%)
- emergency admissions involving surgery increased by 5.7% – higher for private hospitals (11.9%) compared with public hospitals (4.7%).
From 2020–21 to 2021–22:
- elective admissions involving surgery decreased by 6.6% – higher for public hospitals (14.1%) compared with private hospitals (3.0%)
- emergency admissions involving surgery decreased by 3.7% – higher for private hospitals (5.0%) compared with public hospitals (3.5%).
How many interventions were provided to admitted patients?
In 2021–22:
- 24.8 million interventions were reported, with 12.7 million performed in public hospitals and 12.0 million in private hospitals
- 77% of hospitalisations in public hospitals and nearly all (96%) hospitalisations in private hospitals involved at least one intervention
- public hospitals accounted for nearly 4 out of 5 Obstetric procedures (including childbirth) (79%) and Procedures on respiratory system (78%)
- 75% of Radiation oncology procedures were performed in public hospitals
- private hospitals accounted for over 4 out of 5 Dental services procedures (83%) provided and Procedures on nervous system (80%).
From 2020–21 to 2021–22, the number of interventions fell by 4.3%, from 25.9 million interventions in 2020–21 to 24.8 million interventions in 2021–22. This decrease was higher for public hospital interventions, which fell by 4.7%, from 13.4 million interventions in 2020–21 to 12.7 million in 2021–22.
How many interventions were provided to patients receiving same-day acute care?
In 2021–22:
- 11.5 million interventions were reported for patients in same-day acute care hospitalisations
- Cerebral anaesthesia (general anaesthesia and sedation, 2.6 million procedures), Haemodialysis (1.7 million) and Administration of pharmacotherapy (mostly chemotherapy, 1.1 million) accounted for almost half (46%) of all procedures.
From 2020–21 to 2021–22, the number of interventions reported for same-day acute separations decreased by 2.7%, from 11.8 million down to 11.5 million separations.
How many interventions were provided to patients receiving overnight acute care?
In 2021–22:
- 11.0 million interventions were reported for patients receiving overnight acute care hospitalisations
- around 3 in 4 (73%) of these hospitalisations in public hospitals involved at least one intervention, and in private hospitals, it was 9 in 10 (90%) hospitalisations
- 43% of interventions in public hospitals (3.1 million) were Generalised allied health interventions (for example, physiotherapy and other rehabilitation procedures).
From 2020–21 to 2021–22:
- the number of interventions reported for overnight acute separations decreased by 5.1% from 11.6 million down to 11.0 million separations
- Arthroplasty of knee decreased by 12.6% from 61,000 down to 53,000 overnight acute separations
- Non-invasive ventilatory support increased by 13.2% from 96,000 to 108,000 overnight acute separations.
How many surgical procedures were provided?
This section presents information on hospitalisations involving a surgical procedure undertaken in an operating theatre. In 2021–22:
- 2.8 million hospitalisations (or 24% of all hospitalisations) involved surgery, with 3 in 5 (61%) of these occurring in private hospitals
- hospitalisations involving surgery accounted for 16% of all hospitalisations in public hospitals and 36% of all hospitalisations in private hospitals
- there were 2.3 million elective admissions involving surgery and 70% of these occurred in private hospitals
- for public hospitals 62% of surgical hospitalisations were elective admissions, 29% were emergency admissions, and 9% did not have an urgency status assigned
- for private hospitals, 94% of surgical hospitalisations were elective admissions, 3% were emergency admissions, and 3% did not have an urgency status assigned.
From 2020–21 to 2021–22, hospitalisations involving surgery decreased by 200,000 (or 5.8%), from 3 million to 2.8 million.
Emergency hospitalisations involving surgery
- there were 373,000 emergency hospitalisations involving surgery (where hospitalisation was required within 24 hours). 86% of these occurred in public hospitals
- the most common principal diagnosis associated with these hospitalisations was Acute appendicitis and Fracture of femur
- Other debridement of skin and subcutaneous tissue was the most common surgical intervention (at the procedure block level) for emergency admissions involving surgery, and most (91%) of these were performed in public hospitals.
From 2020–21 to 2021–22, emergency hospitalisations involving surgery decreased by 15,000 (or 3.7%), from 388,000 down to 373,000.
Elective hospitalisations involving surgery
In 2021–22:
- there were 2.3 million elective hospitalisations involving surgery (where surgery did not need to be performed within 24 hours), with 7 in 10 of these occurring in private hospitals
- Other cataract surgery was the most common surgical intervention (at the procedure block level) for elective hospitalisations involving surgery with over 76% of these performed in private hospitals.
From 2020–21 to 2021–22, elective hospitalisations involving surgery decreased by 160,000 (or 6.6%), from 2,420,000 down to 2,260,000.
What other information is available?
More information on these data are available in tables 6.1–6.4, 6.12–6.13, 6.21–6.22 in the Admitted patient care 2021–22: What procedures were performed? data tables.
Definitions of the terms used in this section are available in the Glossary.
A patient may receive more than one intervention within the one episode of admitted patient care.
Hospitalisations involving surgery
Surgical separations are identified as separations with a ‘surgical AR-DRG’. Surgical separations for childbirth, and subacute and non-acute separations are included in these. Therefore, the data presented for 2015–16 to 2017–18 are not comparable with 2014–15 and earlier.
Emergency hospitalisations involving surgery
Emergency admissions involving surgery are identified as acute care separations with a ‘surgical AR-DRG’, and for which the urgency of admission was reported as Emergency—indicating that the patient required admission within 24 hours.
Elective hospitalisations involving surgery
Elective admissions involving surgery are identified as separations with a ‘surgical AR DRG’ and for which the urgency of admission was reported as Elective—indicating that hospitalisation could be delayed beyond 24 hours. They do not include separations where the urgency of admission was Not assigned or was not reported.
The nature of the services provided to an admitted patient during an episode of care can be described in several ways including by a broad category of service and by a diagnosis group. In Australia, the diagnosis group is the Australian Refined Diagnosis Related Group (AR-DRG).
Broad category of service
Hospitalisations are categorised into the following broad categories of service.
- Childbirth – includes all childbirth care such as caesarean delivery and vaginal delivery. Does not include newborn care.
- Mental health – includes mental health care for conditions such as dementia and depression.
- General intervention (Surgical) – includes surgical care such as knee replacement.
- Medical – includes care not involving surgical care such as haemodialysis.
- Specific intervention (Other) – includes care that is not Surgical or Medical such as endoscopy.
- Subacute and non-acute care – includes rehabilitation, palliative, psychogeriatric, maintenance care or geriatric evaluation and management.
In 2021–22:
- of the 11.6 million hospitalisations, 55% of hospitalisations were for Medical, 1 in 4 (23%) were for General intervention (Surgical) and 12% were for Specific intervention (Other)
- public hospitals accounted for 3 in 4 Medical hospitalisations (76%) and almost 4 in 5 Childbirth hospitalisations (77%)
- private hospitals accounted for over 3 in 5 of surgical hospitalisations (62%) and mental health hospitalisations (62%).
Changes over time
- From 2020–21 to 2021–22, hospitalisations for General Intervention (Surgical) have decreased by 10.9% (from 1.1 million to 1 million) in public hospitals and 3.2% (1.7 million to 1.65 million) in private hospitals.
- From 2017–18 to 2021–22, hospitalisations for Rehabilitation have decreased from 465,900 to 382,000. In public hospitals, the decline on average is 6.0% per year and in private hospitals it is 4.6% per year.
Public hospitals
In 2021–22:
- Just over 3 in 4 acute care hospitalisations (5 million of 6.5 million) were Medical.
- 1 in 6 acute care hospitalisations (1.1 million) were General intervention (Surgical).
- Diseases and disorders of the kidney and urinary tract was the most common Major diagnostic category (MDC) accounting for almost 24% of hospitalisations in public hospitals.
Private hospitals
In 2021–22:
- 2 in 5 acute care hospitalisations (1.7 million of 4.2 million) were General intervention (Surgical)
- 38% of acute care hospitalisations (1.6 million) were Medical
- Diseases and disorders of the digestive system was the most common MDC accounting for 18% of hospitalisations in private hospitals.
Major diagnostic category and AR-DRG
Same-day acute care
In 2021–22:
- the 20 most common AR-DRGs accounted for 2 in 3 same-day acute hospitalisations
- 24% of same-day acute hospitalisations were for Haemodialysis (dialysis), with Chemotherapy the next most common AR-DRG (10%)
- public hospitals provided 4 in 5 same-day acute hospitalisations for Haemodialysis (dialysis)
- private hospitals provided 82% of same-day acute hospitalisations for Retinal procedures and 88% of Dental extractions and restorations.
Overnight acute care
In 2021–22:
- childbirth made up the top 3 AR-DRGs for overnight acute hospitalisations (Vaginal Delivery, Intermediate Complexity, followed Caesarean Delivery, Minor Complexity and Vaginal Delivery, Minor Complexity, and most of these (79%, 58% and 78%, respectively) were in public hospitals.
- private hospitals provided 88% of overnight hospitalisations for Other Shoulder Interventions.
What other information is available?
More information on these data are available in tables 5.1–5.5 in Admitted patient care 2021–22: What services were provided?
Definitions of the terms used in this section are available in the Glossary.
Broad categories of service
The broad categories of service are:
- Childbirth: hospitalisations for which the AR-DRG was associated with childbirth (does not include newborn care).
- Mental health: hospitalisations for which either the care type was reported as Mental health care (between 2015–16 and 2017–18) or for which specialised psychiatric care days were reported (for 2013–14 to 2015–16), excluding hospitalisations for childbirth.
- Surgical: acute hospitalisations for which the AR-DRG belonged to the Surgical partition of the AR DRG classification (involving an operating room procedure).
- Medical: acute hospitalisations for which the AR-DRG belonged to the Medical partition (not involving an operating room procedure)
- Other: acute hospitalisations for which the AR-DRG did not belong to the Surgical or Medical partitions (involving a non-operating room procedure, such as endoscopy).
Subacute and non-acute care: hospitalisations for which the care type was Rehabilitation care, Palliative care, Psychogeriatric care, Geriatric evaluation and management or Maintenance care.
MDCs and AR-DRGs
Major diagnostic categories (MDCs) are 23 mutually exclusive categories into which all possible principal diagnoses fall. The diagnoses in each category correspond to a single body system or aetiology, broadly reflecting the speciality providing care. Each category is partitioned according to whether a surgical procedure was performed. This preliminary partitioning into major diagnostic categories occurs before a diagnosis related group is assigned.
The Australian Refined Diagnosis Related Groups (AR-DRGs) is a classification system, which provides a clinically meaningful way to relate the number and type of patients treated in a hospital to the resources required by the hospital. AR-DRGs group patients with similar diagnoses requiring similar hospital services.
AR-DRGs departs from the use of principal diagnosis as the initial variable in the assignment of some groups. A hierarchy of all exceptions to the principal diagnosis-based assignment to a MDC has been created. As a consequence, certain AR-DRGs are not unique to a MDC. This requires both a MDC and an AR-DRG to be generated per patient.
Intensive care is provided to patients who are critically unwell and require complex, multisystem life support such as mechanical ventilation, extracorporeal renal support and invasive cardiovascular monitoring. This section presents information on this care.
Public hospitals that have either an approved level 3 adult Intensive Care Unit (ICU) or an approved paediatric and/or Neonatal ICU report the number of hours spent in an ICU for each hospitalisation and the number of continuous hours of ventilatory support provided, either within ICU, or in another location such as an emergency department.
Hospitalisations with a COVID-19 diagnosis that included time spent in ICU or continuous ventilatory support
Australia’s hospital system has played a significant role in managing and treating people with COVID-19.
Between January 2020 and June 2021, there were over 7,300 hospitalisations (2,600 in 2019–20 and 4,700 in 2020–21) involving a COVID-19 diagnosis, either:
- U07.1 [COVID-19, virus identified] which means the virus has been confirmed by laboratory testing
- U07.2 [COVID-19, virus not identified] which means the virus was clinically diagnosed but laboratory testing is inconclusive, not available or unspecified.
In 2020–21, of the 7,300 hospitilisations involving a COVID-19 diagnosis:
- 329, or 7.0% of these hospitalisations involved a stay in an ICU
- 180, or 3.8% of these hospitalisations involved a period of continuous ventilatory support
- 487, or 10.3% Died in hospital.
There were 263,000 COVID hospitalisations in 2021–22, markedly more than the previous 18 months.
In 2021–22, of the 263,000 hospitilisations involving a COVID-19 diagnosis:
- 7700, or 3.0% of these hospitalisations involved a stay in an ICU
- 3,300 or 1.3% of hospitalisations involved a period of continuous ventilatory support
- 5,300 or 2.0% Died in hospital.
Hospitalisations involving ICU
From 2020–21 to 2021–22:
- hospitalisations involving a stay in a level 3 ICU decreased by 9% - from 156,000 to 141,800 hospitalisations
- the average duration of stay in level 3 ICU increased from 76.6 hours to 87.0 hours
- hospitalisations involving ICU as a proportion of total hospitalisations also decreased, from 13.2 hospitalisations involving a stay in level 3 ICU per 1,000 in 2020–21 to 12.2 in 2021–22.
Over the last five years, from 2017–18 to 2021–22:
- hospitalisations involving a stay in ICU has decreased by 12%, from 161,000 in 2017–18 down to 142,000 in 2021–22
- hospitalisations involving ICU as a proportion of total hospitalisations also decreased, from 14.4 hospitalisations involving a stay in level 3 ICU per 1,000 in 2017–18 to 12.2 in 2021–22.
Hours in intensive care provided to admitted patients
In 2021–22, 12.3 million hours of care in level 3 ICUs were reported for 142,000 hospitalisations. Compared with 2020–21, where there was 12.0 million hours reported for 156,000 hospitalisations. This was a 3.1% increase in hours (383,000 hours), but a 9.1% decrease in hospitalisations (14,200 hospitalisations).
Public hospitals
In 2021–22:
- for every 1,000 hospitalisations, 14.0 involved a stay in a level 3 ICU
- 93 hospitals provided ICU care in 96,000 hospitalisations – this care involved 10.1 million hours or 420,000 patient days of care.
- the average duration of stay in ICU was 106 hours (4.4 days).
From 2020–21 to 2021–22:
- the duration of stay in ICU increased by 11.4 hours, from 94.2 hours in 2020–21 to 105.6 hours in 2021–22
- hospitalisations involving a stay in ICU decreased by 7.2%, from 103,000 to 96,000.
Private hospitals
In 2021–22:
- for every 1,000 hospitalisations, 9.6 involved a stay in a level 3 ICU
- ICU care was provided in 46,000 hospitalisations – 2.2 million hours and 91,700 patient days
- the average duration of stay in ICU was 48 hours per hospitalisation (2 days).
From 2020–21 to 2021–22:
- the duration of stay in ICU increased by 5.9 hours, from 42.1 hours in 2020–21 to 48.0 hours in 2021–22
- hospitalisations involving a stay in ICU decreased by 13%, from 53,000 to 46,000.
Hours of continuous ventilatory support provided to admitted patients
Continuous ventilatory support (CVS) refers to the use of invasive ventilatory support or mechanical ventilation (a machine to assist breathing).
In 2021–22, 4.8 million hours of CVS were reported for 45,600 hospitalisations in Australian hospitals. Compared with 2020–21, this was 472,000 hours of CVS more for 200 fewer hospitalisations. This increase in CVS hours is likely due to an increase in COVID-19 hospitalisations.
From 2017–18 to 2021–22:
- the total number of hours of CVS increased by 17%, from 4.1 million hours in 2017–18 to 4.8 million in 2021–22
- the average duration of CVS increased from 88 hours in 2017–18 to 104 hours in 2021–22.
Public hospitals
In 2021–22:
- 4.4 million hours (183,400 patient days) of CVS was provided for 37,000 hospitalisations
- 5.4 hospitalisations per 1,000 involved CVS and the average duration of CVS was 120 hours per hospitalisation (5 days).
From 2020–21 to 2021–22:
- although hospitalisations involving CVS decreased by 2.5%, total hours of CVS increased by 12%, or 456,000 hours
- the average duration of CVS increased by 14%, from 105 hours to 120 hours.
Private hospitals
In 2021–22:
- 355,800 hours (14,800 patient days) of CVS was provided in 8,900 hospitalisations
- for every 1,000 hospitalisations, 1.9 hospitalisations involved CVS and the average duration of CVS was 40 hours per hospitalisation (1.7 days).
From 2020–21 to 2021–22:
- hospitalisations involving CVS increased by 9.0%, from 8,100 to 8,800
- total hours of CVS increased by 4.6%, or 16,000 hours.
Overlap between ICU care and CVS
CVS is usually, but not always, involved with an ICU stay.
In 2021–22:
- 141,800 hospitalisations reported a stay in an ICU and of these, 37,100 reported a period of CVS
- 1 in 3 (31%) hospitalisations in public hospitals reporting a stay in ICU also reported a period of CVS
- 15% of hospitalisations in private hospitals reporting a stay in ICU also reported a period of CVS
- of the hospitalisations that did not involve a stay in ICU, a period of CVS was reported for 9,000.
What other information is available?
More information about these data are available in data tables 5.6–5.8 and S5.8–S5.9 in Admitted patient care 2021–22: What services were provided?
Definitions of the terms used in this section are available in the Glossary.
Intensive care unit
An ICU is a designated ward of a hospital which is specially staffed and equipped to provide observation, care and treatment to patients with actual or potential life-threatening illnesses, injuries or complications, from which recovery is possible. The ICU provides special expertise and facilities for the support of vital functions and utilises the skills of medical, nursing and other staff trained and experienced in the management of these problems.
A level 3 adult, pediatric or neonatal ICU must:
- be capable of providing complex, multisystem life support for an indefinite period
- be a tertiary referral centre for patients (adults, neonates or children) in need of intensive care services and have extensive backup laboratory and clinical service facilities to support the tertiary referral role
- be capable of providing mechanical ventilation, extracorporeal renal support services and invasive cardiovascular monitoring for an indefinite period (to neonates and children aged less than 16 if a paediatric ICU), or care of a similar nature.
If a patient’s episode involves more than 1 period in an ICU, then the total number of hours in ICU are summed for reporting.
The quality of data submitted for hospitalisations involving ICU varies across jurisdictions.
Continuous ventilatory support
CVS, or invasive ventilatory support or mechanical ventilation refers to the use of an endotracheal tube and a machine (ventilator) to assist breathing.
Periods of ventilatory support that are associated with anaesthesia during surgery, and which are considered an integral part of the surgical procedure, are not reported here. The quality of data submitted for hospitalisations involving CVS varies across jurisdictions.
Other data sources
Australian and New Zealand Intensive Care Society (ANZICS) reporting – the ANZICS Centre for Outcome and Resource Evaluation (CORE) reports data from several intensive care registries.
OECD Indicators
The Organisation for Economic Co-operation and Development (OECD) presents comparative information on surgical procedures. The comparability of international surgical procedures may be affected by differences in definitions of hospitals, collection periods and admission practices.
This section includes information on the proportion of surgeries performed on a same-day basis for:
- cataract surgeries
- tonsillectomies
The number of:
- caesarean sections per 100 live births
- coronary revascularisation procedures per 100,000 population, and the proportion of these that were coronary angioplasties
- hip replacement surgeries per 100,000 population
- knee replacement surgeries per 100,000 population
The proportion of surgeries performed laparoscopically for:
- cholecystectomies
- inguinal herniorrhaphies
- appendicectomies.
Highlights
Proportion of cataract surgeries that were performed on a same-day basis
A high proportion of cataract surgeries performed on a same-day basis may point to the efficient use of resources.
In 2021–22:
- the proportion of cataract surgeries performed as same-day procedures in Australia (98.1%) was higher than the 2020 OECD average (92.2%)
- the proportion of patients receiving cataract surgeries performed as same-day procedures has been increasing over time, with 97.3% performed as same-day procedures in 2017–18.
Proportion of tonsillectomies that were performed on a same-day basis
In 2021–22:
- Australia’s proportion of tonsillectomies that were performed on a same-day basis (18.3%) was lower than the 2020 OECD average (34.2%)
- the proportion of tonsillectomies performed as same-day procedures has increased over time, from 13.6% in 2017–18 to 18.3% in 2021–22.
Number of caesarean sections per 100 live births
In 2021-22, Australia’s rate of caesarean sections per 100 live births (39.6) was higher than the 2020 OECD average (24.2). This is an increase of 1.3 caesarean sections per 100 live births when compared to 2020–21 (38.3 per 100 live births), and an increase of 4.5 per 100 in 2017–18 (35.1 per 100 live births).
Number of coronary revascularisation procedures per 100,000 population
In 2021–22:
- the coronary revascularisation procedure rate for Australia was below the 2020 OECD average (178.9 and 196.3 per 100,000 population, respectively), and within the interquartile range
- coronary angioplasty accounted for 77.5% of all coronary revascularisation procedures in Australia, lower than the 2020 OECD average (86.9%).
Number of hip and knee replacement surgeries per 100,000 population
In 2021–22:
- Australia’s rate of hip replacement surgery in 2021–22 was below the 2020 OECD average (158.7 and 169.7 per 100,000 population, respectively)
- Australia’s rate of knee replacement surgery was above the 2020 OECD average (181.4 and 107.8 per 100,000 population, respectively).
Proportion of selected surgical procedures that were performed laparoscopically
Laparoscopic (keyhole) surgery is less invasive (and therefore considered to be safer) than ‘open’ approaches.
In 2021–22, Australia had higher proportions of the 3 selected procedures that were performed laparoscopically:
- 95.3% of cholecystectomies in Australia were performed laparoscopically, compared with the 2020 OECD average (91.8%). This has increased over time, with 94.2% performed laparoscopically in 2017–18.
- 93.6% of appendicectomies in Australia were performed laparoscopically, compared with the 2020 OECD average (79.3%). This has increased over time, with 91.4% performed laparoscopically in 2017–18.
- 48.6% of inguinal herniorrhaphies in Australia were performed laparoscopically, compared with the 2020 OECD average (35.9%). This has increased over time, with 44.0% performed laparoscopically in 2017–18.
What other information is available?
More information is available in tables 6.5–6.6 in Admitted patient care 2021–22: What procedures were performed?
International comparisons are available on the OECD website.
Definitions of the terms used in this section are available in the Glossary.
OECD indicator: Length of stay
It should be noted that these statistics might be affected by variation in admission practices both within Australia and internationally. Data for Tasmania, the Australian Capital Territory and the Northern Territory are for public hospitals only. However, data for private hospitals in Tasmania, the Australian Capital Territory and the Northern Territory are included in the Australian total.
Average length of stay
The average length of stay (ALOS) is calculated as the total number of patient days reported for the hospital (or group of hospitals), divided by the number of separations.
This section presents analysis of average weekly hospitalisations (presented by date of admission) over 4 years (2018–19 to 2021–22) to highlight the impact of COVID-19 on hospitalisations and allow comparison between years.
Since early 2020, a range of restrictions have been introduced at various times to prevent and reduce the spread of COVID-19 and maintain adequate capacity of the healthcare system to deal with the pandemic. Some of these restrictions were applied nationally, while others were applied on a regional or hospital level as local areas responded to outbreaks.
Over this period several initiatives have impacted the provision of healthcare services and reduced the flow of patients seeking in-hospital care, including:
- patients being re-directed to other healthcare services if they had symptoms consistent with COVID-19 or have been a close contact of someone who had been infected
- establishment of new modes of delivering healthcare services (e.g., telehealth services and ‘virtual’ care models) that could re-direct patients seeking non-urgent care
- changes in patient behaviours, including changes in healthcare seeking behaviours
- restricted activities that might reduce risks for some kinds of healthcare issues, such as injuries that could result in an emergency admission.
Nationally, following a decision by National Cabinet, restrictions were applied to selected elective surgeries from 26 March 2020. Under these restrictions, Urgency Category 1 and exceptional Category 2 procedures were prioritised. These restrictions were gradually eased from 29 April 2020 onwards, though similar restrictions have been applied in some jurisdictions over a longer period.
This range of measures impacted on the number of people being seeking hospital care, including to emergency departments and being admitted for elective surgery.
Following the restrictions put in place on elective surgery in 2019–20, many jurisdictions implemented programs to fast-track elective surgeries and provided increased funding for surgeries which were delayed because of the restrictions.
Explore the data
The data visualisations below present data on hospitalisations (by date of admission) for 2018–19 to 2021–22, including:
- average daily hospitalisations (by week) by
- state and territory
- urgency category
-
actual and projected hospitalisations (by date of admission) for 2018–19 to 2021–22 (by month).
Impact of COVID-19 on admitted patient activity
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
Hospital admissions
This line graph shows hospital admissions between 2018–19 and 2021–22. Data is presented by average daily admissions (by week), cumulative admissions (by week), projected vs actual daily admissions (by month) and urgency category. National, state and territory data is available.
Highlights
Hospitalisations decreased in 2019–20
Nationally, over the five years between 2014–15 and 2018–19, the number of hospitalisations increased on average by 3.3% each year. However, between 2018–19 and 2019–20, the number of hospitalisations overall decreased by 2.8%:
- hospitalisations in public hospitals decreased by 1.7%
- hospitalisations in private hospitals decreased by 4.5%.
This decrease was due to changes in behaviours and healthcare provision during the COVID-19 pandemic, including restrictions on non-urgent elective surgery. These effects varied between public and private hospitals.
For public hospitals, in 2019–20:
- same-day hospitalisations decreased by 0.2% compared with 2018–19 and overnight hospitalisations decreased by 3.4%
- hospitalisations with an urgency category of Emergency decreased by 2.8% and Elective admissions decreased by 2.6%.
For private hospitals, in 2019–20:
- same-day hospitalisations decreased by 4.1% compared with 2018–19 and overnight hospitalisations decreased by 5.5%
- hospitalisations with an urgency of admission of Emergency decreased by 3.3% and Elective admissions decreased by 6.2%.
Admitted patient activity returning to normal in 2020–21
In 2020–21, admitted patient activity increased when compared with 2019–20, approaching levels projected based on pre-COVID year-on-year average increases:
- Overall, hospitalisations increased by 6.3% from 11.1 to 11.8 million hospitalisations.
- Overnight hospitalisations increased by 3.3% and same-day hospitalisations increased by 8.1%.
- The largest increase was for hospitalisations in private free-standing day hospitals (13.9%) compared with hospitalisations in public acute hospitals (3.6%).
- Hospitalisations in Other private hospitals, (or private hospitals offering a mix of same-day and overnight hospitalisations) increased 9.5%.
Admitted patient activity decreased compared with 2020–21
In 2021–22:
- Hospitalisations decreased by 2.1% compared with 2020–21 – from 11.8 million to 11.6 million.
- Overnight hospitalisations decreased by 2.2% (4.4 million to 4.3 million) and same-day hospitalisations decreased by 2.0% (7.4 million to 7.3 million).
- The smallest decrease was for private free-standing day hospitals (1.2%, 1.09 million to 1.07 million).
- Patient days per 1,000 population decreased by 0.5% - from 1,110 in 2017–18 to 1,088 in 2021–22 – consistent with longer term trends.
See ‘More information about the Data’ section below for information on how the projected presentations data were calculated.
Projected and actual hospital admissions
Projected hospital admissions were calculated using the average daily admissions for each month over a six-year period, from 2013–14 to 2018–19.
The average change per year was then applied onto the 2018–19 and 2019–20 data to create a projection for average daily admissions for each month in 2019–20, 2020–21 and 2021–22.
Hospital admission data is captured for completed separations within the data year. Hospital stays where the separation date did not occur within the same data year as the admissions are not included in the analysis. This is the likely cause of the apparent decrease in admissions at the end of each data year.
Because of the way in which admitted patient care data are complied, hospitalisations are underestimated towards the end of the collection period for 2019–20, 2020–21 and 2021–22. This is because the datasets only include hospitalisations with a separation date within the collection period, and therefore, do not include data about patients for which the episode of care had begun, but had not yet ended.
What other information is available on COVID‑19?
Data tables on hospitalisations involving a COVID-19 diagnosis are available for download, Admitted patient care 2021–22: Separations with a COVID-19 diagnosis.
To explore the influence of the COVID‑19 on other health data, further releases are available on the AIHW website under COVID‑19 Resources.
Information on the total confirmed cases and active cases can be found on the Australian Government Department of Health website.
What other information is available on admitted patient care?
Data are also available on admitted patient care by hospital or LHN in My local area.
Appendixes and caveat information for this data is available to download in the Info and downloads section.
Definitions of the terms used in this section are available in the Glossary.