1. APHA Facts on Private Hospitals
Service Provision
APHA Facts on Private Hospitals

2. About this document:
Private hospitals are a vital partner with the public sector in the provision of a wide range of services. Contrary to the views expressed by some commentators, the private hospitals sector DOES NOT merely provide ‘profitable’ services (whatever these may actually be). The following slides describe the services provided by the private hospitals sector in Australia. Detailed interpretative notes are provided in the comments accompanying each slide. The data has been sourced from: Australian Hospital Statistics, published by Australian Institute of Health and Welfare (AIHW).

3. Admitted Patient Care
The private hospitals sector treat 40% of all patients in Australia.
Private hospitals treated 3,744,677 out of a total 9,256,169 hospital separations for admitted patients, in These included emergency and non-emergency separations, acute, sub-acute and non-acute separations. These figures include over-night and same-day separations but exclude services classified as ‘out-patient’ or ‘non-admitted’ services.
In , private hospitals and day surgeries provided 2.6 million same-day separations, accounting for 48% of all same-day separations and million overnight separations, accounting for more than 30% of all overnight separations in Australia.
(AIHW, a, p. 135, Table 7.19)
Private hospitals consistently accounted for about 40% of separations between 2007–08 and 2011–12.
(AIHW, a, p. 13, Table 2.7)
Admitted patient care, involves:
“Admission to hospital [which] is a formal process, and follows a decision made by a medical officer that a patient needs to be admitted for appropriate management or treatment of their condition, or for appropriate care or assessment of needs.” (AIHW, a, p. 12)
For statistical purposes, the Australian Instituted of Health and Welfare describes the quantum of admitted patient care provided in any one year in terms of “separations” occurring in that period.
“Separation is the term used to refer to the episode of admitted patient care, which can be a total hospital stay (from admission to discharge, transfer or death) or a portion of a hospital stay beginning or ending in a change of type of care (for example, from acute care to rehabilitation). Separation also means the process by which an admitted patient completes an episode of care by being discharged, dying, being transferred to another hospital or by a change of care type.”
The data presented in this chart does not include out-patient/non-admitted patient care
“Out-patient/Non-admitted patient: a patient who receives care from a recognised non-admitted patient service/clinic of a hospital.“(AIHW, a, p. 114, Table 7.1)

4. Patient Days
The private hospital sectors provide more than 30% of all patient days in Australia.
Private hospitals provided 8.7 million out of 27.7 million days of hospitalisation to admitted patients, in
(AIHW, a, p. 19, Table 2.12)
The average length of stay per separation was longer in the public sector, at 3.4 days, than in the private sector, at 2.3 days. Same-day separations accounted for 51% of public hospital separations and 69% of private hospital separations. The average length of stay for overnight separations in public hospitals was 6.0 days while it private hospitals it was 5.3 days.
(AIHW, a, p. 143, Table 7.27)

5. Hospital Beds
Private hospitals and day surgeries provide 1 out of every 3 beds in Australia.
The private hospital sector (both private hospitals and private day hospitals) provides a total of around 28,350 beds. This accounts for nearly 33% of all hospital beds in Australia. Note that the above figures are reflect the average number of available beds during
(AIHW, b, pp. 2, 56-59, Box 4.1 and Table 4.1)

6. Service Categories
Private hospitals and day surgeries provide the following broad categories of service:
This chart shows the proportion of total separations (same-day and overnight) provided in each broad category of services.
Surgical 37% (1,387,686 separations)
Medical 37% (1,374,287 separations)
Other 20% (761,831 separations)
Specialist mental health 4% (140,091 separations); and
Childbirth 2% (80,782 separations)
(AIHW, a, p. 135, Table 7.19)
These services are define by AIHW as follows:
“Surgical: separations for which the AR-DRG belonged to the Surgical partition (involving an operating room procedure), excluding separations for Childbirth and Specialist mental health.
“Medical: separations for which the AR-DRG belonged to the Medical partition (not involving an operating room procedure), excluding separations for Childbirth and Specialist mental health.
“Other: separations for which the AR-DRG did not belong to the Surgical or Medical partitions (involving a non-operating room procedure, such as endoscopy), excluding separations for Childbirth and Specialist mental health.
“Specialist mental health: separations for which specialised psychiatric care days were reported, excluding separations for Childbirth.
“Childbirth: separations for which the AR-DRG was associated with childbirth (does not include newborn care).”
(AIHW, a, p. 136)

7. Private Hospital patient Cohorts
This chart shows the principal source of funds for the admitted patient episode (same-day and overnight) in private hospitals.
Private health 81% (3,029,670 separations or 8 out of every 10 separations)
Public patients 3% (110,131 separations or 1 out of every 30 separations)
“Public patients: includes separations for Medicare-eligible patients who elected to be treated as a public patient and separations with a funding source of Reciprocal health care agreements, Other hospital or public authority (with a public patient election status) and No charge raised (in public hospitals). The majority of separations with a funding source of No charge raised (in public hospitals) were in Western Australia, reflecting that some Public patient services were funded through the Medicare Benefit Schedule.”
Self-funded 8% (299,032 separations or 1 out of every 10 separations)
Workers compensation 2% (65,869 separations or 1 out of every 50 separations)
Motor vehicle third party personal claim 0.2% (7,197 separations or 1 out of every 500 separations)
Department of Veterans’ Affairs 5% (193,041 separations or 1 out of every 20 separations)
Other 1% (39,737 separations or 1 out of every 100 separation)
“ Other: includes separations with a funding source of Other compensation, Department of Defence, Correctional facilities, Other hospital or public authority (without a Public patient election status), Other, No charge raised (in private hospitals) and not reported.”
(AIHW, a, p. 142, Table 7.25)
The above figures do not include care provided to the outpatient/non-admitted patients in public or private hospitals.

8. Elective Surgery
Private hospitals and day surgeries perform 2 out of every 3 elective surgeries.
Private hospitals and Day surgeries treated 1,339,422 out of a total of 2,015,570 separations involving elective surgery in These included separations for which the care type was reported as Acute and separations for Newborn (with at least one qualified day) but excluded records for which the level of urgency was not reported. (AIHW, a, p. 213, Table 10.3)
In the Northern Territory, urgency of admission for private hospital separations was missing for all records. The AIHW classified all these separations as elective. Consequently the number of private sector separations involving elective surgery may be slightly over-counted.
It should be noted that the definition used here is not the same as the definition used for the National Elective Surgery Waiting Times Data Collection (NESWTDC). For the NESWTDC, elective surgery comprises elective care (admission could be delayed by at least 24 hours), where the procedures required by patients are listed in the surgical operations section of the Medicare Benefits Schedule, with the exclusion of specific procedures frequently done by non-surgical clinicians (AIHW 2012f).

9. Chemotherapy Treatment
Private hospitals and day clinics provide more than 45% of chemotherapy treatments.
Private hospitals and day clinics provided 226,933 out of total 368,809 same-day acute separations related to chemotherapy, in
(AIHW, a, p. 174, Table 8.11)
Public hospitals provided individual outpatients with 128,677 occasions of service related to chemotherapy, in The number of occasions of service provided to chemotherapy outpatients by private hospitals is unknown.
(AIHW, a, p. 104, Table 6.4)
Figures for admitted patients and outpatients are not strictly comparable because an occasion of service may not necessarily involve the administration of a chemotherapy infusion however it is possible to infer that private hospitals and day clinics provide more 60 % of chemotherapy services for patients admitted on a same day basis and more than 45% of chemotherapy treatments overall.
The number of chemotherapy treatments delivered during overnight separations in either private or public settings is unknown although it is relatively small .

10. Eye Surgery
Private hospitals and day surgeries perform 70% of eye surgeries.
Private hospitals and day surgeries provided 227,115 out of a total of 319,986 separations involving procedures on the eye and adnexa.
(AIHW, a, p 139, Table 7.22)
Of these separations 216,650 were day only separations and 10,456 were overnight separations provided by private hospital and day surgeries. (AIHW, a, pp. 175 and 196, Tables 8.12 and 9.12)
A ‘procedure’ is defined by the AIHW as :
“a clinical intervention that is surgical in nature, carries a procedural risk,
carries an anaesthetic risk, requires specialised training and/or requires special
facilities or equipment available only in an acute care setting.” (AIHW, a, p330)
Almost all private hospital separations related to diseases of the eye and adnexa involved procedures. Private hospitals and day surgeries provided 230,298 out of total 323,512 separations related to diseases of the eye and adnexa, in
(AIHW, a, p. 128, Table 7.10)
Private hospitals and day surgeries provided 219,723 out of total 300,155 same-day separations and 10,568 out of total 23,321 overnight separations related to diseases of the eye and adnexa, in
(AIHW, a, pp. 170 & 191, Tables 8.7 & 9.7)
The above figures do not include ophthalmology care provided to the outpatient/non-admitted patients in public or private hospitals.

11. Cardiac Procedures Private hospitals perform 47% of heart surgeries.
Private hospitals provided 89,592 out of 194,910 overnight acute separations related to procedures on cardiovascular system, in
(AIHW, a, p. 196, Table 9.12)
Private hospitals provided 45,133 out of 91,012 same-day separations related to procedures on cardiovascular system, in
(AIHW, a, p. 175, Table 8.12)
A ‘procedure’ is defined by the AIHW as :
“a clinical intervention that is surgical in nature, carries a procedural risk,
carries an anaesthetic risk, requires specialised training and/or requires special
facilities or equipment available only in an acute care setting.” (AIHW, a, p330)
A surgical procedure is a procedure used to define surgical AR-DRGs in version 6.0x.
(AIHW, a, p. 333)
Note: the above figures do not include cardiology care provided to the outpatient/non-admitted patients, by outpatient clinic type, in public and/or private hospitals.

12. Rehabilitation Services
Private hospitals treat more than 70% of people admitted for rehabilitation.
Private hospitals treated 226,887 out of total 322,449 separations related to rehabilitation care, in
(AIHW, a, p. 137 & 246, Tables 7.20 & 11.1)
Care type: the care type defines the overall nature of a clinical service provided to an admitted patient during an episode of care (admitted care), or the type of service provided by the hospital for boarders or posthumous organ procurement (other care). Admitted patient care consists of the following categories:
• Acute care
• Rehabilitation care
• Palliative care
• Geriatric evaluation and management
• Psychogeriatric care
• Maintenance care
• Newborn care
• Other admitted patient care—this is where the principal clinical intent does not meet the criteria for any of the above.
Other services include:
• Posthumous organ procurement
• Hospital boarder.
(AIHW, a, p )
The Consultative Committee on Private Rehabilitation (CCPR) has developed the Minimum Requirements for Private Hospital-Based Rehabilitation Services (the Minimum Requirements). The Guidelines are intended to provide guidance to hospitals and health funds in determining private health insurance benefits for private hospital-based rehabilitation care. Guidelines for Recognition of Private Hospital-Based Rehabilitation Services

13. Psychiatric Services
Private psychiatric hospitals care for 30,000 people every year.
In , 49 private hospitals providing specialist psychiatric services admitted 27,729 patients for psychiatric care. Of those patients, 21,378 had a total of 30,554 separations from overnight inpatient care (excluding brief overnight admissions for same-day procedures) with a mean length of stay of 20.4 days. Private hospitals also delivered 169,499 days of ambulatory care.
These 49 private hospitals include stand alone psychiatric hospitals and private hospitals with dedicated psychiatric units.
Because of differences in scope it is not possible to compare statistics published by AIHW and PMHA.
Source: Private Mental Health Alliance - Annual Statistical Report (PMHA‐ASR)‐2010‐2011,

14. Serving Older Australians
Private hospitals and day surgeries admitted 4 out of every 10 patients age over 65.
In , a total of 3.6 million separations were related to patients age 65 and over. Private hospitals treated more than 42% (that is, over 1.5 million) separations from this group age.
(AIHW, a, p , Tables 7.38 & 7.39)
In , patients age 65 and over represented 40.5% of all private hospital admissions and 37.8% of all public hospitals admissions.
In , a total of 1.1 million separations were related to patients age 85 and over. Private hospitals treated nearly 38% (that is, nearly 400,000) separations from this group age.
In , 6.3% of total private hospital treatments were for patients aged 85 years and older. Over the same period, 6.5% of total public hospital treatments were for this age group.

15. Serving Australian Veterans
Private hospitals and day surgeries admitted 6 out of every 10 DVA patients.
In , private hospitals provided care for 63% (that is, 193,041 out of 306,592 separations) of the Department of Veterans’ Affairs (DVA) patients.
(AIHW, a, p. 142, Table 7.25)
The above figures do not include care provided to the outpatient/non-admitted patients in public or private hospitals.

16. Sources:
AIHW ( a). Australian Institute of Health and Welfare. Australian Hospital Statistics. AIHW ( b). Australian Institute of Health and Welfare . Australian's hospitals as a glance. PMHA‐ASR (2010‐2011). Private Mental Health Alliance - Annual Statistical Report