Hospital care shifts away from overnight stays

The Australian Institute of Health and Welfare (AIHW) has published hospital admission data, revealing that hospital admissions rose by an average 3.3% per year between 2014–15 and 2018–19, double the population growth over the same period.

The MyHospitals update reported 11.5 million hospitalisations in Australia for the period 2018–19 — an increase from 10.1 million in 2014–15.

“Hospital care has shifted away from overnight stays over recent years, with the average length of stay declining and a shift toward more same-day hospitalisations,” AIHW spokesperson Dr Adrian Webster said.

“Same-day hospitalisations (where the patient does not stay overnight) have risen faster than overnight hospitalisations, largely due to increases in same-day stays for sub-acute and non-acute care.”

Sub-acute and non-acute care includes rehabilitation, certain types of geriatric and maintenance care and palliative care.

In a population of 1000, same-day hospitalisations rose an average of 2.7% per year in public hospitals and 1.0% in private hospitals. In contrast, overnight hospitalisations rose, on average, 0.5% per year in public hospitals and fell 1.1% per year in private hospitals. The average length of stay in hospital decreased by an average of 0.8% per year from 5.5 days to 5.4 days.

Six in ten admissions were to public hospitals in 2018–19 and publicly funded hospital admissions grew faster than admissions funded by private sources (3.7% average growth per year compared with 2.6%).

Between 2014–15 and 2018–19, emergency admissions increased at a higher rate than elective admissions in both public and private hospitals (3.9% average annual growth for public and 4.8% for private compared to 2.7% growth in public elective admissions and 2.0% growth in private elective admissions). In particular, the growth in emergency admissions involving surgery for complications related to type 2 diabetes increased by 14% in the last 12 months.

The data shows that vaccine-preventable hospitalisations were 22% lower in 2018–19 than in 2017–18, following a spike in admissions due to influenza in 2017–18. However, overall admissions for potentially preventable hospitalisations increased during this period, driven by an increase in hospitalisations for complications related to diabetes.

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