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HOSPITAL VISITS

Definition

This topic refers to information collected about respondents' hospital visits, including admissions, casualty/emergency, outpatients, and day clinics for the respondent's own health.

Population

Information was obtained for all persons in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS).

Methodology

For the purposes of this survey, a hospital was defined as an institution which offers residential health care, other than a nursing or convalescent home. Only visits related to the respondent's own health were included; visits such as taking another sick or injured person to emergency are excluded. Visits to dental hospitals, which are sometimes attached to a hospital as part of the outpatients section are also excluded from this topic; these cases were recorded under dental consultations (see Dental consultations for more information).

In order for an admission to hospital to be counted, the stay in hospital must have commenced with formal admission and ended in formal discharge, with discharge taking place in the 12 months prior to interview. However, in some cases persons who had not been discharged may be included; this may occur when persons who were technically still admitted patients were enumerated when home on day release or as hospital-at-home patients. Length of stay in these cases would be recorded as the period from admission to date of interview.

Day clinics, which are often attached to or operate as part of a hospital, offer minor surgery or diagnosis procedures such as scans, ultrasounds, endoscopies, cardiac tests, etc. They do not offer residential health care in the same way as hospitals but in some cases a visit may result in an overnight stay. Included in the survey are all reported visits to day clinics, except those visits solely for the purpose of an X-ray.

Information collected on hospital visits varied between the non-remote and remote areas. Each received a different set of questions for which conceptually consistent responses were categorised together for output purposes. The medical reasons for hospitalisation were not recorded.

Non-remote

Non-remote respondents were asked whether they had been to the outpatients section of a hospital for their own health in the last 2 weeks, and if so, how many times. Further details were obtained about whether this visit was related to a previous admission to hospital, and if not, whether the visit related to an expected admission to hospital.

Non-remote respondents were asked whether they had been to a casualty or emergency ward for their own health in the last 2 weeks, excluding times resulting in the respondent being admitted to hospital. If yes, respondents were asked how many times they had been to a casualty or emergency ward.

Non-remote respondents were asked whether they had been to a day clinic for minor surgery or diagnostic tests, other than x-rays, for their own health in the last 2 weeks, excluding visits to outpatients and casualty or emergency. If yes, respondents were asked how many times they had been to a day clinic.

Non-remote respondents were asked whether they had been admitted to hospital in the 12 months prior to interview, excluding visits to outpatients, casualty/emergency ward or day clinics, and the number of times admitted in that 12 month period. Further details were obtained about the respondent's most recent admission to hospital in the last 12 months, including whether this was an overnight stay, length of stay (number of nights in hospital), whether they had been discharged in the two weeks prior to interview, whether they had been admitted as a Medicare or Private patient, and whether they had stayed in a public or private hospital. If they chose not to be admitted as a Medicare patient, the respondent was asked the reason for doing so. These questions were asked after questions about recent visits to casualty and outpatients units, and questions about recent visits to day clinics, to minimise the risk of respondents reporting these visits as hospital admissions.

Remote

Remote respondents were asked whether they had stayed overnight in a hospital in the 12 months prior to interview, and how many times they had been to hospital and stayed overnight in that 12 month period. Further details were obtained about the respondent's most recent overnight stay in the last 12 months, including number of nights in hospital and whether they had been discharged in the two weeks prior to interview. These questions were asked prior to questions about recent visits to casualty and outpatients units so that hospital admissions could be defined clearly as an overnight stay at hospital.

Remote respondents were then asked whether they had visited an outpatients, emergency or casualty department at a hospital because they were hurt or sick in the last 2 weeks, and how many times they did so in the last 2 weeks.

All respondents, from both non-remote and remote areas, were then asked whether they needed to go to hospital in the previous 12 months but didn't. If yes, this was followed by a question regarding the reason they didn't go from the below responses:

• Cost
• Discrimination
• Service not culturally appropriate
• Language problems
• Transport/distance
• Does not trust the hospital
• Waiting time too long or not available at time required
• Not available in area
• Too busy (including work, personal, family responsibilities)
• Dislikes service/professional, afraid, embarrassed
• Felt it would be inadequate
• Decided not to seek care
• Other

• Patient type at most recent hospital admission refers to the patient type as reported by respondents, not to the type of hospital to which admitted; a person may be a private patient at either a public or private hospital.
• In non-remote areas, a person may legitimately have reported no nights in hospital if admitted and discharged on the same day.
• The wording of the questions, and their sequencing after questions about visits to casualty/emergency and outpatients sections at hospitals, were designed to ensure that, as far as possible, respondents did not report use of hospital services (outpatient clinics in particular) as visits to day clinics or vice versa. However, some crossover in reporting between hospital and day clinics may have occurred, particularly for cases where day clinics are located on hospital premises.
• Although interviewers provided guidance to respondents if queried, in non-remote areas the decision to report a visit against casualty/emergency or outpatients was the respondent's choice. While the distinction between casualty/emergency and outpatients units could be expected to be clear-cut in most cases, the potential for respondents to confuse outpatients with day clinics, or possibly outpatients with day admissions may have affected results. In remote areas, casualty/emergency and outpatients were not collected separately, furthermore, day clinic data were not collected.
• Responses to the question about reasons a respondent didn't go to the health professional require interpretation by respondents on a perceived 'need' to go to the service or health professional. Some respondents may have interpreted this as being a medical emergency, while others may have interpreted it to include routine check-ups.
• Respondents may have needed to go to the service or health professional. However, due to being unable to access the particular service or health professional, may have sought care elsewhere. Respondents may then have seen the need as not being relevant as they received attention and therefore respond in the negative to the question.