Hospital resources

In Australia, hospital services are provided by both public and private hospitals. The state and territory governments largely own and manage public hospitals. Public acute hospitals mainly provide 'acute care' for short periods, although some provide longer-term care, such as for some types of rehabilitation. Public psychiatric hospitals specialise in the care of people with mental health problems, sometimes for long periods.

Private hospitals are mainly owned and managed by private organisations—either for-profit companies, or not-for-profit non-government organisations. They include day hospitals that provide services on a day-only basis, and hospitals that provide overnight care.

How many hospitals were there?

In 2014–15, there were 1,322 hospitals in Australia. There were 698 public hospitals (compared with 752 in 2010–11) and 624 private hospitals (compared with 593 in 2010–11) (Table 1). The decrease in public hospitals between 2010–11 and 2014–15 was mainly due to the reclassification of 46 very small hospitals in Queensland as non-hospital services.

Table 1: Public and private hospitals, states and territories, 2014–15
Public and private hospitals NSW Vic Qld WA SA Tas ACT NT Total
Public hospitals                  
Public acute hospitals 217 149 118 89 75 22 3 5 678
Public psychiatric hospitals 8 2 4 3 2 1 0 0 20
Total public hospitals 225 151 122 92 77 23 3 5 698
Private hospitals                  
Private free-standing day hospital facilities 112 88 54 40 28 n.p. n.p. n.p. 342
Other private hospitals 91 79 55 20 27 n.p. n.p. n.p. 282
Total private hospitals 203 167 109 60 55 n.p. n.p. n.p. 624
Total 428 318 231 152 132 n.p. n.p. n.p. 1,322

n.p. not published.

How many beds?

The number of hospital beds is a better indicator of the availability of hospital services than the number of hospitals, as the size of hospitals, and the range of services provided, can vary considerably. However, the range and types of patients that different hospitals treat (or their 'casemix') can also affect the comparability of hospital bed numbers.

Public hospitals

Between 2010–11 and 2014–15, public hospital bed numbers increased by an average of 1.1% per year—from 57,800 to almost 60,300 beds. This was despite the decrease in the number of public hospitals.

In 2014–15:

  • there was about 1 public hospital bed per 400 people
  • 2% of beds were in public psychiatric hospitals
  • 12% of public hospital beds were same-day beds or chairs.

The majority of public hospital beds were in larger hospitals, located in the more densely populated areas. There were over 40,000 beds available in Major cities, compared with about 1,800 beds in Remote areas.

Private hospitals

Between 2010–11 and 2014–15, private hospital bed numbers increased by an average of 2.9% per year—from 28,400 to about 32,000. In 2014–15: 3% of beds were in private hospitals that specialised in same-day care (Figure 1)

  • there was about 1 private hospital bed per 700 people.

Figure 1: Proportion of beds by hospital type, public and private hospitals, 2014–15

This pie chart shows that 63%25 of hospital beds are in Public acute hospitals, 31%25 are in Other private hospitals, 3.3%25 are in Private free standing day hospitals and 2.4%25 are in Public psychiatric hospitals. The data for this figure are available in Chapter 2 of Hospital resources 2014–15: Australian hospital statistics.

Note: Percentages for figures may not sum to 100% due to rounding.

For more information on the numbers of public hospitals and beds in each state or territory, see Chapter 2 of Hospital resources 2014–15: Australian hospital statistics. For more information about the number of private hospitals and beds in each state or territory, see Private hospitals, Australia, 2014-15.

How diverse were Australia's public hospitals?

The 698 public hospitals are very diverse in size and the types of services they provided for admitted and non-admitted patients (Table 2).

In 2014-15, the 30 Principal referral hospitals, accounted for more than 2.1 million separations—or hospitalisations—that is, almost 36% of the total for public hospitals (Figure 2). These hospitals also accounted for 36% of patient days (the number of days of admitted patient care provided) for public hospitals (Figure 3).

Most of the Public acute group C, Public acute group D and Very small hospitals are located in Regional and Remote areas. They delivered mainly acute care for admitted patients and most had outpatient clinics.

The 39 Subacute and non-acute hospitals mainly provided rehabilitation, geriatric evaluation and management, palliative care and maintenance care.

There were 8 Outpatient hospitals located in Regional and Remote areas. These provided a range of outpatient services and generally did not admit patients.

For more information on hospital diversity in each state and territory, see Chapter 3 of Hospital resources 2014–15: Australian hospital statistics.

Table 2: Public hospital peer groups, 2014–15
Hospital type Major cities Regional Remote Total Emergency
depts
Outpatient
clinics
Elective
surgery
IC units Available beds
(average)
Separations
(average)
Principal referral 27 3 0 30 30 30 30 30 650 70,988
Women's and children's 12 0 0 12 9 12 10 10 211 22,639
Public acute group A 33 28 1 62 60 62 57 48 267 32,175
Public acute group B 24 20 1 45 45 45 43 9 138 16,980
Public acute group C 11 114 18 143 55 141 86 2 40 3,595
Public acute group D 4 134 52 190 59 169 9 0 17 594
Very small 0 84 38 122 24 88 0 0 8 90
Psychiatric 16 4 0 20 0 5 0 1 103 599
Subacute and non-acute 28 11 0 39 0 32 0 0 65 1,532
Outpatient 0 4 4 8 5 7 0 0 1 31
Other 23 4 0 27 1 16 5 1 34 4,063
Total 178 406 114 698 288 607 240 101 86 8,567

Figure 2: Proportion of hospitalisations, by public hospital peer group, 2014–15

Figure 3: Proportion of patient days, by public hospital peer group, 2014-15

How were hospitals funded?

Public and private hospitals are funded from a range of sources, reflecting the types of patients they treat and the services they provide.

About 90% of care in public hospitals and 32% of care in private hospitals is funded by governments. The remainder of funding for care in public and private hospitals is provided by Individuals, Department of Veterans' Affairs and Other.

Governments mainly fund emergency department and outpatient services, whereas admitted patient services are commonly funded by private (non-government) sources, as well as government sources.

Hospital funding and expenditure

This report includes information about sources of funding for public and private hospitals and how they spent the money.

Hospital funding is the money received by hospitals to pay for the services they provide. Public and private hospitals receive funding from Australian Government, state and territory governments, private health insurance funds and out-of-pocket payments by individuals.

Hospital expenditure is the money spent by hospitals on the goods and services they use, such as salary payments, drugs, and medical and surgical supplies.

Public hospitals

In general terms, the state and territory governments and the Australian Government provide most of the funds for public hospitals (AIHW 2015c) (Figure 4).

Between 2009-10 and 2013-14:

  • after adjusting for inflation, funding for public hospitals increased by an average of 4.2% each year
  • the proportion of public hospital funding by the Australian Government decreased from 38% to 37% (Figure 5).

Private hospitals

Private hospitals are mainly funded by private health insurance and out-of-pocket payments by patients (Figure 4). Between 2009-10 and 2013-14:

  • funding for private hospitals increased by an average of 5.0% each year
  • the proportion of private hospital funding provided by the Australian Government decreased from 33% to 30% (Figure 6).

For more information on hospital funding, see Chapter 4 of Hospital resources 2014-15: Australian hospital statistics (AIHW 2016b) and Health expenditure Australia 2013-14 (AIHW 2015c).

Figure 4: Funding sources for public and private hospitals, 2013-14

 

Figure 5: Funding sources for public hospitals, 2009-10 to 2013-14

This figure is a grouped horizontal line chart showing changes in public hospital funding by state and territory governments, Australian Government and Non-government sources between 2009–10 and 2013–14. It shows that the proportion of public hospital funding that was from the Australian Government fluctuated around 38%25 between 2009–10 and 2013–14.

Figure 6: Funding sources for private hospitals, 2009-10 to 2013-14

This figure is a grouped horizontal line chart showing changes in private hospital funding by state and territory governments, Australian Government and Non-government sources between 2009–10 and 2013–14. It shows that the proportion of public hospital funding that was from the Australian Government decreased from 33%25 to 30%25%25 between 2009–10 and 2013–14.

Sources of funding for admitted patients

Between 2010-11 and 2014-15, the number of hospitalisations with a principal funding source of Private health insurance increased by an average of 5.9% per year and hospitalisations with a funding source of Department of Veterans' Affairs decreased by an average of 3.8% each year.

In 2014-15:

  • 50% of hospitalisations were for public patients (who were not charged for their stay, funded by governments) and 42% were funded by Private health insurance
  • 82% of hospitalisations in public hospitals were for public patients
  • 83% of hospitalisations in private hospitals were funded by Private health insurance
  • fewer than 1% of hospitalisations in public hospitals and about 7% in private hospitals were Self-funded
  • about 1% of hospitalisations in public hospitals and 2% in private hospitals were funded by Workers compensation and Motor vehicle third party personal claim.

For more information about admitted patient funding sources, see Chapter 7 of Admitted patient care 2014-15: Australian hospital statistics (AIHW 2016a).

How much did hospitals spend?

Recurrent expenditure includes:

  • salary expenditure—including salaries and wages
  • non-salary expenditure—including payments to Visiting medical officers; and costs of drug, medical and surgical supplies (other than large equipment which is regarded as capital expenditure, not reported here).

Public hospitals

In 2014-15:

  • recurrent expenditure on public hospital services (including by Local hospital networks and state/territory health authorities, except in Queensland) was about $57 billion (including depreciation)
  • salary payments accounted for 61% of recurrent expenditure (Figure 7)
  • Principal referral hospitals accounted for about 39% of recurrent expenditure on public hospital services.

For more information see Chapter 4 of Hospital resources 2014-15: Australian hospital statistics (AIHW 2016b).

Figure 7: Recurrent expenditure (including depreciation) on public hospital services, 2014-15

This pie chart shows 61%25 of recurrent expenditure on public hospitals is for salaries, 16%25 is for other expenditure, 7%25 is for medical and surgical supplies, 6%25 for administrative expenses, 4.1%25 for drug supplies and 2.4%25 for payments to visiting medical officers. The data for this figure are available in Chapter 4 of Hospital resources 2014–15: Australian hospital statistics.  

Private hospitals

In 2014-15, recurrent expenditure by private hospitals was more than $12 billion (including depreciation) (ABS 2016) and almost 50% of this expenditure was for salary payments.

Between 2010-11 and 2014-15, recurrent expenditure by private hospitals increased by an average of 4.0% per year (after adjusting for inflation).

How many people were employed in Australia's hospitals?

Hospital employees include medical officers (such as surgeons, anaesthetists and other specialists), nurses, diagnostic and allied health professionals (such as physiotherapists and occupational therapists), administrative and clerical staff, and domestic and other personal care staff.

For the first time in 2014-15, staff numbers were included for public hospital services managed or delivered at either the Local hospital network-level, or at the state/territory health authority-level (except for Queensland).

The staff numbers do not include visiting medical officers in public hospitals and most medical officers who provide services in private hospitals.

Public hospitals

In 2014-15, about 330,000 full-time equivalent staff were employed in providing public hospital services, of which:

  • 42% were nurses
  • 13% were salaried medical officers
  • 14% were diagnostic and allied health professionals (Figure 8).

About 28,000 of these staff were employed in Local hospital networks or at the state/territory health authority-level except for Queensland.

For more information on public hospital staffing in each state and territory, see Chapter 5 of Hospital resources 2014-15: Australian hospital statistics (AIHW 2016b).

Figure 8: Average full-time equivalent staff (%), public and private hospitals, 2014-15

This is a grouped vertical bar chart showing the number and type of average full-time equivalent staff employed in public hospitals each year between 2010–11 and 2014–15. It shows the number of salaried medical officers increased by an average of 4.8%25 per year and the number of nurses increased by an average of 3.6%25 per year.

Note: For public hospitals, a clinical support staff category does not exist. These staff may be included in other categories, for example in Administrative and clerical staff or Domestic and other staff.

Private hospitals

In 2014–15, Australia's private hospitals employed about 64,400 full-time equivalent staff. Of these, 93% were employed in private hospitals not specialising in same-day care (Other private hospitals) (ABS 2016).

Of the staff employed in private hospitals:

  • 56% were nurses
  • 2% were salaried medical officers
  • 6% were diagnostic and allied health professionals (Figure 8).

The staffing mix in private hospitals is somewhat different from that in public hospitals. This is because most medical services are provided by visiting medical specialists (who are not hospital employees), and the range of services provided is different.

For more information on private hospitals see Private hospitals, Australia, 2014–15 (ABS 2016).

References

Australian Bureau of Statistics (ABS) 2016. Private hospitals, Australia 2014–15. ABS cat. no. 4390.0. Canberra: ABS.

Australian Institute of Health and Welfare (AIHW) 2015c. Health expenditure Australia 2013–14. Health and welfare expenditure series no. 54. Cat. no. HWE 63. Canberra: AIHW.

AIHW 2016a: Admitted patient care 2014–15: Australian hospital statistics. Health services series no. 68. Cat. no. HSE 172. Canberra: AIHW.

AIHW 2016b. Hospital resources 2014–15: Australian hospital statistics. Health services series no. 71. Cat. no. HSE 176. Canberra: AIHW.