Torres and Cape

Elective surgery waiting list activity is measured by the number of additions to and removals from public hospital elective surgery waiting lists, and the number of patients admitted for their awaited procedure.

Explore the data

This data visualisation below presents data for 2022–23 and recent years.

The data can also be explored:

• nationally, for additions to waiting lists and reason for removal
• by Local Hospital Network (LHN) (where data is available)
• by hospital (where data is available).

Highlights

Admissions from elective surgery waiting lists

In 2022–23:

• there were 735,500 admissions from public hospital elective surgery waiting lists – 99% of which were elective admissions for the intended procedure and 1% of which were emergency admissions because the patient’s condition deteriorated or for other reasons
• ofthe 735,500 admissions, 239,800 (33%) were Category 1, 278,600 (38%) were Category 2, and 217,100 (30%) were Category 3
• Principal referral and women’s and children’s hospitals and Public acute group A hospitals accounted for approximately three‑quarters of all admissions from elective surgery waiting lists (40% and 34%, respectively)
• 4.4% of admissions from public hospital elective surgery waiting lists were for First Nations people, who represent 3.8% of the Australian population.

In 2022–23, admissions from elective surgery waiting lists increased by 18% compared with 2021–22, likely due to the easing of COVID-19 restrictions and limitations on hospital services during the previous period. In comparison, in the last three years, there was a 17% decrease in admissions in 2021–22, a 9.6% increase in 2020–21 and a 9.2% decrease in 2019–20. In the years preceding this period, the number of admissions increased annually on average by 2.1% from 2014–15 to 2018–19. 

The change in the number of elective surgery admissions, from 2021–22 to 2022–23, was not uniform across Australia. In the ACT, admissions decreased by 9.9%, while admissions increased in Victoria by 29%.

Additions to elective surgery waiting lists

In 2022–23, 855,500 patients were added to elective surgery waiting lists in Australia – a 9.2% increase from the number of patients added in 2021–22. However, it should be noted that:

• the number of patients added in 2018–19, which was prior to the outbreak of COVID-19, was 893,000
• in the 5 years prior to 2018–19, the number of additions to elective surgery waiting lists increased, on average, by 2.5% each year. 

Removals from elective surgery waiting lists

In 2022–23:

• 888,400 patients were removed from public hospital elective surgery waiting lists – an increase of 17% compared with 2021–22
• most patients removed from waiting lists (83%) were admitted for their intended procedure
• 17% were removed from waiting lists for other reasons (for example, the surgery was no longer required, they were treated elsewhere, transferred to another hospital’s waiting list, were unable to be contacted, or died).

The 17% increase in removals in 2022–23 followed a 16% decrease in 2021–22, a 11% increase in 2020–21 and an 8.0% decrease in removals in 2019–20. This fluctuating pattern in recent years is likely due to restrictions and limitations in services that were able to be provided in response to COVID-19 outbreaks at different periods. In the years before COVID-19, the total number of removals from waiting lists increased on average by 2.3% each year between 2014–15 and 2018–19.

Between 2021–22 and 2022–23, there was an 18% decrease in patient removals due to being transferred to another hospital’s waiting list; and in the year prior, it decreased by 12%. In comparison, between 2019–20 and 2020–21 there was an increase of 40%; and in the year prior, it increased by 20%. The increase in these previous two years were possibly due, in part, to management of waiting lists during COVID-19.  

The surgical speciality describes the area of clinical expertise held by the doctor scheduled to perform the elective surgery. This section presents information on the type of elective surgery provided, by surgical speciality, in 2022–23 and changes over recent years.

Information on 11 categories of surgical speciality is presented. The ‘other’ category contains data for surgeons whose speciality was not one of the 11 specified categories.

Explore the data

This data visualisation below presents data for 2022–23 and recent years.

The data can be explored:

• nationally or by state/territory, by surgical speciality
• by Local Hospital Network (LHN) (where data is available)
• by hospital (where data is available).

The overall impact of the COVID–19 pandemic in recent years should be considered when interpreting this data.

Highlights

In 2022–23, of the 735,500 admissions from elective surgery waiting lists:

• 20% were for General surgery (on abdominal organs, including endocrine surgery and breast surgery), which was the most common surgical specialty resulting in an admission from a waiting list
• 15% were for Urological surgery (on organs of the urinary system such as bladder, urethra, and kidneys) and 14% were for Ophthalmology surgery (on eyes and optic nerves).

Changes over time

• Between 2021–22 and 2022–23, overall admissions from elective surgery waiting lists increased by 18%, whereas between 2018–19 and 2022–23, it decreased annually by 0.8%.
• Between 2021–22 and 2022–23, Otolaryngology, head, and neck surgery and Ophthalmology surgery had the largest increase in admissions 27% and 25% respectively. This was not consistent with changes between 2018–19 and 2022–23; in that period, Otolaryngology, head, and neck surgery decreased annually by 1.9%, while Ophthalmology surgery slightly increased annually by 0.5%.
• Between 2021–22 and 2022–23, Vascular surgery and Urological surgery had the smallest increase in admissions by 10.7% and 11.1% respectively, while between 2018–19 and 2022–23, these both decreased annually by 1.4% and 0.4% respectively. 

In general, admissions from elective surgery waiting lists decreased in 2019–20, increased in 2020–21, decreased in 2021–22 and then increased again in 2021–22. This pattern was evident across all surgical specialties, except for cardiothoracic surgery which had decreased in 2020–21.

The intended surgical procedure describes the type of surgery for which a patient has been placed on a public hospital elective surgery waiting list. In some instances, the intended procedure may not reflect what was actually performed during the hospitalisation.

Explore the data

In the data visualisations below, you can explore data about admissions from elective surgery waiting lists for 15 selected intended procedures and ‘other’ procedures for 2022–23 and recent years by:

• state/territory
• Local Hospital Network (LHN) (where data is available)
• Hospital (where data is available).

The 15 intended procedures selected were previously known as indicator procedures, chosen due to their typically high volume of admissions and long wait times.

Highlights

In 2022–23:

• the 15 selected intended procedures accounted for 34% of admissions from elective surgery waiting lists
• Cataract extraction was the most common selected intended surgical procedure with 75,500 patients admitted, followed by Cystoscopy with 55,200 patients admitted. 

Changes over time

Admissions for all selected intended procedures increased between 2022–23 compared with 2021–22, likely due to the easing of elective surgery restrictions, bringing the delivery of health care services closer towards pre-pandemic levels. 

The three procedures with the greatest increase in admissions between 2022–22 and 2022–23 were: Septoplasty (which increased by 47%), Total knee replacement (42%) and Haemorrhoidectomy (41%). However, over the long-term, between 2018–19 and 2022–23, admissions for most indicator procedures decreased. The greatest decreases in annual admissions were for Varicose veins treatment (which decreased on average by 9.0%), Myringotomy (8.1%) and Tonsillectomy (6.2%).

Waiting times data provides information about the length of time waited by patients on public hospital elective surgery waiting lists before being admitted for surgery.

Explore the data

In the data visualisation below, you can explore waiting times for elective surgery by hospital peer group and clinical urgency category of the surgery for 2022–23 and other recent years.

The data can also be explored by:

• hospital (where data is available)
• local Hospital Network (LHN) (where data is available).

Highlights

In 2022–23:

• the overall time within which 50% of patients were admitted (the median waiting time) was 49 days, and the time within which 90% of patients were admitted was 361 days
• 9.6% of patients waited more than 365 days for their surgery
• the 50th percentile (median) waiting time for patients admitted from waiting lists to Principal referral and Women’s and children’s hospitals (37 days) was shorter than for smaller hospitals categorised as Public acute group A hospitals and Public acute group B hospitals (54 days and 66 days, respectively).

Changes over time

Between 2021–22 and 2022–23, waiting times (measured at the 50^th and 90^th percentiles) increased across most states/territories. The exceptions were:  waiting times in Tasmania decreased on both measures (50^th and 90^th percentile waiting times), South Australia decreased in respect of the 90^th percentile waiting time, and the waiting time in the Northern Territory decreased in respect of the 50^th percentile wait time.  

50th percentile (median) waiting time

Between 2021–22 and 2022–23, the 50th percentile waiting time:

• increased overall from 40 days to 49 days
• increased for all public hospital peer groups. 

Between 2018–19 and 2022–23, the 50th percentile waiting time:

• increased from 41 days to 49 days
• increased for all public hospital peer groups by over 10 days, except Principal referral and Women’s and children’s hospitals, which slightly increased by 2 days.

90th percentile waiting time

Between 2021–22 and 2022–23, the 90th percentile waiting time:

• increased overall from 323 days to 361 days 
• increased for all public hospital peer groups.

 Between 2018–19 and 2022–23, the 90th percentile waiting time:

• increased overall from 279 days to 361 days
• increased for all public hospital peer groups. 

Patients who waited more than 365 days 

Between 2021–22 and 2022–23, the proportion of patients who waited more than 365 days to be admitted increased from 6.3% to 9.6%. Prior to 2021–22, this proportion increased from 2.1% in 2018–19 to 7.6% in 2020–21.

Waiting times by clinical urgency category

When a patient is placed on a public hospital elective surgery waiting list, a clinical assessment is made to determine the urgency with which they require elective surgery (the clinically recommended time). The proportion of patients seen within the recommended time is the percentage of patients who were admitted for surgery within the clinically recommended time as defined by their clinical urgency category.

The ‘overdue wait’ is the amount of time spent waiting while overdue—that is, after 30, 90, or 365 days for clinical urgency categories 1, 2 and 3, respectively. The average overdue wait time (in days) is calculated for patients who were still waiting for their elective surgery as at 30 June 2022, who were ready for care, and who had waited beyond the recommended time.

Due to the lack of comparability of clinical urgency categories between states and territories, these data are presented for each state and territory separately.

In 2022–23, the proportion of patients admitted within the clinically recommended time was:

• for New South Wales; 77%
• for Victoria; 75% 
• for Queensland; 78%
• for Western Australia; 76%
• for South Australia; 74%
• for Tasmania; 62%
• for the Australian Capital Territory; 69%
• for the Northern Territory; 68%.

 In 2022–23, the average overdue wait time was:

• for New South Wales; 114 days
• for Victoria; 260 days
• for Queensland; 97 days
• for Western Australia; 147 days
• for South Australia; 112 days
• for Tasmania; 253 days
• for the Australian Capital Territory; 144 days
• for the Northern Territory; 391 days.

The surgical speciality describes the area of clinical expertise held by the doctor performing the elective surgery.

Explore the data

In the data visualisation below, you can explore elective surgery waiting times by surgical speciality for 2022–23 and for other recent years by:

• area of surgical specialty
• state and territory
• local hospital network (LHN) (where data is available)
• hospital (where data is available).

Highlights

In 2022–23:

• the surgical speciality with the highest median waiting time (50^th percentile) was Ophthalmology (105 days)
• the surgical specialty with the highest 90^th percentile waiting time was Otolaryngology, head and neck surgery (507 days)
• the surgical speciality with the lowest median and 90th percentile waiting time was Cardiothoracic surgery (20 days and 108 days, respectively)
• the surgical specialities that had the highest proportions of patients who waited more than 365 days to be admitted were Otolaryngology, head and neck surgery and Orthopaedic surgery (21% and 18%, respectively).

Changes over time

Between 2018–19 and 2022–23:

• the median waiting time increased for 11 out of the 12 surgical specialties, excluding Plastic and reconstructive surgery which decreased by 1 day from 26 days in 2021–22 to 25 days in 2022–23
• the 90^th percentile waiting time increased for all 12 surgical specialties, with Otolaryngology, head and neck surgery having the largest increase of 150 days from 357 days in 2018–19 to 507 days in 2022–23.
• Neurosurgery median waiting times increased from 38 days to 45 days.

Waiting list statistics for intended surgical procedures can indicate performance in particular areas of elective surgery. Information on the types of elective surgery provided by public hospitals is shown by the intended surgical procedure, for selected procedures only.

A range of restrictions and disruptions to elective surgeries occurred as a result of COVID-19 which has impacted elective surgery waiting times across most procedures from 2019–20 onwards. Prior to this, between 2016–17 and 2019–20, median waiting times for elective surgeries tended to remain relatively stable across most procedures.

Explore the data

In the data visualisations below, you can explore elective surgery waiting times for 2022–23 and other recent years by:

• a list of 15 selected intended procedures (also previously known as indicator procedures)
• state and territory
• local hospital network (LHN), and hospital level (for all intended procedures).

Highlights

In 2022–23, for the 15 selected intended (indicator) procedures:

• Coronary artery bypass graft had the shortest median and 90^th percentile waiting times with 19 and 103 days respectively, and <1% of patients waited more than 365 days to receive this type of surgery. 
• Septoplasty had the highest median and 90^th percentile waiting time with 365 and 666 days respectively. 

In 2022–23, for the top 25 intended procedures:

• Curettage and evacuation of uterus had the shortest median and 90^th percentile waiting time with 4 and 53 days respectively. The proportion of patients waiting more than 365 days to receive this elective surgery of <1%. 
• Septoplasty had the highest median and 90^th percentile waiting time with 365 and 666 days respectively.

Changes over time

Between 2018–19 and 2022–23, for the 15 selected intended (indicator) procedures:

• Coronary artery bypass graft surgery consistently had the lowest waiting times across all of the waiting time measures
• Septoplasty consistently had the highest median waiting times and Myringoplasty/Tympanoplasty consistently had the highest 90^th percentile waiting time except for 2020–21 and 2022–23 when waiting times for Septoplasty were 500 and 666 days
• Septoplasty had the largest increase in median and 90^th percentile waiting time with 124 and 292 days, respectively from 241 and 374 days in 2018–19 to 365 and 666 days in 2022–23 
• Coronary artery bypass graft surgery and Cytoscopy had the lowest increase in median waiting times of just 2 days, respectively from 17 and 24 days in 2018–19 to 19 and 26 days in 2022–23
• Coronary artery bypass graft surgery had the lowest increase in 90^th percentile waiting times of 28 days from 75 days in 2018–19 to 103 days in 2022–23.

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.

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%.

Length of stay is the number of days between admission to hospital, and separation. 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 hospitalisations. 

OECD indicator: Length of stay

The Organisation for Economic Co-operation and Development (OECD) presents comparative information on the ALOS for overnight hospitalisations as an indicator of efficiency. The comparability of international ALOS may be affected by differences in definitions of hospitals, collection periods and admission practices.

Performance indicator: Average length of stay for selected AR-DRGs

The ALOS for selected AR-DRGs is an indicator of Efficiency and sustainability under the Australian Health Performance Framework (AHPF).

Explore the data

In the data visualisation below, you can view the ALOS by selected medical procedures, by state and territory, and by type of hospital (peer group).

Highlights

In 2021–22:

• the ALOS for overnight hospitalisations in Australia was 5.7 days (5.9 days for public hospitals and 5.2 days for private hospitals), which is 1.8 days lower than the OECD average (7.5 days)
• there were notable differences (more than 1 day) in the ALOS between public and private hospitals for 6 of the 20 selected diagnosis groups – the AR-DRGs, (for example, the ALOS for Chronic obstructive airways disease, minor complexity was 2.9 days for public hospitals and 6.0 for private hospitals).

Between 2017­–18 and 2021–22, the overall ALOS for hospitalisations in Australia continued to fluctuate, only increasing from 2.70 days to 2.74 days. Prior to this, the ALOS declined over the years as the ALOS was 3.0 days in 2012–13, dropping to 2.8 days in 2016–17.

The ALOS for overnight hospitalisations in public hospitals increased by 2.3% per year (5.4 to 5.9 days), whilst private hospitals decreased by 0.2% (5.21 to 5.17 days).

Significant changes in ALOS over time may be related to changes in admission practices and improvements in the coverage of reporting.