Hospital Services Report

September quarter 2002 Notes

This document contains the most up-to-date information available at the time of preparation.

This Hospital Services Report is available on the Department of Human Services Internet site located at: http://www.health.vic.gov.au/hsr/index.htm

Design and production by Department of Human Services, Melbourne, Victoria.

September 2002

ii Contents

Introduction 1 1. Patients waiting for residential aged care placement 2 2. Hospital admitted patient activity 4 3. Access to emergency services 6 4. Access to critical care services 15 5. Access to elective surgery 17 6. Private health insurance 28 7. Glossary 29

iii Introduction

Consumers, health care providers and government all need information on the Access to Emergency Services quality of health services. Public access to information assists consumers to From 1 January 2002, emergency department data in this report are derived from understand the health care system, it assists providers of health services in electronic rather than paper-based reporting. planning and increases the accountability of the Department of Human Services to the people in the state of Victoria, Australia. A number of graphs and tables refer to major metropolitan hospitals. The major metropolitan hospitals include: The Hospital Services Report was introduced in 1995. This edition includes data Angliss Hospital for the September quarter 2002, which covers the months of July, August and Austin & Repatriation Medical Centre September. - Austin campus - Repatriation campus The information included in this report is often requested from the Department. Box Hill Hospital Since technical information of this nature is very difficult to interpret, each graph Dandenong Hospital and table needs to be carefully considered in the context of the complexity of the Frankston Hospital health care system. Department staff, hospital staff, general practitioners and Maroondah Hospital other health care professionals may be able to assist you to interpret this report. Monash Medical Centre - Clayton campus - Moorabbin campus Royal Melbourne Hospital St Vincent's Hospital Sunshine Hospital The Alfred The Northern Hospital Western Hospital

1 1. Patients waiting for residential aged care placement

How many patients are waiting for residential aged care placements?

Figure 1.1 Number of acute and sub acute patients waiting for residential aged care placement 1 2

Patients 800

700 614 600 574 565 128 Interim Care 500 123 Sub Acute 176 Acute 400 278 300 261 254 200

100 190 208 135 0 Mar-02 Jun-02 Sep-02

1 Hospitals reporting sub acute are Angliss, Anne Caudle, Bundoora Extended Care, Bethlehem, Broadmeadows, Caritas Christi, Caulfield General, Dandenong, Goulburn Valley, Grace McKellar, Hampton, Kingston, Latrobe Regional, Maroondah, Mt Eliza, Melbourne Extended Care Rehabilitation Service, Peter James, Queen Elizabeth Centre, Royal Talbot, St George’s, Sunshine and Williamstown. 2 Hospitals reporting acute are The Alfred, Angliss, Austin & Repatriation, Ballarat, Barwon Health, Bendigo, Box Hill, Dandenong, Frankston, Goulburn Valley, Latrobe Regional, Maroondah, Monash Medical Centre (Clayton & Moorabbin) , The Northern, Rosebud, Royal Melbourne, Sandringham, St Vincent’s, Sunshine, Western and Williamstown.

Source: Department of Human Services Bed Census.

2 How many bed days are spent waiting for residential aged care placements?

Figure 1.2 Number of bed days patients wait for residential aged care placement 1

Total bed days 30,000 27,733

25,000 22,957 9,817 20,612 Interim Care 20,000 6,173 Sub Acute 8,136 Acute 15,000

11,225 11,971 10,000

9,400 5,000 5,559 5,945 3,076 0 Mar-02 Jun-02 Sep-02

1 Notes for Figure 1.1 apply. Source: Department of Human Services Bed Census.

3 2. Hospital Admitted Patient Activity

How many patients are admitted to hospital?

Table 2.1 Admitted patients by individual hospital 1 2

September June September % Change September 2001 Hospital quarter 2001 quarter 2002 quarter 2002 to September 2002 Major metropolitan hospitals 3 Angliss Hospital 5,971 5,709 5,964 -0.1% Austin & Repatriation Medical Centre 17,043 17,147 17,227 1.1% Box Hill Hospital 9,289 9,472 10,301 10.9% Dandenong Hospital 6,609 7,410 7,735 17.0% Frankston Hospital 10,262 10,240 11,132 8.5% Maroondah Hospital 4,450 4,981 4,998 12.3% Monash Medical Centre 19,783 19,231 20,433 3.3% Royal Melbourne Hospital 18,564 19,946 20,270 9.2% St Vincent's Hospital 10,838 11,470 11,585 6.9% Sunshine Hospital 4 5,828 7,969 7,680 31.8% The Alfred 13,699 14,405 14,048 2.5% The Northern Hospital 6,666 7,011 7,182 7.7% Western Hospital 4 7,360 8,072 9,363 27.2% Other metropolitan hospitals Caulfield General Medical Centre 426 415 500 17.4% Mercy Public Hospital, East Melbourne 4,717 4,413 4,850 2.8% Peter MacCallum Cancer Institute 3,446 3,825 4,098 18.9% Royal Children's Hospital 5 7,423 7,951 7,423 n.a. Royal Women's Hospital 6,726 6,700 7,070 5.1% Sandringham & District Memorial Hospital 3,639 3,987 4,162 14.4% The Royal Victorian Eye and Ear Hospital 3,332 3,258 3,212 -3.6% Other metropolitan hospitals 11,912 12,558 13,239 11.1%

1 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 2 2002/2003 data are provisional. 3 Major metropolitan hospitals contain the campuses listed in the Introduction. 4 Change in activity is as a result of the opening of new beds at Sunshine since 2 July 2001. 5 September quarter 2002 data for Royal Children's Hospital are currently not available. Estimates have been included for comparative purposes. 4 Table 2.1 Admitted patients by individual hospital (continued)

September June September % Change September 2001 Hospital quarter 2001 quarter 2002 quarter 2002 to September 2002 Major regional hospitals Ballarat Health Services 6,220 6,078 6,049 -2.7% Barwon Health 11,998 13,234 11,326 -5.6% Bendigo Health Care Group 5,394 6,035 6,065 12.4% Goulburn Valley Health 4,449 4,858 4,906 10.3% Latrobe Regional Hospital 5,349 5,465 6,067 13.4% Other rural hospitals Central Gippsland Health Service 2,602 2,514 2,590 -0.5% South West Healthcare 3,508 3,660 3,745 6.8% Wangaratta District Base Hospital 2,970 3,126 3,420 15.2% Wimmera Health Care Group 2,214 2,249 2,354 6.3% Wodonga Regional Health Service 4,138 4,232 4,319 4.4% Other rural hospitals 35,794 36,392 37,831 5.7%

Grand total 262,619 274,013 281,144 7.1%

Source: Victorian Admitted Episode Dataset (17 November 2002 update).

5 3. Access to Emergency Services

How many emergency patients are admitted to hospital? 1 2 3 4 Figure 3.1 Patients admitted to public hospitals requiring emergency care

Patients 100,000 95,449 95,745 93,498 90,186 90,155 90,000 87,672 85,775 85,685 82,511 80,000 All hospitals Major metropolitan hospitals

70,000 Other hospitals

59,711 60,000 57,862 57,715 55,270 55,459 53,021 50,808 51,338 49,383 50,000

37,734 36,034 40,000 34,967 34,916 35,636 34,696 34,347 33,128 34,651

30,000 Sep-00 Dec-00 Mar-01 Jun-01 Sep-01 Dec-01 Mar-02 Jun-02 Sep-02

1 Major metropolitan hospitals contain the campuses listed in the Introduction. 2 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 3 2002/2003 data are provisional. 4 September quarter 2002 data for Royal Children's Hospital are currently not available . Estimates have been included for comparative purposes.. Source: Victorian Admitted Episode Dataset (17 November 2002 update).

6 How many emergency patients are admitted to hospital?

Table 3.1 Emergency admissions 1 2 3

September June September % Change June 2002 % Change September 2001 Hospital quarter 2001 quarter 2002 quarter 2002 to September 2002 to September 2002 Major metropolitan hosptals 4

Angliss Hospital 2,482 2,146 2,268 5.7% -8.6% Austin and Repatriation Medical Centre 4,339 4,600 5,101 10.9% 17.6% Box Hill Hospital 4,261 4,520 4,777 5.7% 12.1% Dandenong Hospital 4,136 4,871 5,084 4.4% 22.9% Frankston Hospital 5,513 5,550 6,132 10.5% 11.2% Maroondah Hospital 2,673 3,020 3,049 1.0% 14.1% Monash Medical Centre 6,722 6,031 6,387 5.9% -5.0% Royal Melbourne Hospital 5,620 5,962 6,202 4.0% 10.4% St Vincent's Hospital 3,938 3,903 3,737 -4.3% -5.1% 5 Sunshine Hospital 2,349 3,937 3,317 -15.7% 41.2% The Alfred 5,777 5,613 5,034 -10.3% -12.9% The Northern Hospital 3,477 3,664 3,624 -1.1% 4.2% 5 Western Hospital 3,983 3,898 4,999 28.2% 25.5% 6 Other hospitals total 34,916 37,734 36,034 -4.5% 3.2% Major hospitals total 55,270 57,715 59,711 3.5% 8.0%

Grand total 90,186 95,449 95,745 0.3% 6.2% 1 2002/2003 data are provisional. 2 Data exclude elective, maternity, newborn and statistical admissions. 3 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 4 Major metropolitan hospitals include the campuses listed in the Introduction. 5 Changes in activity reflect the opening of an adult emergency department at Sunshine on 2 July 2001. 6 September quarter 2002 data for Royal Children's Hospital are currently not available. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (17 November 2002 update).

7 How many patients are treated in each hospital emergency department?

Table 3.2 Patients treated in hospital emergency departments, by Individual Hospitals 1 2

% Change September 2001 Hospital September quarter 2001 June quarter 2002 September quarter 2002 to September 2002 Major metropolitan hospitals 3 Angliss Hospital 8,413 9,224 9,505 13.0% Austin and Repatriation Medical Centre 8,908 10,083 10,080 13.2% Box Hill Hospital 8,987 9,155 9,268 3.1% Dandenong Hospital 10,211 11,307 11,437 12.0% Frankston Hospital 9,880 10,701 11,241 13.8% Maroondah Hospital 7,410 8,229 8,152 10.0% Monash Medical Centre 12,577 13,392 13,652 8.5% Royal Melbourne Hospital 11,021 11,947 11,980 8.7% St Vincent's Hospital 7,552 7,708 7,733 2.4% Sunshine Hospital 4 10,423 13,643 13,835 32.7% The Alfred 8,795 9,257 9,049 2.9% The Northern Hospital 10,522 11,525 11,343 7.8% Western Hospital 8,150 7,328 8,148 0.0% Other metropolitan hospitals Royal Children's Hospital 14,671 16,242 16,615 13.3% Major regional hospitals Ballarat Health Services 7,639 8,879 9,249 21.1% Barwon Health 9,224 10,205 10,380 12.5% Bendigo Health Care Group 8,363 8,073 7,744 -7.4% Goulburn Valley Health 6,440 7,313 6,699 4.0% Latrobe Regional Hospital 6,791 7,122 7,259 6.9% Total 4 175,977 191,333 193,369 9.9%

1 Data include all emergency department patients, that is, they include patients who are subsequently admitted to hospital and patients who are treated in the emergency department without being admitted to hospital. 2 September quarter 2002 data are provisional. 3 Major metropolitan hospitals include the campuses listed in the Introduction. 4 Changes in activity reflect the opening of a new adult emergency department at Sunshine Hospital on 2 July 2001. Source: Pre-January 2002 - Hospital Access Program reports. Post-January 2002 - Victorian Emergency Minimum Dataset. 8 Table 3.3 Patients staying in selected public hospital emergency departments for over 12 hours while waiting for a hospital bed 1 2 3 4 5

September quarter 2001 June quarter 2002 September quarter 2002 Hospital Numbers Percentage Numbers Percentage Numbers Percentage Major metropolitan hospitals 6 Angliss Hospital 138 9.6% 123 8.9% 254 18.0% Austin and Repatriation Medical Centre 821 31.8% 422 12.6% 597 17.2% Box Hill Hospital 598 23.6% 553 22.1% 512 18.3% Dandenong Hospital 698 31.1% 584 25.3% 585 23.7% Frankston Hospital 719 24.2% 407 14.6% 475 15.6% Maroondah Hospital 396 26.5% 278 13.7% 477 25.5% Monash Medical Centre 956 31.5% 829 28.6% 1,031 32.3% Royal Melbourne Hospital 934 33.2% 1,070 33.2% 1,116 33.9% St Vincent's Hospital 7 155 8.1% 258 13.2% 159 7.8% Sunshine Hospital 8 16 1.10% 171 8.6% 140 9.5% The Alfred 772 40.7% 750 34.9% 906 42.7% The Northern Hospital 613 29.9% 638 31.6% 759 38.1% Western Hospital 69 2.8% 266 13.5% 454 18.6% Other metropolitan hospitals Royal Children's Hospital 27 1.2% 17 0.6% 106 3.4% Major regional hospitals Ballarat Health Services 15 1.0% 32 2.0% 76 4.8% Barwon Health 297 7.7% 274 6.7% 407 9.9% Bendigo Health Care Group 62 3.8% 125 6.4% 137 8.5% Goulburn Valley Health 0 0.0% 0 0.0% 0 0.0% Latrobe Regional Hospital 29 2.8% 91 8.4% 94 7.7% Total 7,315 18.0% 6,888 15.6% 8,285 18.4% 1 The period of ‘stay’ is calculated from the time the patient arrives in the emergency department to the time when the patient leaves the emergency department. 2 Data represent the number of emergency department patients admitted to ward who spend more than 12 hours in the emergency department prior to being admitted as a proportion of all emergency department patients admitted to ward. 4 Data for September quarter 2001 and June quarter 2002 have been altered from previous reports due to a new reporting source. 5 September quarter 2002 data are provisional. 6 Major metropolitan hospitals include the campuses listed in the Introduction. 7 June and September quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. 8 Changes in activity reflect the opening of a new adult emergency department at Sunshine Hospital on 2 July 2001. Source: Victorian Emergency Minimum Dataset. 9 How many patients stay for an extended period in the emergency department?

Figure 3.2 Patients staying in emergency departments for over 12 hours while waiting for a hospital bed 1 2 3 4

Patients 70,000 66,095 64,772 65,484 62,795 64,660 64,060 63,214 59,851 59,851 59,557 61,189 60,000 57,771 58,355 58,048 54,739

50,000

40,000 Total number of patients treated in emergency departments

30,000 Patients staying in emergency department for longer than 12 hours who were admitted to ward

20,000

10,000

2,481 2,636 2,198 2,624 1,966 1,862 1,664 1,844 1,595 1,958 2,429 2,501 2,822 2,853 2,610 0 Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02

1 The period of ‘stay’ is calculated from the time the patient arrives in the emergency department to the time when the patient leaves the emergency department. 2 A new adult emergency department opened at Sunshine Hospital on 2 July 2001. 3 September quarter 2002 data are provisional. Estimates have been included for St Vincent’s Hospital for June and September quarters 2002.. Source: Pre-January 2002 – Hospital Access Program reports Post-January 2002 - Victorian Emergency Minimum Dataset.

10 How many emergency department patients are treated within ideal time?

Figure 3.3 Emergency department achievement of ACEM waiting times by triage category 1 2

100%

90%

80%

70%

Proportion of category 1 60% patients treated immediately Proportion of category 2 patients treated within 10 minutes 50% Proportion of category 3 patients treated within 30 minutes

40% Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02

1 Waiting times are calculated as the time between presentation at the emergency department and commencement of treatment. The following Australasian College for Emergency Medicine (ACEM) patient categories and recommended treatment times are used: Category 1: Resuscitation case requiring immediate treatment, for example, major trauma, cardiac arrest, unconsciousness, shock. Category 2: Emergency case requiring treatment within 10 minutes, for example, severe trauma, chest pain, severe pain, severe breathing difficulty. Category 3: Urgent case requiring treatment within 30 minutes, for example, moderate trauma, infection, breathing difficulty. 2 The business rule for ‘treatment time’ changed in July 2002, now taking into account treatment by nurses. 3 September quarter 2002 data are provisional.

Source: Pre-January 2002 – Hospital Access Program reports Post-January 2002 - Victorian Emergency Minimum Dataset. 11 How many emergency department patients are treated within ideal time?

Table 3.4 Patients treated in selected public hospital emergency departments in triage category 1, 2 or 3 within ACEM recommended waiting times: September quarter 2002 ¹ ²

Triage Category 1 Triage Category 2 Triage Category 3 Total Treated Total Treated in Total Treated in Hospital patients immediately patients 10 minutes patients 30 minutes Major metropolitan hospitals 3 Angliss Hospital 23 100% 486 83% 2,218 81% Austin and Repatriation Medical Centre 130 100% 829 81% 3,447 65% Box Hill Hospital 82 100% 579 80% 3,557 53% Dandenong Hospital 111 100% 979 84% 3,089 54% Frankston Hospital 144 100% 2,442 92% 5,085 75% Maroondah Hospital 64 100% 601 83% 2,352 68% Monash Medical Centre 175 100% 1,410 78% 4,341 70% Royal Melbourne Hospital 201 100% 1,321 81% 3,479 77% St Vincent's Hospital 4 112 100% 708 66% 3,330 58%

Sunshine Hospital 35 100% 684 82% 4,169 77% The Alfred 271 100% 1,080 77% 3,284 82% The Northern Hospital 126 100% 751 96% 3,798 86% Western Hospital 153 100% 810 84% 2,612 82% Other metropolitan hospitals Royal Children's Hospital 25 100% 324 83% 3,916 75% Major regional hospitals Ballarat Health Services 60 100% 300 87% 1,743 93% Barwon Health 53 100% 573 73% 2,103 60% Bendigo Health Care Group 22 100% 448 100% 2,422 98% Goulburn Valley Health 24 96% 284 84% 1,713 86% Latrobe Regional Hospital 60 100% 406 90% 1,713 87% Total 1,871 100% 15,015 83% 58,371 74% 1 Australasian College for Emergency Medicine (ACEM). The business rule for 'treatment time' changed in July 2002/03, now taking into account treatment from nurses. 2 September quarter 2002 data are provisional. 3 Major metropolitan hospitals include the campuses listed in the Introduction. 4 September quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. Source: Pre-January 2002 - Hospital Access Program reports. Post-January 2002 - Victorian Emergency Minimum Dataset. 12 How often do hospital emergency departments go on ‘bypass’?

Figure 3.4 Periods of ambulance bypass of public hospitals 1 2

Bypass Incidents 1,200

900

614 581 600 416 322

300 189

0 Sep-01 Dec-01 Mar-02 Jun-02 Sep-02 Quarters

1 Hospital emergency departments can request to go on ambulance bypass when the emergency department has reached maximum capacity and the treatment of patients already in the emergency department could be significantly compromised with the arrival, by ambulance, of further patients. Each individual period of ambulance bypass is for two hours or less. 2 Bypass policy allows for critically ill or injured patients to be taken to the nearest hospital emergency department regardless of bypass status. Source: Metropolitan Ambulance Service.

13 How often do hospital emergency departments go on 'bypass'?

Table 3.5 Periods of ambulance bypass, by Individual Hospital 1 2

Sep-01 Dec-01 Mar-02 Jun-02 Sep-02 Hospital Qtr Qtr Qtr Qtr Qtr Major metropolitan hospitals 3

Angliss Hospital 9 6 5 3 7 Austin & Repatriation Medical Centre 48 18 1 23 33 Box Hill Hospital 42 18 9 17 17 Dandenong Hospital 25 41 11 27 41 Frankston Hospital 69 37 40 42 39 Maroondah Hospital 57 32 15 11 26 Monash Medical Centre 54 49 43 106 104 Royal Melbourne Hospital 137 26 5 60 117 St Vincent's Hospital 34 23 3 17 27 Sunshine Hospital 4 0 6 4 28 21 The Alfred 74 50 24 15 31 The Northern Hospital 62 14 5 21 38 Western Hospital 3 2 24 46 80 Total 614 322 189 416 581

2 Metropolitan Ambulance Service (MAS) response times are now being reported in MAS Response Report: A Quarterly Statistical Review of MAS, Melbourne. Copies of the Response Report can be obtained from MAS, Corporate Planning and Corporate Communications Unit, phone (03) 9840 3648.

3 Major metropolitan hospitals include the campuses listed in the Introduction.

4 As a result of the new adult emergency department opening at Sunshine Hospital on 2 July 2001, data commences from September quarter 2001 only.

Source: Metropolitan Ambulance Service.

14 4. Access to Critical Care Services

How many hospital beds are available for patients who need intensive care? Table 4.1 Average number of public hospital intensive care beds available and open at 9.00a.m., by Month 1 2 3

Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Available 4 2.3 3.2 2.8 4.6 4.4 5.8 4.4 5.9 6.3 5.1 4.0 3.1 1.9 2.0 1.5 Total Open 5 105.3 102.8 104.4 98.6 99.5 97.2 96.7 95.0 96.3 95.0 97.9 97.9 99.7 93.8 100.1 Available (incl Barwon) 6 n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. 2.0 2.0 1.6 Total Open ICU (incl Barwon) 6 n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. 106.7 101.0 106.8 Total Open ICU & HDU (incl Barwon) 7 n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. 131.6 126.5 132.4

1 Based upon hospital census taken at 9.00a.m. daily.

2 The data in this table represents an average for each month and varies from Table 4.3 which gives averages for the quarter.

3 Changes to reporting in the December quarter 2001 account for the lower number of beds open. Previously, Northern, Maroondah and Western included some high dependency beds.

4 Available beds are unoccupied beds which are staffed, functional and available to receive new patients.

5 Total open beds are all functioning and staffed beds, regardless of whether they are occupied.

6 Change in counting from July 2002 to include Barwon Health intensive care.

7 Change in counting from July 2002 to include all unit beds ie. Intensive Care and Stepdown Beds and Barwon Health.

Source: Office of the Coordinator of Emergency and Critical Care Services.

How many hospital beds are available for patients who need coronary care? Table 4.2 Average number of public hospital coronary care beds available and open at 9.00a.m., by Month 1

Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Available 5.3 4.0 6.0 6.1 6.4 7.6 7.7 8.1 10.2 7.8 5.1 5.2 4.5 3.4 3.6 Total Open 71.8 72.6 73.2 73.8 74.0 73.6 71.7 73.0 74.6 72.9 74.4 72.5 66.4 68.0 67.7 Available (incl Geelong) n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. 5.3 3.9 3.9 Total Open (incl Geelong) n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. 72.4 74.0 73.7 ¹ Notes under Table 4.1 apply. Source: Office of the Coordinator of Emergency and Critical Care Services.

15 How many hospital beds are available for patients who need intensive care?

Table 4.3 Average number of public hospital intensive care beds available and open at 9.00a.m., by Hospital: September quarter 2002 ¹ ²

Total Open Total Open Hospital Available 3 ICU 4 . ICU & HDU 4 Major metropolitan hospitals 5 Angliss Hospital n.a. n.a. n.a. Austin and Repatriation Medical Centre - 11.2 11.9 Box Hill Hospital 0.0 5.1 7.0 Dandenong Hospital 0.0 6.9 6.9 Frankston Hospital 0.3 6.3 7.8 Maroondah Hospital 0.4 3.1 6.2 Monash Medical Centre 0.4 11.3 11.3 Royal Melbourne Hospital 0.1 12.7 18.0 St Vincent's Hospital 0.2 9.2 9.2 Sunshine Hospital n.a. n.a. n.a. The Alfred 0.2 20.4 25.6 The Northern Hospital - 5.0 7.1 Western Hospital 0.2 6.7 8.8 Other hospitals Barwon Health 0.1 7.0 10.4 Total 6 1.9 104.8 130.2 1 Based upon hospital census taken at 9.00a.m. daily. 2 Changes to reporting in the December quarter 2001 account for the lower number of beds open. Previously, Northern, Maroondah and Western included some high dependency beds. 3 Available beds are unoccupied beds which are staffed, functional and available to receive new patients. 4 Total open beds are all functioning and staffed beds, regardless of whether they are occupied. Cardio thoracic beds at Royal Melbourne Hospital and The Alfred have been included in total open beds since November 2000. 5 Major metropolitan hospitals include the campuses listed in the Introduction. 6 The data in this table represents an average for the quarter and varies from tables 4.1 and 4.2 which are averages for each month. Source: Office of the Coordinator of Emergency and Critical Care Services.

16 5. Access To Elective Surgery

How many people are on hospital waiting lists for elective surgery? Figure 5.1 Waiting list by urgency 1 2 3 4 5

50,000

45,000 41,648 40,412 39,528 40,000

35,000

30,000 26,010 Total waiting list 25,341 24,898 25,000 Non-urgent cases Patients 20,000 Semi-urgent cases

15,000 Urgent cases

10,000 14,867 14,392 13,940 5,000

0 771 679 690 At 30 September 2001 At 30 June 2002 At 30 September 2002

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions. 2 The waiting list patient categories are: • Urgent cases (waiting list category 1): Admission within 30 days desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency. • Semi-urgent cases (waiting list category 2): Admission within 90 days desirable for a condition causing some pain, dysfunction or disability but which is not likely to deteriorate quickly or become an emergency. • Non-urgent cases (waiting list category 3): Admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability which is very unlikely to deteriorate quickly and which does not have the potential to become an emergency. 3 September quarter 2001 and June quarter 2002 data have been amended from the previous reports. 4 2002/2003 data are provisional. 5 Data are currently not available for St Vincent’s Hospital. Aggregate data have been used for comparative purposes.

Source: Elective Surgery Information System.

17 How many people are on hospital waiting lists for elective surgery?

Table 5.1 Waiting lists by Urgency, by Individual Hospital 1 2 3

Urgent cases Semi-urgent cases Non-urgent cases

Hospital 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 Major metropolitan hospitals 4 Angliss Hospital 18 27 25 209 177 239 215 224 256 Austin and Repatriation Medical Centre 48 59 41 1,255 1,145 1,091 1,270 1,205 1,185 Box Hill Hospital 40 38 36 504 553 535 645 740 784 Dandenong Hospital 47 53 34 776 1,067 1,084 1,883 2,427 2,486 Frankston Hospital 62 64 65 1,919 2,292 2,219 1,285 1,174 1,064 Maroondah Hospital 8 19 7 232 157 174 580 855 963 Monash Medical Centre 93 76 105 1,005 1,367 1,322 2,862 2,991 2,988 Royal Melbourne Hospital 98 38 43 1,011 846 825 1,822 1,502 1,521 St Vincent's Hospital 5 41 39 39 1,054 742 622 671 876 861 Sunshine Hospital 8 5 8 147 256 156 447 550 491 The Alfred 77 85 79 1,680 1,325 1,219 1,443 1,145 1,088 The Northern Hospital 46 39 48 965 859 983 2,074 1,863 1,872 Western Hospital 33 20 22 795 529 604 1,000 887 854 Other metropolitan hospitals Royal Children's Hospital 21 26 23 177 191 209 1,092 1,379 1,403 Royal Women's Hospital 29 17 20 239 182 159 375 197 201 Sandringham & District Memorial Hospital 4 6 10 194 164 120 443 341 323 The Royal Victorian Eye and Ear Hospital 18 10 13 854 499 470 2,314 2,180 1,980

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions. 2 September quarter 2001 and June quarter 2002 data have been amended from the previous reports. 3 September quarter 2002 data are provisional. 4 Major metropolitan hospitals include the campuses listed in the Introduction. 5 Aggregate waiting list figures provided by St Vincent's Hospital for September quarter 2002 are preliminary and may change.

18 Table 5.1 Waiting lists by Urgency, by Individual Hospital (continued)

Urgent cases Semi-urgent cases Non-urgent cases

Hospital 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 Major regional hospitals Ballarat Health Services 3 1 4 293 253 276 1,209 1,051 1,049 Barwon Health 11 7 16 612 651 617 1,988 1,660 1,551 Bendigo Health Care Group 18 9 21 411 395 379 761 709 651 Goulburn Valley Health 22 17 19 141 325 243 189 191 206 Latrobe Regional Hospital 13 9 8 109 114 150 632 465 441 Other rural hospitals Wangaratta District Base Hospital 2 5 1 111 105 75 279 301 301 West Gippsland Hospital 11 10 3 174 198 169 531 428 379 Total 771 679 690 14,867 14,392 13,940 26,010 25,341 24,898

Source: Elective Surgery Information System.

19 What is the throughput of people waiting for elective surgery?

Table 5.2 Admissions and cancellations, by Individual Hospital 1 2 3

Patients on Waiting Lists Admissions from Waiting Lists Patients Cancelled from Waiting Lists

During the Quarter During the Quarter Hospital at 30 Sep 2001 at 30 Jun 2002 at 30 Sep 2002 Sep-01 Jun-02 Sep-02 Sep-01 Jun-02 Sep-02 Major metropolitan hospitals 4 Angliss Hospital 442 428 520 650 743 783 50 135 158 Austin and Repatriation Medical Centre 2,573 2,409 2,317 1,866 2,077 1,896 437 497 392 Box Hill Hospital 1,189 1,331 1,355 1,254 1,346 1,415 187 216 165 Dandenong Hospital 2,706 3,547 3,604 975 1,187 1,320 226 217 533 Frankston Hospital 3,266 3,530 3,348 1,246 1,389 1,606 466 556 389 Maroondah Hospital 820 1,031 1,144 770 780 708 187 118 146 Monash Medical Centre 3,960 4,434 4,415 2,235 1,814 1,962 401 439 490 Royal Melbourne Hospital 2,931 2,386 2,389 1,618 1,943 1,684 382 615 404 St Vincent's Hospital 5 1,766 1,657 1,522 1,445 1,204 1,291 476 206 202 Sunshine Hospital 602 811 655 903 1,172 1,295 152 230 219 The Alfred 3,200 2,555 2,386 1,760 1,374 1,446 455 412 405 The Northern Hospital 3,085 2,761 2,903 1,152 1,139 1,151 301 272 232 Western Hospital 1,828 1,436 1,480 1,002 1,258 1,110 415 221 359 Other metropolitan hospitals

Royal Children's Hospital 1,290 1,596 1,635 2,666 2,344 2,722 254 176 228 Royal Women's Hospital 643 396 380 796 725 761 262 189 148 Sandringham & District Memorial Hospital 641 511 453 596 671 566 168 229 106 The Royal Victorian Eye and Ear Hospital 3,186 2,689 2,463 2,871 2,803 2,843 327 341 518

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions.

2 September quarter 2001 and June quarter 2002 data have been amended from the previous reports.

3 September quarter 2002 data are provisional.

4 Major metropolitan hospitals include the campuses listed in the Introduction.

5 Aggregate waiting list figures provided by St Vincent's Hospital for September quarter 2002 are preliminary and may change. 20 Table 5.2 Admissions and cancellations, by Individual Hospital (continued)

Patients on Waiting Lists Admissions from Waiting Lists Patients Cancelled from Waiting Lists

During the Quarter During the Quarter Hospital at 30 Sep 2001 at 30 Jun 2002 at 30 Sep 2002 Sep-01 Jun-02 Sep-02 Sep-01 Jun-02 Sep-02 Major regional hospitals Ballarat Health Services 1,505 1,305 1,329 703 647 676 95 229 98 Barwon Health 2,611 2,318 2,184 798 1,127 1,054 195 203 213 Bendigo Health Care Group 1,190 1,113 1,051 653 1,205 1,138 128 122 99 Goulburn Valley Health 352 533 468 623 609 700 93 90 112 Latrobe Regional Hospital 754 588 599 1,013 1,026 1,040 61 82 71 Other rural hospitals Wangaratta District Base Hospital 392 411 377 569 569 605 63 40 88 West Gippsland Hospital 716 636 551 558 535 538 117 56 61 Total 41,648 40,412 39,528 28,722 29,687 30,310 5,898 5,891 5,836

Source: Elective Surgery Information System.

21 How many people are on hospital waiting lists for longer than the ideal time?

Table 5.3 People on elective surgery waiting lists for longer than ideal time, by Individual Hospital 1 2 3

Urgent cases waiting over 30 days Semi-urgent cases waiting over 90 days

Hospital 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 Major metropolitan hospitals 4 Angliss Hospital 0 0 0 0 0 0 Austin & Repatriation Medical Centre 0 0 0 569 476 460 Box Hill Hospital 0 0 0 99 89 94 Dandenong Hospital 0 0 0 455 633 667 Frankston Hospital 0 0 0 1,067 1,440 1,450 Maroondah Hospital 0 0 0 52 35 44 Monash Medical Centre 0 0 0 360 663 665 Royal Melbourne Hospital 0 0 0 484 342 318 St Vincent's Hospital 5 0 0 0 504 323 223 Sunshine Hospital 0 0 0 27 27 11 The Alfred 0 0 0 1,201 836 705 The Northern Hospital 0 0 0 438 264 389 Western Hospital 0 0 0 344 196 227 Other metropolitan hospitals Royal Children's Hospital 0 0 0 0 0 1 Royal Women's Hospital 0 0 0 0 0 0 Sandringham & District Memorial Hospital 0 0 0 57 19 20 The Royal Victorian Eye and Ear Hospital 0 0 0 279 110 69

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions.

2 September quarter 2001 and June quarter 2002 data have been amended from the previous reports.

3 September quarter 2002 data are provisional.

4 Major metropolitan hospitals include the campuses listed in the Introduction.

5 Aggregate waiting list figures provided by St Vincent's Hospital for September quarter 2002 are preliminary and may change.

22 Table 5.3 People on elective surgery waiting lists for longer than ideal time, by Individual Hospital (continued)

Urgent cases waiting over 30 days Semi-urgent cases waiting over 90 days

Hospital 30 Sep 2001 30 Jun 2002 30 Sep 2002 30 Sep 2001 30 Jun 2002 30 Sep 2002 Major regional hospitals Ballarat Health Services 0 0 0 102 73 73 Barwon Health 0 0 0 254 321 267 Bendigo Health Care Group 0 0 0 240 207 203 Goulburn Valley Health 0 0 0 4 37 44 Latrobe Regional Hospital 0 0 0 2 0 1 Other rural hospitals Wangaratta District Base Hospital 0 0 0 13 20 5 West Gippsland Hospital 0 0 0 33 48 49 Total 0 0 0 6,584 6,159 5,985

Source: Elective Surgery Information System.

23 What percentage of patients are admitted within clinically ideal times? Figure 5.2 Percentage of patients from elective surgery waiting lists who were admitted within the ideal time , by Urgency 1 2

100%

90%

80%

70% Urgent cases Semi-urgent cases 60%

50%

40% Jun-01 Sep-01 Dec-01 Mar-02 Jun-02 Sep-02

Quarters

1 September quarter 2001 and June quarter 2002 data have been amended from the previous reports. 2 September quarter 2002 data are provisional.

Source: Elective Surgery Information System.

24 What percentage of patients are admitted within clinically ideal times?

Table 5.4 Percentage of people from elective surgery waiting lists who were admitted within the ideal time, by Urgency, by Individual Hospital 1 2

Urgent cases admitted within 30 days during the quarter Semi-urgent cases admitted within 90 days during the quarter June 2002 September 2002 June 2002 September 2002 Hospital Number Percentage Number Percentage Number Percentage Number Percentage Major metropolitan hospitals 3 Angliss Hospital 116 100.00% 112 100.00% 383 100.00% 442 99.10% Austin & Repatriation Medical Centre 546 100.00% 570 100.00% 740 67.15% 594 65.13% Box Hill Hospital 361 100.00% 371 100.00% 626 86.82% 700 85.16% Dandenong Hospital 375 100.00% 378 100.00% 215 62.14% 252 65.63% Frankston Hospital 372 100.00% 364 100.00% 418 57.98% 512 56.83% Maroondah Hospital 208 100.00% 211 100.00% 283 92.18% 260 94.55% Monash Medical Centre 606 100.00% 659 100.00% 508 71.15% 575 69.53% Royal Melbourne Hospital 709 100.00% 626 100.00% 540 69.86% 507 75.33% St Vincent's Hospital 4 245 100.00% 273 100.00% 588 73.78% 666 76.46% Sunshine Hospital 59 100.00% 54 100.00% 399 94.77% 424 94.64% The Alfred 635 100.00% 645 99.85% 332 58.76% 405 64.08% The Northern Hospital 298 100.00% 278 100.00% 429 69.64% 495 76.39% Western Hospital 205 100.00% 202 100.00% 498 77.81% 506 81.88% Other metropolitan hospitals Royal Children's Hospital 349 100.00% 480 100.00% 522 100.00% 598 100.00% Royal Women's Hospital 139 100.00% 166 100.00% 427 100.00% 465 100.00% Sandringham & District Memorial Hospital 99 100.00% 88 100.00% 319 89.86% 252 87.80% The Royal Victorian Eye and Ear Hospital 88 100.00% 121 100.00% 1,506 87.92% 1,491 93.77%

1 June quarter 2002 data have been amended from the previous reports. 2 September quarter 2002 data are provisional. 3 Major metropolitan hospitals include the campuses listed in the Introduction. 4 Aggregate waiting list figures provided by St Vincent's Hospital for September quarter 2002 are preliminary and may change.

25 Table 5.4 Percentage of people from elective surgery waiting lists who were admitted within the ideal time, by Urgency, by Individual Hospital (continued)

Source: Elective Surgery Information System.

26 What is the admission source of total hospital activity? Figure 5.3 Separations by admission type: September quarter 2002 1 2 3

Emergency 34% admissions 45% 95,745 Other elective admissions 4 5 127,629

10% 11%

Other admissions8 Elective admissions 27,460 from the waiting list 6 7

30,310 1 Percentages may not add to 100% due to rounding. 2 2002/2003 data are provisional. 3 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 4 Excludes patients admitted from the elective surgery waiting list. 5 Data are currently not available for Royal Children's Hospital. Estimates have been used for comparative purposes. 6 Patients admitted from the elective surgery waiting list during the quarter (ESIS). 7 Data are currently not available for St Vincent’s Hospital. Aggregate data have been used for comparative purposes. 8 Includes maternity, newborn and statistical (change in patient care type) admissions. Source: Victorian Admitted Episode Dataset (17 November 2002 update). Elective Surgery Information System. 27 6. Private Health Insurance

How many Victorians have private health insurance hospital cover?

Figure 6.1 Health insurance status of Victorians 1 2 3

Without private health insurance hospital cover

56.4% of 3,500,000 55.4% of 56.2% of With private health insurance population population population hospital cover without private without private without private health insurance 3,000,000 health insurance 44.6% of health insurance 43.8% of 43.6% of hospital cover hospital cover population with hospital cover population with population with private health private health private health 2,500,000 2,746,000 2,766,000 2,682,000 insurance insurance insurance hospital cover hospital cover hospital cover 2,000,000 2,159,000 2,140,000 2,138,000

1,500,000

1,000,000

500,000

0 At 30 September 2001 At 30 June 2002 At 30 September 2002

1 Data are for all people covered by insurance, that is, contributors, partners and dependants. 2 Data for current and previous quarters are provisional. 3 Statistics reflect total persons covered by any level of hospital private health insurance. Source: Private Health Insurance Administration Council (4 December 2002).

28 7. Glossary

What do the terms used in this report mean?

Admitted Patient Intensive Care Someone who is an inpatient in a hospital. Sameday patients who are admitted for less A hospital unit with specialised staff and equipment to provide continuous care for critically than 24 hours are also counted as inpatients but people who attend hospital for outpatient ill, injured or post-operative patients. clinics are not. Non Sameday Patient Cancellation In the context of this report, a non sameday patient is an inpatient who leaves hospital on a The request for elective surgery has been withdrawn and the patient is removed from this later date than when they were admitted. hospital's Waiting List without admission for the awaited procedure. This can occur for Separation clinical reasons, transfer of the patient to another hospital, or at the request of the patient. When an inpatient leaves a hospital. This is the technical way of counting the number of Casemix Funded inpatients treated by a hospital. A system of funding hospitals according to the actual number and type of services that they Step Down Bed provide. Casemix funding was introduced for most Victorian public hospitals in July 1993. Hospital beds with specialised staff and equipment to care for patients who no longer Coronary Care need coronary or intensive care but are not yet ready to move to a general hospital ward. A hospital unit with specialised staff and equipment to care for patients with heart disease. Transfer Elective Admission When an inpatient is moved from one hospital to another. This might be in order to obtain A planned admission to hospital. Emergency admissions and transfers from other a specialised treatment not available at the first hospital or because of the patient’s hospitals are not counted as elective admissions. preferences.

Elective Surgery Waiting List Hospital Planned surgery that is not an emergency requiring hospital admission within 24 hours. A major public hospital that performs elective surgery for public patients and uses a waiting list to properly keep track of people who require elective surgery. Emergency Admission

An unplanned admission to hospital due to unexpected illness or injury that requires urgent care.

Emergency Department A hospital department that specialises in providing emergency care for people who are in need of urgent care (ambulance cases for example) and people who choose to seek treatment in an emergency department.