Spending on admitted patients

Hospitals account for a large share of the funds Australia spends on the health sector each year. One way to assess hospital efficiency is to see how much money each hospital uses in comparison to its peers to provide specific treatments or procedures.

Making comparisons is difficult, as some hospitals may use more resources to treat patients with the same diagnosis because the patients they treat are sicker and have more complex care requirements. Therefore, it is important to adjust for these differences before comparing the cost of care between hospitals.

To assist in the comparing the cost of care between hospitals, the former National Health Performance Authority developed cost per national weighted activity unit (NWAU). Cost per NWAU adjusts for the factors that increase hospital costs to allow comparison. The measure provides an indicator of relative efficiency across more than 80 of Australia’s largest public hospitals.

Explore the data

In the visualisation below you can explore information on the cost per NWAU, total national weighted activity unit, and percentage of private patients over the three-year period from 2012–13 to 2014–15 by hospital in each state and territory.

Highlights

In 2014–15:

• some public hospitals spent almost twice as much as others to provide similar services to similar types of acute admitted patients
• the average cost of care (cost per NWAU) ranged from $3,300 at one hospital to $6,400 at another.

Between 2012–13 and 2014–15:

• the average cost of delivering care in major public hospitals decreased by 1%, after adjusting for inflation
• there was a 6% increase in hospital activity but hospital spending only rose by 5%, suggesting that as a group, major public hospitals have improved in their efficiency – delivering care for less cost.

Watch an animated explanation of how hospitals’ average cost of care is measured.

The funding source describes the major source of funds used to pay for a hospitalisation. Funding source types are: 

• Public patient
• Private health insurance
• Self-funded
• Workers compensation
• Motor vehicle third party personal claim
• Department of Veterans' Affairs
• Other (includes Department of Defence, Correctional facilities, Other hospital or public authority, Health service budget—no charge raised due to hospital decision)

A hospitalisation may be funded by more than one funding source, but information on those other funding sources is not always available. For example, Private health insurance is reported for any hospitalisation that used private health insurance to fund all or part of their admission, regardless of whether it was the major source of funds. In many cases, however, funding for these admissions is also derived from a combination of Medicare subsidies and out-of-pocket fees.

Highlights

In 2021–22:

• for all hospitalisations in public and private hospitals, 54% were funded as Public patients, and 39% were funded by Private health insurance
• 87% of hospitalisations in public hospitals were funded as Public patients, compared with 6.4% in private hospitals
• for private hospitals, 80% of hospitalisations were funded by Private health insurance (compared with 11% in public hospitals) and 7.9% were self-funded.

Funding source

In 2021–22:

• Public hospitals accounted for 95% of Public patient hospitalisations and 16% of Private health insurance-funded hospitalisations.
• Private hospitals accounted for 4.9% of Public patient hospitalisations and 83% of Private health insurance-funded hospitalisations.
• 14% of hospitalisations in Women’s and children’s hospitals and 12% of hospitalisations in Principal referral hospitals were Private health insurance-funded.

Between 2017–18 and 2021–22:

• Public patient hospitalisations increased on average by 2.2% each year. They increased on average by 1.9% each year in public hospitals and by 11.6% each year in private hospitals
• Private health insurance hospitalisations decreased on average by 0.7% each year. They decreased on average by 5.6% each year in public hospitals and increased by 0.4% each year in private hospitals
• Self-funded hospitalisations increased on average by 4.7% each year and Department of Veterans’ Affairs funded hospitalisations decreased on average by 6.6% each year.

Elective admissions involving surgery for Public patients in private hospitals has been increasing since the start of the pandemic, from 33,400 in 2019–20 to 52,100 in 2020–21 and then to 57,400 in 2021–22.

Relative cost of admitted patient care (average cost weight)

Relative cost of admitted patient care is the costliness of an AR-DRG relative to all other AR-DRGs such that the average for all separations is 1.00. A hospitalisation with a cost weight of 5.0, therefore, on average costs 10 times as much as a hospitalisation with a cost weight of 0.5. There are separate cost weights for hospitalisations (directly related to the diagnosis related group (AR-DRG) assigned to the hospitalisation) in the public and private sectors, reflecting the differences in the range of costs and AR-DRGs in the different sectors.

In 2021–22:

• the average cost weight for public acute hospitals, ranged from 1.17 in New South Wales to 0.59 in the Northern Territory. The relatively low average cost weight for the Northern Territory reflects the relatively large proportion of same-day hospitalisations for dialysis in that jurisdiction.
• in public hospitals, the lowest average cost weights were for Public patient hospitalisations (1.00), and the highest average cost weights were for hospitalisations funded by Motor vehicle third party personal claim (2.46)
• in private hospitals, the lowest average cost weights were for Public patients (0.64), which reflects the relatively large numbers of contracted care for dialysis in Western Australia and South Australia.