4390.0 - Private Hospitals, Australia, 2010-11 Quality Declaration 
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 07/09/2012   
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GLOSSARY

Accredited/certified hospitals

Hospitals that are accredited/certified by the Australian Council on Healthcare Standards (ACHS 2003), Benchmark Certification, Business Excellence Australia (SAI-Global Ltd) or any other body approved for private sector quality criteria certification or ISO 9000 quality family standards. Participation in these schemes is voluntary and accreditation is awarded when hospitals demonstrate a continuing adherence to quality assurance standards. Hospital accreditation/certification is regarded as one of the few indicators of hospital quality that is available nationally.

Acute hospitals

These provide at least minimal medical, surgical or obstetrical services for admitted patient treatment and/or care and provide round-the-clock comprehensive qualified nursing services as well as other necessary professional services. They must be licensed by the state or territory health authority. Most of the patients have acute conditions or temporary ailments.

Admitted patient

An admitted patient undergoes a hospital's formal admission process. See also Patient.

Allied health services

These are provided by units and clinics for the treatment and counselling of patients. They mainly comprise physiotherapy, speech therapy, family planning, dietary advice, optometry and occupational therapy.

Australian Refined Diagnosis Related Groups (AR-DRG)

An Australian patient classification system compromising a description of body systems, a separation of medical and surgical procedures, and a description of a hierarchy of procedures, medical problems and other factors that differentiate processes of care (Australian Government Department of Health and Ageing, 2008)

Australian Standard Geographical Classification (ASGC)

The ASGC provides a common framework of statistical geography and thereby enables the production of statistics which are comparable and can be spatially integrated. In this publication, the only ASGC classifications referred to are Capital City Statistical Division and Rest of state/territory.



Australian Statistical Geography Standard (ASGS)

The ASGS replaces the ASGC. In this publication, the only ASGS classifications referred to are Metro (metropolitan area of Australia, eg Sydney, Geelong) and Rural.



Available beds

Available beds are those immediately available (occupied and unoccupied) for the care of admitted patients as required. In the case of Free-standing day hospital facilities, they include chairs, trolleys, recliners and cots and are used mainly for post-surgery recovery purposes only. See also Beds and Occupied beds.

Average length of stay in hospital

This is calculated by dividing the aggregate number of patient days by the number of separations associated with those patient days.

Beds/chairs

These are provided for the care and treatment of admitted (same-day and overnight-stay) patients. See also Available beds and Occupied beds.

Bed occupancy rate

Is calculated by dividing patient days by the product of average number of beds and the number of days in the year (365 days in 2008-09) and expressed as a percentage.

Equation: ZZ OLD glossary_occ_rate

Capital expenditure

Refers to expenditure on acquisition or enhancement of an asset (excluding financial assets). Examples are: expenditure on land and buildings, computer facilities, major medical equipment, plant and other equipment, and expenditure in relation to intangible assets, having regard to guidelines followed as to the differentiation between capital and recurrent costs.

Chain volume measures

Chain volume measures are derived by revaluing the original current price series of recurrent expenditure for private hospitals by a specifically compiled measure of price change. See Explanatory Note 25 for further information.

Emergency departments

A bona fide emergency department is a department that provides levels 4 to 6 of emergency services as defined by the guide to the Role Delineation of Health Services, 3rd edition, New South Wales, Department of Health, 2002. Six levels of emergency services roles are identified:

      Level 0 - No service
      Level 1 - No planned emergency service
      Level 2 - Emergency service in small hospital. Designated assessment and treatment area. Visiting medical officer on call.
      Level 3 - As Level 2 plus designated nursing staff available 24 hours. Has 24 hour access to medical officer(s) on site or available within 10 minutes. Specialists in general surgery, anaesthetics, paediatrics and medicine available for consultation. Full resuscitation facilities in separate area.
      Level 4 - As Level 3 plus can manage most emergencies. Purpose designed area. Full-time director. Experienced medical officer(s) and nursing staff on site 24 hours. Specialists in general surgery, paediatrics, orthopaedics, anaesthetics and medicine on call 24 hours.
      Level 5 - As Level 4 plus can manage all emergencies and provide definitive care for most. Has undergraduate teaching and undertake research. Has designated registrar. May have neurosurgery service.
      Level 6 - As Level 5 plus has neurosurgery and cardiothoracic surgery on site. Sub-specialists available on rosters. Has registrar on site 24 hours.

Factors influencing health status and contact with health service

These factors relate to occasions when circumstances other than a disease, injury or external cause are recorded as "diagnoses" or "problems". This can arise in two main ways:
  • when a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination or to discuss a problem which is in itself not a disease or injury;
  • when some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

For profit/not for profit sector

'Not for profit' hospitals are those which qualify as a non-profit organisation with either the Australian Taxation Office (ATO) or the Australian Securities and Investments Commission. These are further categorised as 'Religious or charitable' and 'Other' (comprising bush nursing, community and memorial hospitals). All other hospitals are classed as 'For profit'.

Frame

The list of units available for selection in a census or sample survey. In this case, all licensed private hospitals operating during the reference period comprise the frame. This list is supplied by the State and Territory Health Authorities (SHAs) and the Private Health Insurance branch of the Department of Health and Aging (DoHA).

Free-standing day hospital facilities

These provide investigation and treatment for acute conditions on a day-only basis and are approved by the Commonwealth for the purposes of basic table health insurance benefits.

Full-time equivalent staff

Full-time equivalent staff represent the sum of full-time staff and the full-time equivalent of part-time staff during the last week of the pay period ending on of before 30 June, or for a typical week of hospital operation. It is derived by adding the on-job hours worked and hours of paid leave (sick, recreation, long service, workers' compensation leave) by/for a staff member divided by the number of hours normally worked by a full-time staff member when on the job under the relevant award or agreement. See also Staff.

Gross capital expenditure

Gross capital expenditure refers to expenditure in a period on the acquisition or enhancement of an asset (excluding financial assets), such as buildings and building construction, information technology, major medical equipment and transport.

ICD

International Statistical Classification of Diseases and Related Health Problems. The purpose of the ICD is to permit the systematic recording, analysis, interpretation and comparison of mortality and morbidity data collected in different countries or areas and at different times. The ICD, which is endorsed by the World Health Organisation (WHO), is primarily designed for the classification of diseases and injuries with a formal diagnosis. Further information is available from the WHO web site <www.who.int>.

Income

Three categories of income are identified:
      Patient income includes income/revenue received by, and due to, the hospital in respect of patient liability for accommodation and other fees (including for prostheses), regardless of source of payment (Commonwealth, state and local government, private health fund, insurance company, direct from patient, payment from third parties such as Workcover payments) or status of patient (whether admitted or non-admitted patient). Excluded is GST.

      Recoveries include income received from rental of hospital facilities including facility fees paid by medical practitioners, meals and accommodation for staff, TV, telephone and Internet fees. Income for extraordinary items, GST, and Australian Government Paid Parental Leave Scheme are excluded.

      Other income includes income received from car parks, sales of goods and services, sponsorship and fundraising, interest/investment, dividends, meals and accommodation for visitors, sundry income, net profit (or loss) on the sale of assets. Income for extraordinary items, GST, and Australian Government Paid Parental Leave Scheme are excluded as are payments received from state or territory governments.
      .
Labour costs

Includes employer contributions into superannuation funds, workers' compensation premiums/costs, payroll tax, wages and salaries including provisions for employee entitlements, contract payments for medical services.

Net capital expenditure

Net capital expenditure refers to gross capital expenditure less disposals of capital assets items such as buildings and building construction, information technology, major medical equipment and transport.

Net operating margin

Net operating margin is derived by subtracting recurrent expenditure from income and expressing the result as a proportion of income.

Occasions of service

Any services provided to a non-admitted patient in a functional unit (e.g.radiology) of the hospital. Each diagnostic test or simultaneous set of related diagnostic tests is counted as one occasion of service.

Occupied beds

The number of occupied beds is calculated by multiplying the number of average available beds by the occupancy rate. See also Beds, Available Beds, and Bed Occupancy Rate.

Other domestic services

Includes staff services, accommodation, bedding and linen, hardware, crockery, cutlery, laundering and cleaning of uniforms.

Other specialised units/wards

Includes neurosurgical unit, acute spinal cord injury unit, burns unit, major plastic/reconstructive surgery unit, transplantation units, acute renal dialysis unit, infectious diseases unit, comprehensive epilepsy centre, clinical genetics unit, AIDS unit, diabetes unit, in-vitro fertilisation unit, post-acute rehabilitation units and other specialised services.

Patient

A patient is a person for whom a hospital accepts responsibility for treatment and/or care.

An admitted patient undergoes a hospital's formal admission process. Babies born in hospital are excluded unless they are provided with medical care other than that which would normally be provided to a newborn, or they remain in hospital after the mother has been discharged, or are the second or subsequent live born infant of a multiple birth and the mother is currently an admitted patient. Persons accompanying a sick patient (e.g. nursing mothers and parents accompanying sick children) are also excluded.

Overnight-stay patients are admitted to and separated from hospital on different dates (i.e. they stay at least one night in hospital).

Same-day patients are admitted and separated on the same day (i.e. they are in hospital for a period that does not include an overnight stay).

Non-admitted patients do not undergo a hospital's formal admission process. These include outpatients, accident and emergency patients and off-site (community/outreach) patients.

Patient days

These are the aggregate number of days of stay (i.e. calculated as separation date minus admission date) for all overnight-stay patients who were separated from hospital during the year. Periods of approved leave are subtracted from these calculations. Same-day patients are each counted as having a stay of one day.

Patient income

Includes revenue received by, and due to, the hospital in respect of patient liability for accommodation and other fees, regardless of source of payment (Commonwealth, health fund, insurance company, direct from patient) or status of patient (whether admitted or non-admitted patient). It does not include recoveries (i.e. income received from items such as staff meals and accommodation, and facility fees paid by medical practitioners) or Other income (i.e. income such as investment income from temporarily surplus funds and income from charities, bequests, meals and accommodation provided to visitors, and kiosk sales).

Patient insurance status

Indicates whether or not hospital insurance is held by a patient through a registered health insurance fund, or a general insurance company. Patients who have insurance cover only for ancillary services are regarded as not having hospital insurance.


Patient separation

Occurs when an admitted patient:
  • is discharged
  • is transferred to another institution
  • leaves against medical advice
  • dies whilst in care
  • changes their type of care from/to acute, rehabilitation, palliative or non-acute care (known as statistical discharge), or
  • leaves hospital for a period of seven or more days.

Procedure

A clinical intervention that:
  • is surgical in nature; and/or
  • carries a procedural risk; and/or
  • carries an anaesthetic risk; and/or
  • requires specialised training; and/or
  • requires special facilities or equipment only available in an acute care setting.

For admitted patients, procedures undertaken during an episode of care are recorded in accordance with ICD-10-AM 6th edition.

Psychiatric hospitals

Psychiatric hospitals are licensed/approved by each state or territory health authority and cater primarily for admitted patients with psychiatric, mental or behavioural disorders.

Recurrent Expenditure

Comprises expenditure on wages and salaries and other labour costs, drug, medical and surgical supplies, food supplies, domestic services, administrative expenses, fuel and power, purchases of finished goods, patient transport, repairs and maintenance, contract services, depreciation and amortisation, non-labour contract expenses and other recurrent expenditure. For further information refer to the National Health Data Dictionary which is available on the AIHW web site www.aihw.gov.au.

Repairs and maintenance

Includes costs of maintaining, repairing, replacing and providing additional equipment, maintaining and renovating buildings, and minor additional works.

Separation

Discharge from private hospital facility. See Patient Separation.

Specialised service


A facility or unit dedicated to the treatment or care of patients with particular conditions or characteristics.

Staff

Includes:
  • staff employed by the hospital and contract staff employed through an agency in cases where the contract is for the supply of labour;
  • nursing staff, comprising registered nurses and enrolled nurses;
  • administrative and clerical staff, including computing staff, finance staff and civil engineers;
  • domestic and other staff includes staff, includes including trades people, maintenance staff and staff engaged in cleaning, laundry services, the provision of food;
  • diagnostic and health professionals, including qualified diagnostic health professionals, allied health professionals and laboratory technicians.

Statistical discharge - type of care change

This is how hospitals record situations where changes in the type of care patients are receiving occur but do not result in the patients actually leaving the hospital. It is recorded as a discharge but only for statistical purposes. Examples of these are when the type of care changes from/to acute, rehabilitation, palliative or non-acute care

Statistical divisions

These are groupings of the whole or part of legal local government areas. They are designed to be relatively homogeneous regions characterised by identifiable social and economic units within the region. Capital City Statistical Divisions, shown in some tables of this publication, comprise Sydney, Melbourne, Brisbane, Adelaide, Perth, Greater Hobart, Darwin and Canberra.

Type of centre

Free-standing day hospital centres are categorised by type according to their main economic activity. The following types of centres are separately categorised:
  • general surgery
  • specialist endoscopy
  • ophthalmic
  • plastic/cosmetic
  • gynaecology
  • dental
  • oral and maxillofacial surgery
  • oncology
  • dialysis
  • family planning
  • fertility treatment
  • other (which includes sleep disorder clinics).

Wages and salaries (including on-costs)

Includes wages and salaries, superannuation employer contributions, payroll tax, workers' compensation and workcare premiums, uniforms, education, personnel costs and fringe benefits tax.