ABOUT THIS PUBLICATION
This publication presents details from the 2003-04 national census of private hospitals. Three categories of hospitals are identified: acute hospitals, psychiatric hospitals and free-standing day hospital facilities.
There are relatively few psychiatric hospitals and some of these are owned by the same parent company. To maintain the confidentiality of their data, psychiatric hospitals are combined with acute hospitals in most tables in this publication. Any differences between the data given in this publication and the data shown in other reports on hospital activity are due to differences in scope and coverage, relative completeness of the data sources and differing error resolution procedures.
CHANGES IN THIS PUBLICATION
The structure of this publication has been changed from previous years. All Hospitals, private acute and psychiatric hospitals, and free-standing day hospital facilities are separated into individual chapters. Tables 6 and 7 from the 2002-03 publication have been combined and now form Table 2.5 (Private acute and psychiatric hospitals, separations, patient days, average length of stay and bed occupancy rates, by hospital type and hospital size, Australia). Dedicated day surgery units have been included in counts of selected specialised wards and units in private acute and psychiatric hospitals (Table 2.8).
For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070.
This publication presents data for the private hospital sector in 2003-04. Comparable data for public hospitals is available in Australian Hospitals 2003-04, produced by the Australian Institute of Health and Welfare (AIHW). According to the AIHW, nearly 4 in ten hospital patients in Australia were admitted to private hospitals in 2003-04, representing nearly one-third of all days of hospitalisation.
There were 525 private hospitals operating in Australia in 2003-04 compared with 536 in 2002-03. This decrease of 2.1% in the total number of private hospitals was reflected in both acute and psychiatric (1.7%) and free-standing day hospitals (2.5%). This is the first downturn in the number of free-standing day hospitals since 1993-94. Despite this decrease, the number of available beds and chairs increased 2.0% from 26,364 in 2002-03 to 26,589 in 2003-04. Similarly, total patient separations increased by 3.3% (2.6m in 2002-03 to 2.7m in 2003-04). Private hospitals provided 7.3m days of hospitalisation to patients in 2003-04, an increase of 1.0% from 7.2m in 2002-03. Staff numbers also increased by 2.2% to 48,577 people (full-time equivalent).
Sex and Age
There was little change in the characteristics of private hospital patients with females accounting for 55.1% of all patient separations, and people aged 65 and over accounting for 35.4% of all patient separations. Overall, there were 147 patient separations per 1,000 population for females and 122 patient separations per 1,000 population for males.
The proportion of patient separations reported as being covered by hospital insurance continued to increase for all private hospitals. In 2003-04, 80.1% of patient separations reported having hospital insurance compared with 77.7% in 2002-03 and 71.3% in 1999-2000. Patient separations reported being covered by hospital insurance in private acute and psychiatric hospitals rose by 2.6% with a similar rise of 2.3% for free-standing day hospitals.
All Private Hospitals, Hospital insurance (a)
The total number of procedures increased by 5.4 % from 5.6 million in 2002-03 to 5.9 million in 2003-04. Of these procedures, 4.9 million were performed in acute and psychiatric hospitals and the remainder in free-standing day hospitals. The greatest proportion of procedures were non-invasive, cognitive and interventions nec (42.6%) followed by procedures on the digestive system (12.6%). This pattern is reflected in both the acute & psychiatric and free-standing day hospitals.
Examples of non-invasive and cognitive interventions are services such as dietary education and exercise therapy (often used for development of treatment plans, programs, case reviews or follow up to previous procedures performed). For further details of the classification refer to Volume 3 International Statistical Classification of Diseases and Related Health Problems, 10th Revision-Australian Modification (ICD-10-AM).
For acute and psychiatric hospitals, non-invasive, cognitive and interventions, nec accounted for 43.8% of all procedures performed in 2003-04, up from 42.7 % in the previous year. The next most common procedures in acute and psychiatric hospitals were on the digestive system (10.6 %), the musculoskeletal system (6.7 %) and dermatological and plastic procedures (4.4%).
For free-standing day hospitals. non-invasive, cognitive and interventions, nec accounted for the highest proportion of all procedures performed on patients in 2003-04 at 36.9%. This is followed by procedures on the digestive system (21.7 %), dermatological and plastic procedures (8.2 %) and the eye and adnexa (7.7%).
The most common principal diagnosis for separations from all private hospitals was Factors influencing health status and contact with health services (19.2%) followed by Diseases of the Digestive system (16.2%). This was similar to 2002-03 where Factors influencing health status and contact with health services comprised 18.7% of patient separations and Diseases of the Digestive System comprised 16.6% of patient separations.
Mode of Separation
The majority (96.9%) of all patients were discharged to their place of usual residence in 2003-04. Patient separations discharged to usual residence increased by 2.4% for private acute and psychiatric hospitals and 7.1% for free-standing day hospitals since 2002-03. For private acute and psychiatric hospitals, Queensland showed the greatest increase of 7.0% with Victoria reporting the lowest increase of less than 1%. These changes can be attributed to the overall increase in patient separations for both private acute and psychiatric and free-standing day hospitals.
The number of those patients discharged from a private acute and psychiatric hospital to another hospital increased slightly overall from 37.3% in 2002-03 to 37.6% in 2003-04. New South Wales and Queensland increased transfers by 13.7% and 6.1% respectively while in the remainder of Australian states and territories, transfers to other hospitals dropped by 5.9%.
INCOME & EXPENDITURE
While the number of private hospitals has declined, patient activity continues to grow with total income generated at $6,274m in 2003-04, up from $5,758m in 2002-03. Total income from private acute and psychiatric hospitals was $5,933m which accounted for 94.6% of all private hospital income.
Total recurrent expenditure for all private hospitals increased by 8.5% to $5,859m in 2003-04 from $5,401m in 2002-03. The proportion of wages and salaries attributed to recurrent expenses dropped 1.1% for private acute and psychiatric hospitals to 51.5% and 1.9% for free-standing day hospitals to 39.2%.
The private hospital sector invested $331m in building and other capital assets in 2003-04, with private acute and psychiatric hospitals increasing investment from $290m in 2002-03 to $309 in 2003-04. Conversely, free-standing day hospitals decreased investment from $24m in 2002-03 to $22m in 2003-04.
NET OPERATING MARGIN
Net operating margin is derived by subtracting recurrent expenditure from income and expressing the result as a proportion of income. The net operating margin for acute and psychiatric hospitals during 2003-04 was 6.0%, remaining steady at the level of the previous year. For free-standing day hospital facilities, the net operating margin was much higher at 17.1%, slightly higher than the previous year's percentage of 15.6%, but consistent with the previous five years.
All Private Hospitals, Net Operating Margin
Hospital accreditation has been identified as an indicator of capability within the National Health Performance Framework (for further information refer to Australian Hospitals 2003-04, produced by Australian Institute of Health and Welfare (AIHW)).
As at the 30 June 2004, the main organisations used by hospitals to obtain accreditation were Australian Council on Healthcare Standards (ACHS)(used by 406 hospitals) and Benchmark Certification (used by 76 hospitals).