Appendix H: Data

Separations in public and private hospitals, by service related group

Separations data in public and private hospitals is collected (amongst other methods) through casemix classification. This data gives an indication of the service levels for different specialties in the public and private hospital sector.

Table 1: Separations in public and private hospitals, by service related group, 2003-04

		Public hospitals	Private hospitals
Cardiology		216,723	44,793
Interventional cardiology		54,323	60,541
Dermatology		19,062	4,059
Endocrinology		43,486	9,717
Gastroenterology		126,365	48,121
Diagnostic gastointestinal endoscopy		145,194	350,261
Haematology		101,248	45,746
Immunology and infections		89,751	17,486
Medical oncology		53,694	36,237
Chemotherapy		127,675	144,157
Neurology		127,595	25,276
Renal medicine		39,413	10,600
Dialysis		620,649	133,621
Respiratory medicine		214,111	70,392
Rheumatology		13,857	4,682
Pain management		17,402	21,657
Non-subspecialty medicine		249,145	86,769
Breast surgery		15,782	16,264
Colorectal surgery		36,879	37,432
Upper gastrointestinal surgery		55,184	30,838
Head and neck surgery		9,872	14,163
Dentistry		24,563	78,749
Ear nose and throat		75,406	74,414
Orthapaedics		254,016	243,363
Opthalmology		77,014	144,787
Plastic Surgery		89,812	126,802
Urology		111,921	107,001
Vascular surgery		38,554	30,862
Non-subspecialty surgery		271,259	131,154
Extensive burns		2,022	177
Tracheostomy		8,005	1,340
Gynaecology		161,397	180,337
Obstetrics		278,819	93,356
Qualified neonates		55,928	14,494
Drug and alcohol		65,868	18,739
Psychiatry		125,156	88,922
Non-acute psychiatry		4,348	11,017
Rehabilitation		78,536	57,866
Geriatric		12,199	1,151
Palliation		19,571	5,357
Maintenance		24,699	2,616
Psychogeriatric		1,581	7,900

Figure 3: Separations in public and private hospitals, by service related group (selected), 2003-04

Principal diagnosis

The following data has been extracted from the Australian Institute of Health and Welfare publication Australian Hospital Statistics 2003-04 (2005). It is taken from Tables S9.1 and S9.2, Selected Separation Statistics for all principal diagnoses in 3 character ICD-10-AM groupings, public and private hospitals (respectively), Australian, 2003-04.

The data have been aligned to selected specialties (those used in the analysis of Chapter 5, where applicable) using International Classification of Disease coding, by World Health Organisation. It is noted that the principal diagnoses are actually for ICD-10-AM. The ICD-10-AM is the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification. Thus, there may be slight differences between the two different classifications used to make the alignment.

Gastroenterology

It has been assumed that Block K, Diseases of the digestive system, of the International Classification of Disease is broadly representative of gastroenterology services in hospitals. The importance of the private hospital sector for disease of the digestive system is clear (see table below).

Table 2: Separations in public and private hospitals, principal diagnoses, ICD-10-AM block K, 2003-04

Public

Separations 359,507
Same day separations 165,207
Patient days 1,047,077

Private

Separations 423,935
Same day separations 319,001
Patient days 691,928

Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2003-04 (2005)

Obstetrics and gynaecology

It has been assumed that Block O, Pregnancy, childbirth and the puerperium, of the International Classification of Disease, is broadly representative of obstetric services in hospitals. It is difficult to easily define gynaecological services using the International Classification of Disease, so this has not been attempted.

Table 3: Separations in public and private hospitals, principal diagnoses, ICD-10-AM block O, 2003-04

Public

Separations 309,114
Same day separations 77,436

Private

Separations 140,609
Same day separations 52,677

Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2003-04 (2005)

Dermatology

It has been assumed that Block L, Diseases of the skin and subcutaneous tissue, of the International Classification of Disease, is broadly representative of dermatology services in hospitals.

Table 4: Separations in public and private hospitals, principal diagnoses, ICD-10-AM Block L, 2003-04

Public

Separations 78,101
Same day separations 30,024

Private

Separations 41,571
Same day separations 27,505

Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2003-04 (2005)

Psychiatry

It has been assumed that Block F, Mental and behavioural disorders, of the International Classification of Disease, is broadly representative of psychiatry services in hospitals.

Table 5: Separations in public and private hospitals, principal diagnoses, ICD-10-AM Block F, 2003-04

Public

Separations 167,900
Same day separations 41,902

Private

Separations 119,068
Same day separations 88,319

Source: Australian Institute of Health and Welfare, Australian Hospital Statistics 2003-04 (2005)

Other psychiatry data

Taken from Australian Institute of Health and Welfare (AIHW) 2003. Mental health services in Australia 2000-01. Canberra: AIHW (Mental Health Services no. 4).

In 2000-01, private hospitals comprised 21.3% of overnight patient days per 1,000 population (26.3 patient days per 1,000 population compared with 123.4 in total). Of these overnight patient days, private hospitals had a greater length of stay - at 15.0 average days compared with 9.9 in public acute hospitals.

Ambulatory mental health care provided by hospitals (non admitted services) and community based mental health care services accounted for 37.1% of state and territory expenditure on
mental health services for 1999–00 (DHA 2002).

However, results from the National Survey of Mental Health and Wellbeing 1997 indicated that this imbalance does not reflect the relative use of these types of services. Most people with mental illness receive mental health care through ambulatory care services (eg 77.4% of those who used services saw general practitioners) rather than through admission to hospital (less than 1%) (ABS 1998a). The National Mental Health Policy also emphasises the promotion of a community-based system of treatment and support. Overall, there were 3.6 million mental health service contacts per 1,000 population in 2000-01, in public community mental health services.

In 2000-01 there were 64,551 separations for the principal diagnosis of depressive episode (ICD F32-33). Of these separations, 53% were in the private sector.