Admitted patient activity
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.
Admitted patient access
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).
Average length of stay
All data in these visualisations are available for download in the Data & downloads section of the MyHospitals website.
Hospital sector
This bar graph shows the average length of stay for selected AR-DRGs in 2021–22. Data is presented by public/private. National data is available. In 2021–22, heart failure and shock had the longest length of stay for private hospitals at 6.4 days and for public hospitals at 3.9 days.
Hospitals and LHNs
This figure shows the average length of overnight stay between 2011–12 and 2021–22. Data is presented by measure (average length of overnight stay, number of hospital stays, number of overnight bed stays, and percentage of hospital stays that were overnight), procedure category and peer group. Hospital data is available.
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.
What other information is available?
More information about ALOS can be found in figures 2.2–2.3 in Admitted patient care 2021–22: How much activity was there?
Definitions of the terms used in this section are available in the Glossary.
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. Two measures for ALOS are presented:
- ALOS for all separations
- ALOS excluding same-day separations
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). The selected AR-DRGs were chosen on the basis of:
- homogeneity, where variation is more likely to be attributable to the hospital’s performance rather than variations in the patients themselves
- representativeness across clinical groups
- differences between jurisdictions and/or sectors
- policy interest, as evidenced by (1) inclusion of similar groups in other tables in Australian hospital statistics, such as indicator procedures for elective surgery waiting time, (2) high volume and/or cost and (3) changes in volume over years.
Due to changes in the AR-DRG classification, the data presented here are not comparable with the data presented in previous years.
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.