Hospital Services Report

September quarter 2003 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.

December 2003

ii Contents

Introduction 1 1. Patients waiting for residential aged care placement 3 2. Hospital admitted patient activity 5 3. Access to emergency services 7 4. Access to critical care services 17 5. Access to elective surgery 19 6. Private health insurance 31 7. Glossary 33

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Introduction

Consumers, health care providers and government all need information on the quality of health services. Public access to information assists consumers to understand the health care system, it assists providers of health services in planning and increases the accountability of the Department of Human Services to the people in the state of Victoria, Australia.

The Hospital Services Report was introduced in 1995. This edition includes data for the September quarter 2003, which covers the months of July, August and September.

The information included in this report is often requested from the Department. Since technical information of this nature is very difficult to interpret, each graph and table needs to be carefully considered in the context of the complexity of the health care system. Department staff, hospital staff, general practitioners and other health care professionals may be able to assist you to interpret this report.

A number of graphs and tables refer to major metropolitan hospitals. A list of the major metropolitan hospitals can be found in the glossary.

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

700 621 572 600 527 Interim Care 207 500 Sub Acute 199 174 Acute 400

300 254 241 216 200

100 160 132 137 0 Mar-03 Jun-03 Sep-03

1 Hospitals reporting sub acute are Angliss, Anne Caudle, Bundoora Extended Care, Bethlehem, Broadmeadows, Caritas Christi, Caulfield General, Dandenong, Goulburn Valley, Grace McKellar, 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 Hospital, 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.

3 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 25,253 25,050 25,000 19,267 Interim Care 20,000 10,723 11,321 Sub Acute Acute 7,643 15,000

10,000 10,901 10,827 7,366 5,000

4,258 3,629 2,902 0 Mar-03 Jun-03 Sep-03

1 Notes for Figure 1.1 apply. Source: Department of Human Services Bed Census. 4

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4 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 2002 Hospital quarter 2002 quarter 2003 quarter 2003 to September 2003 Major metropolitan hospitals 3 Angliss Hospital 5,964 5,680 5,977 0.2% Austin Hospital 17,228 17,342 17,839 3.5% Box Hill Hospital 10,311 10,642 11,462 11.2% Dandenong Hospital 7,738 7,411 7,394 -4.4% Frankston Hospital 11,130 11,083 11,500 3.3% Maroondah Hospital 4,998 5,119 5,333 6.7% Monash Medical Centre 20,436 20,775 21,917 7.2% Royal Melbourne Hospital 20,253 21,344 21,898 8.1% St Vincent's Hospital 11,671 11,605 11,658 -0.1% Sunshine Hospital 7,679 7,247 7,538 -1.8% The Alfred 14,048 14,118 13,244 -5.7% The Northern Hospital 7,182 7,085 7,589 5.7% Western Hospital 9,368 8,845 8,910 -4.9% Other metropolitan hospitals Caulfield General Medical Centre 504 529 591 17.3% Mercy Public Hospital, East Melbourne 4,850 4,577 4,759 -1.9% Peter MacCallum Cancer Institute 4,098 4,269 4,729 15.4% Royal Children's Hospital 8,549 8,346 8,523 -0.3% Royal Women's Hospital 7,070 7,227 8,193 15.9% Sandringham & District Memorial Hospital 4,180 4,051 4,140 -1.0% The Royal Victorian Eye and Ear Hospital 3,212 3,421 3,405 6.0% Other metropolitan hospitals 13,239 13,133 13,534 2.2% 1 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 2 2003/2004 data are provisional. 3 Major metropolitan hospitals contain the campuses listed in the Glossary.

5 Table 2.1 Admitted patients by individual hospital (continued)

September June September % Change September 2002 Hospital quarter 2002 quarter 2003 quarter 2003 to September 2003 Major regional hospitals Ballarat Health Services 6,035 5,916 6,281 4.1% Barwon Health 13,238 13,782 14,382 8.6% Bendigo Health Care Group 6,077 6,208 6,339 4.3% Goulburn Valley Health 4,907 5,221 5,243 6.8% Latrobe Regional Hospital 6,068 5,589 5,874 -3.2% Other rural hospitals Central Gippsland Health Service 2,590 2,666 2,982 15.1% Northeast Health Wangaratta 3,420 3,119 3,475 1.6% South West Healthcare 3,746 3,791 3,771 0.7% Wimmera Health Care Group 2,362 2,301 2,468 4.5% Wodonga Regional Health Service 4,319 3,787 4,326 0.2% Other rural hospitals 38,211 36,178 37,146 -2.8%

Grand total 284,681 282,407 292,420 2.7%

Source: Victorian Admitted Episode Dataset (17 November 2003 update).

6 3. Access to Emergency Services

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

Patients 110,000 103,953 97,366 100,000 94,697 95,948 92,871 94,164 89,940 89,262 92,044 90,000 All hospitals

80,000 Major metropolitan hospitals

Other hospitals 70,000

59,694 61,455 59,066 58,553 60,000 56,756 56,960 56,928 54,372 54,449

50,000 42,498 37,672 37,737 36,882 35,611 40,000 35,568 36,115 34,813 35,116

30,000 Sep-01 Dec-01 Mar-02 Jun-02 Sep-02 Dec-02 Mar-03 Jun-03 Sep-03

1 Major metropolitan hospitals contain the campuses listed in the Glossary. 2 Data refer to the number of WIES-fundable separations. 3 2003/2004 data are provisional.

Source: Victorian Admitted Episode Dataset (17 November 2003 update).

7 How many emergency patients are admitted to hospital?

Table 3.1 Emergency admissions 1 2 3

September June September % Change June 2003 % Change September 2002 Hospital quarter 2002 quarter 2003 quarter 2003 to September 2003 to September 2003 Major metropolitan hospitals

Angliss Hospital 2,268 2,099 2,291 9.1% 1.0% Austin Hospital 5,108 5,506 5,743 4.3% 12.4% Box Hill Hospital 4,784 4,980 5,615 12.8% 17.4% Dandenong Hospital 5,084 4,533 4,768 5.2% -6.2% Frankston Hospital 6,097 5,734 5,884 2.6% -3.5% Maroondah Hospital 3,049 3,000 3,157 5.2% 3.5% Monash Medical Centre 6,385 6,482 7,421 14.5% 16.2% Royal Melbourne Hospital 6,189 6,185 6,289 1.7% 1.6% St Vincent's Hospital 3,755 3,995 4,124 3.2% 9.8% Sunshine Hospital 3,316 3,065 3,233 5.5% -2.5% The Alfred 5,035 4,468 4,453 -0.3% -11.6% The Northern Hospital 3,624 3,760 3,890 3.5% 7.3% Western Hospital 5,000 4,746 4,587 -3.4% -8.3% Major hospitals total 59,694 58,553 61,455 5.0% 3.0%

Other hospitals total 37,672 35,611 42,498 19.3% 12.8% Grand total 97,366 94,164 103,953 10.4% 6.8% 1 2003/2004 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).

Source: Victorian Admitted Episode Dataset (17 November 2003 update).

8 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

Patients 69,892 70,000 66,147 65,778 64,742 64,081 63,236 63,724 63,324 62,344 63,142 63,737 62,471 62,822 61,754 60,000 57,357

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 2,840 2,547 1,848 2,409 3,437 2,831 2,807 2,185 1,668 1,681 1,444 1,371 1,426 1,285 1,982 0 Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Apr-03 May-03 Jun-03 Jul-03 Aug-03 Sep-03

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 2003/2004 data are provisional. Source : Victorian Emergency Minimum Dataset.

9 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 2002 Hospital September quarter 2002 June quarter 2003 September quarter 2003 to September 2003 Major metropolitan hospitals Angliss Hospital 9,505 9,129 9,503 0.0% Austin Hospital 10,080 9,938 10,062 -0.2% Box Hill Hospital 9,268 9,234 9,446 1.9% Dandenong Hospital 11,456 11,516 11,704 2.2% Frankston Hospital 11,241 11,049 11,167 -0.7% Maroondah Hospital 8,152 8,228 8,186 0.4% Monash Medical Centre 13,652 12,997 13,723 0.5% Royal Melbourne Hospital 11,980 11,684 11,467 -4.3% St Vincents Hospital 7,745 7,971 7,432 -4.0% Sunshine Hospital 13,835 13,756 14,308 3.4% The Alfred 9,049 9,667 9,867 9.0% The Northern Hospital 11,343 12,622 13,864 22.2% Western Hospital 8,148 7,645 7,720 -5.3% Other metropolitan hospitals Royal Children's Hospital 16,615 14,306 15,548 -6.4% Major regional hospitals Ballarat Health Services 9,249 8,811 9,034 -2.3% Barwon Health 10,381 9,546 9,533 -8.2% Bendigo Health Care Group 7,799 7,896 7,987 2.4% Goulburn Valley Health 6,703 6,822 7,271 8.5% Latrobe Regional Hospital 7,263 6,533 6,646 -8.5% Total 193,464 189,350 194,468 0.5%

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 2003/2004 data are provisional. Source: Victorian Emergency Minimum Dataset. 10 Table 3.3 Patients staying in selected public hospital emergency departments for over 12 hours while waiting for a hospital bed 1 2 3

September quarter 2002 June quarter 2003 September quarter 2003 Hospital Numbers Percentage Numbers Percentage Numbers Percentage Major metropolitan hospitals Angliss Hospital 254 18% 93 7% 252 20% Austin Hospital 597 17% 247 8% 656 19% Box Hill Hospital 512 18% 309 11% 602 19% Dandenong Hospital 586 24% 328 13% 580 23% Frankston Hospital 475 16% 192 6% 306 9% Maroondah Hospital 477 25% 361 20% 398 22% Monash Medical Centre 1,031 32% 634 19% 1,024 29% Royal Melbourne Hospital 1,116 34% 845 24% 1,116 31% St Vincents Hospital 215 11% 158 7% 116 8% Sunshine Hospital 140 9% 67 5% 198 12% The Alfred 906 43% 391 16% 907 38% The Northern Hospital 759 38% 578 25% 781 34% Western Hospital 454 19% 306 13% 625 27% Other metropolitan hospitals Royal Children's Hospital 106 3% 23 1% 158 5% Major regional hospitals Ballarat Health Services 74 5% 20 1% 22 1% Barwon Health 262 9% 258 8% 382 14% Bendigo Health Care Group 136 8% 171 11% 179 11% Goulburn Valley Health 0 0% 0 0% 194 15% Latrobe Regional Hospital 94 8% 134 12% 181 15% Total 8,194 19% 5,115 11% 8,677 19% 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.

3 2003/2004 data are provisional. 4 St Vincent's Hospital data for 2001/02 are not accurate due to issues that have arisen while implementing a new information system. This has been fixed for 2002/03. Source: Victorian Emergency Minimum Dataset.

11 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 3

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-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Apr-03 May-03 Jun-03 Jul-03 Aug-03 Sep-03

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 2003/2004 data are provisional.

Source : Victorian Emergency Minimum Dataset. 12 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 2003 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 Angliss Hospital 27 100% 497 67% 2,370 73% Austin Hospital 101 100% 820 82% 3,626 68% Box Hill Hospital 101 100% 905 78% 3,463 55% Dandenong Hospital 80 100% 1,094 96% 3,478 93% Frankston Hospital 88 100% 2,582 96% 4,949 80% Maroondah Hospital 59 100% 553 83% 2,609 73% Monash Medical Centre 162 100% 1,890 86% 4,930 80% Royal Melbourne Hospital 212 100% 1,215 80% 3,596 74% St Vincent's Hospital 118 100% 686 78% 2,694 69% Sunshine Hospital 25 100% 693 99% 4,630 89% The Alfred 213 100% 1,331 78% 3,706 76% The Northern Hospital 87 100% 929 99% 3,491 97% Western Hospital 123 100% 797 93% 2,670 89% Other metropolitan hospitals Royal Children's Hospital 42 100% 444 90% 4,239 78% Major regional hospitals Ballarat Health Services 55 100% 251 84% 1,605 89% Barwon Health 58 100% 885 99% 2,582 95% Bendigo Health Care Group 54 100% 701 100% 2,411 100% Goulburn Valley Health 28 100% 363 88% 1,826 86% Latrobe Regional Hospital 36 100% 356 91% 1,762 91% Total 1,669 100% 16,992 88% 60,637 81% 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 2003/2004 data are provisional.

Source: Victorian Emergency Minimum Dataset.

13 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

580 600 448

300 218 178 113

0 Sep-02 Dec-02 Mar-03 Jun-03 Sep-03 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.

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

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

Sep-02 Dec-02 Mar-03 Jun-03 Sep-03 Hospital Qtr Qtr Qtr Qtr Qtr Major metropolitan hospitals

Angliss Hospital 7 2 6 9 20 Austin Hospital 33 9 6 11 27 Box Hill Hospital 17 6 8 13 34 Dandenong Hospital 41 12 7 30 78 Frankston Hospital 39 13 14 25 40 Maroondah Hospital 26 11 3 8 18 Monash Medical Centre 104 39 13 23 54 Royal Melbourne Hospital 116 74 30 8 40 St Vincent's Hospital 27 1 6 18 Sunshine Hospital 21 7 3 5 20 The Alfred 31 2 2 2 13 The Northern Hospital 38 11 3 11 16 Western Hospital 80 31 18 27 70 Total 580 218 113 178 448

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.

Source: Metropolitan Ambulance Service.

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16 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

Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Apr-03 May-03 Jun-03 Jul-03 Aug-03 Sep-03 Available 3 1.9 2.0 1.5 3.1 3.8 3.7 5.2 4.7 4.3 4.5 2.3 1.5 2.9 1.7 1.4 Total Open 4 99.7 93.8 100.1 98.6 98.8 96.7 95.0 103.2 103.1 99.9 107.3 109.6 107.8 106.6 104.6 Available (incl Barwon Health) 5 2.0 2.0 1.6 3.7 4.5 4.2 5.9 5.6 4.9 4.8 2.8 1.9 3.2 2.2 1.9 Total Open ICU (incl Barwon Health) 5 106.7 101.0 106.8 105.9 105.3 103.3 101.4 110.2 110.8 108.1 115.2 117.7 116.5 114.0 112.3 Total Open ICU & HDU (incl Barwon Health) 6 131.6 126.5 132.4 129.4 134.4 130.5 129 135.5 138.2 134.9 142.5 141.7 142 141.3 139.8

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 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.

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

6 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-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Apr-03 May-03 Jun-03 Jul-03 Aug-03 Sep-03 Available 4.5 3.4 3.6 4.9 7.3 4.7 7.9 8.5 8.4 6.7 5.1 5.6 6.7 4.7 5.0 Total Open 66.4 68.0 67.7 66.1 68.2 69.0 70.3 70.9 72.3 70.6 70.3 69.7 70.2 69.6 71.0 Available (incl Barwon Health) 5.3 3.9 3.9 5.6 7.9 5.2 8.8 9.3 9.2 7.2 5.5 6.1 7.3 5.2 5.5 Total Open (incl Barwon Health) 72.4 74.0 73.7 72.1 74.2 75.0 76.3 76.9 78.3 76.6 76.3 75.7 76.2 75.6 77.0 1 Notes under Table 4.1 apply.

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

17 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 2003 ¹

Total Open Total Open Hospital Available 2 ICU 3 ICU & HDU 3 Major metropolitan hospitals Angliss Hospital Austin Hospital 0.03 11.7 13.2 Box Hill Hospital - 6.2 7.9 Dandenong Hospital 0.07 6.9 6.9 Frankston Hospital 0.50 6.1 7.8 Maroondah Hospital 0.20 4.0 5.9 Monash Medical Centre 0.43 12.5 12.5 Royal Melbourne Hospital 0.07 15.8 20.1 St Vincent's Hospital 0.17 9.5 9.5 Sunshine Hospital The Alfred 0.23 21.7 27.8 The Northern Hospital 0.07 5.2 7.6 Western Hospital 0.23 6.8 9.4 Other hospitals Barwon Health 0.43 7.8 12.5

Total 4 2.43 114.3 141.0

1 Based upon hospital census taken at 9.00a.m. daily. 2 Available beds are unoccupied beds which are staffed, functional and available to receive new patients. 3 Total open beds are all functioning and staffed beds, regardless of whether they are occupied. 4 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. 18 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

50,000

45,000 39,552 38,634 37,972 40,000

35,000

30,000 Total waiting list 24,901 23,108 22,576 25,000 Non-urgent cases Patients 20,000 Semi-urgent cases

Urgent cases 15,000

10,000 14,762 14,687 13,966 5,000

0 685 764 709 At 30 September 2002 At 30 June 2003 At 30 September 2003

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 2003/2004 data are provisional.

Source: Elective Surgery Information System.

19 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 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 Major metropolitan hospitals Angliss Hospital 24 42 33 238 231 275 255 222 249 Austin Hospital 41 69 82 1,091 1,148 1,188 1,185 1,200 1,125 Box Hill Hospital 36 42 54 535 603 537 784 830 819 Dandenong Hospital 34 42 51 1,085 1,229 1,294 2,486 2,024 1,870 Frankston Hospital 65 63 61 2,219 1,903 1,979 1,064 782 754 Maroondah Hospital 7 13 6 174 221 213 963 1,007 1,158 Monash Medical Centre 105 79 53 1,322 1,508 1,568 2,987 2,597 2,645 Royal Melbourne Hospital 43 60 37 825 1,091 992 1,520 1,593 1,486 St Vincent's Hospital 35 42 47 644 843 864 864 802 707 Sunshine Hospital 8 13 11 157 205 190 491 710 674 The Alfred 79 84 60 1,219 886 756 1,088 728 591 The Northern Hospital 48 49 41 984 1,055 986 1,872 1,921 1,914 Western Hospital 22 28 25 605 731 757 854 857 793 Other metropolitan hospitals Royal Children's Hospital 23 17 28 208 174 265 1,406 1,362 1,470 Royal Women's Hospital 20 13 9 159 244 134 201 161 157 Sandringham & District Memorial Hospital 10 13 15 120 215 209 323 307 267 The Royal Victorian Eye and Ear Hospital 13 12 14 470 423 429 1,980 1,381 1,419

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2003/2004 data are provisional. 3 Elective surgery data for Mercy Public Hospitals Inc, East Melbourne, Mercy Public Hospitals Inc, Werribee and Williamstown Hospital are only available for 2003/2004. No data was available for FY 2002/2003.

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

Urgent cases Semi-urgent cases Non-urgent cases

Hospital 30 Sep 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 Major regional hospitals Ballarat Health Services 4 5 276 216 211 1,049 882 813 Barwon Health 16 14 12 619 690 714 1,551 1,361 1,320 Bendigo Health Care Group 21 23 24 379 427 422 651 687 647 Goulburn Valley Health 19 25 25 243 278 246 206 209 203 Latrobe Regional Hospital 8 12 10 150 159 134 441 621 594 Other rural hospitals Northeast Health Wangaratta 1 1 2 75 83 88 301 403 457 West Gippsland Hospital 3 8 4 169 199 236 379 461 444 Total 685 764 709 13,966 14,762 14,687 24,901 23,108 22,576

Source: Elective Surgery Information System.

21 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 2002 at 30 Jun 2003 at 30 Sep 2003 Sep-02 Jun-03 Sep-03 Sep-02 Jun-03 Sep-03 Major metropolitan hospitals Angliss Hospital 517 495 557 784 853 785 158 50 73 Austin Hospital 2,317 2,417 2,395 1,896 2,084 1,953 392 388 431 Box Hill Hospital 1,355 1,475 1,410 1,415 1,463 1,322 165 234 279 Dandenong Hospital 3,605 3,295 3,215 1,319 1,548 1,556 532 259 346 Frankston Hospital 3,348 2,748 2,794 1,606 1,551 1,497 389 351 237 Maroondah Hospital 1,144 1,241 1,377 708 816 868 146 127 137 Monash Medical Centre 4,414 4,184 4,266 1,963 2,128 2,243 490 290 330 Royal Melbourne Hospital 2,388 2,744 2,515 1,701 1,719 1,660 405 387 520 St Vincent's Hospital 1,543 1,687 1,618 1,283 1,034 1,295 238 206 174 Sunshine Hospital 656 928 875 1,295 1,170 1,218 218 140 112 The Alfred 2,386 1,698 1,407 1,446 1,344 1,450 405 385 431 The Northern Hospital 2,904 3,025 2,941 1,151 1,311 1,452 231 213 233 Western Hospital 1,481 1,616 1,575 1,110 985 1,048 358 257 233 Other metropolitan hospitals Royal Children's Hospital 1,637 1,553 1,763 2,721 2,562 2,545 228 205 217 Royal Women's Hospital 380 418 300 761 619 845 148 137 168 Sandringham & District Memorial Hospital 453 535 491 566 508 532 106 99 105 The Royal Victorian Eye and Ear Hospital 2,463 1,816 1,862 2,843 2,928 2,898 518 275 210

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2003/2004 data are provisional.

3 Elective surgery data for Mercy Public Hospitals Inc, East Melbourne, Mercy Public Hospitals Inc, Werribee and Williamstown Hospital are only available for 2003/2004. No data was available for FY 2002/2003.

22 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 2002 at 30 Jun 2003 at 30 Sep 2003 Sep-02 Jun-03 Sep-03 Sep-02 Jun-03 Sep-03 Major regional hospitals Ballarat Health Services 1,329 1,098 1,029 676 560 698 98 141 110 Barwon Health 2,186 2,065 2,046 1,052 1,334 1,263 213 228 137 Bendigo Health Care Group 1,051 1,137 1,093 1,138 1,065 1,117 99 99 204 Goulburn Valley Health 468 512 474 700 728 776 112 87 127 Latrobe Regional Hospital 599 792 738 1,040 945 1,091 71 99 68 Other rural hospitals Northeast Health Wangaratta 377 487 547 605 501 551 88 68 46 West Gippsland Hospital 551 668 684 538 576 556 61 37 48 Total 39,552 38,634 37,972 30,317 30,332 31,219 5,869 4,762 4,976

Source: Elective Surgery Information System.

23 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 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 Major metropolitan hospitals Angliss Hospital 0 0 0 0 0 1 Austin Hospital 0 0 0 460 435 526 Box Hill Hospital 0 0 0 94 78 85 Dandenong Hospital 0 0 0 667 808 801 Frankston Hospital 0 0 0 1,450 1,092 1,142 Maroondah Hospital 0 0 0 44 32 66 Monash Medical Centre 0 0 0 665 684 829 Royal Melbourne Hospital 0 0 0 318 488 469 St Vincent's Hospital 0 0 0 227 293 296 Sunshine Hospital 0 0 0 12 29 17 The Alfred 0 0 0 705 368 314 The Northern Hospital 0 0 0 390 382 404 Western Hospital 0 0 0 227 303 294 Other metropolitan hospitals Royal Children's Hospital 0 0 0 0 0 0 Royal Women's Hospital 0 0 0 0 0 0 Sandringham & District Memorial Hospital 0 0 0 20 54 54 The Royal Victorian Eye and Ear Hospital 0 0 0 69 29 51

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2003/2004 data are provisional.

24 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 2002 30 Jun 2003 30 Sep 2003 30 Sep 2002 30 Jun 2003 30 Sep 2003 Major regional hospitals Ballarat Health Services 0 0 0 73 82 74 Barwon Health 0 0 0 267 287 306 Bendigo Health Care Group 0 0 0 203 229 195 Goulburn Valley Health 0 0 0 44 40 34 Latrobe Regional Hospital 0 0 0 1 13 20 Other rural hospitals Northeast Health Wangaratta 0 0 0 5 7 12 West Gippsland Hospital 0 0 0 49 33 63 Total 0 0 0 5,990 5,766 6,053

Source: Elective Surgery Information System.

25 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

100%

90%

80%

70% Urgent cases Semi-urgent cases 60%

50%

40% Jun-02 Sep-02 Dec-02 Mar-03 Jun-03 Sep-03

Quarters

1 2003/2004 data are provisional.

Source: Elective Surgery Information System.

26 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 2003 September 2003 June 2003 September 2003 Hospital Number Percentage Number Percentage Number Percentage Number Percentage Major metropolitan hospitals Angliss Hospital 100 100.00% 132 100.00% 464 100.00% 381 99.74% Austin Hospital 669 100.00% 681 100.00% 693 74.04% 568 70.65% Box Hill Hospital 302 100.00% 332 100.00% 752 83.93% 627 82.39% Dandenong Hospital 336 100.00% 363 100.00% 254 54.39% 257 56.48% Frankston Hospital 306 100.00% 333 100.00% 463 51.39% 525 61.91% Maroondah Hospital 245 100.00% 233 100.00% 232 93.55% 265 85.21% Monash Medical Centre 727 100.00% 681 100.00% 709 76.65% 775 74.59% Royal Melbourne Hospital 724 100.00% 724 100.00% 467 70.65% 425 67.89% St Vincent's Hospital 244 100.00% 324 100.00% 527 75.61% 612 71.58% Sunshine Hospital 81 100.00% 89 100.00% 321 92.51% 304 88.37% The Alfred 495 100.00% 553 100.00% 432 63.44% 481 67.37% The Northern Hospital 225 100.00% 268 100.00% 536 68.98% 587 68.18% Western Hospital 184 100.00% 221 100.00% 390 71.43% 382 69.08% Other metropolitan hospitals Royal Children's Hospital 459 100.00% 484 100.00% 567 100.00% 579 100.00% Royal Women's Hospital 152 100.00% 174 100.00% 368 100.00% 515 100.00% Sandringham & District Memorial Hospital 82 100.00% 66 100.00% 237 91.86% 251 82.84% The Royal Victorian Eye and Ear Hospital 167 100.00% 163 100.00% 1,528 98.01% 1,550 96.81%

1 2003/2004 data are provisional. 2 Elective surgery data for Mercy Public Hospitals Inc, East Melbourne, Mercy Public Hospitals Inc, Werribee and Williamstown Hospital are only available for 2003/2004. No data was available for FY 2002/2003.

27 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.

28 What is the admission source of total hospital activity? Figure 5.3 Separations by admission type: June quarter 2003 1 2 3

Emergency Admissions 36% 43% 103,953

Other elective admissions 4 129,024 10% 11%

Other admissions6 Elective admissions 28,224 from the waiting list 5 31,219

1 Percentages may not add to 100% due to rounding. 2 2003/2004 data are provisional. 3 Data refer to the number of WIES-fundable separations only. 4 Excludes patients admitted from the elective surgery waiting list. 5 Patients admitted from the elective surgery waiting list during the quarter (ESIS). 6 Includes maternity, newborn and statistical (change in patient care type) admissions.

Source: Victorian Admitted Episode Dataset (17 November 2003 update). Elective Surgery Information System. 29

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30 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 57.2% of 57.2% of 56.3% of population population With private health insurance 3,500,000 population without private without private hospital cover without private health insurance 43.7% of health insurance health insurance 42.8% of hospital cover 42.8% of 3,000,000 population with hospital cover hospital cover population with population with private health private health private health insurance 2,824,000 2,828,000 2,500,000 insurance insurance 2,754,000 hospital cover hospital cover hospital cover

2,000,000 2,138,000 2,113,000 2,116,000

1,500,000

1,000,000

500,000

0 At 30 September 2002 At 30 June 2003 At 30 September 2003

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 (5 December 2003). 31

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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 than A hospital unit with specialised staff and equipment to provide continuous care for critically 24 hours are also counted as inpatients but people who attend hospital for outpatient clinics ill, injured or post-operative patients. are not. Major Metropolitan Hospitals Cancellation Include Angliss Hospital, Austin Hospital (Austin Hospital & Heidelberg Repatriation The request for elective surgery has been withdrawn and the patient is removed from this Hospital), Box Hill Hospital, Dandenong Hospital, Frankston Hospital, Maroondah Hospital, hospital's Waiting List without admission for the awaited procedure. This can occur for Monash Medical Centre (Clayton Campus & Moorabbin Campus), Royal Melbourne Hospital, clinical reasons, transfer of the patient to another hospital, or at the request of the patient. St Vincent’s Hospital, Sunshine Hospital, The Alfred, The Northern Hospital and Western Hospital. Casemix Funded A system of funding hospitals according to the actual number and type of services that they Separation provide. Casemix funding was introduced for most Victorian public hospitals in July 1993. When an admitted patient leaves a hospital. This is the technical way of counting the number of admitted patients treated by a hospital. Coronary Care A hospital unit with specialised staff and equipment to care for patients with heart disease. Step Down Bed Hospital beds with specialised staff and equipment to care for patients who no longer need Elective Admission coronary or intensive care but are not yet ready to move to a general hospital ward. A planned admission to hospital. Emergency admissions and transfers from other hospitals are not counted as elective admissions. Transfer When an inpatient is moved from one hospital to another. This might be in order to obtain a Elective Surgery specialised treatment not available at the first hospital or because of the patient’s Planned surgery that is not an emergency requiring hospital admission within 24 hours. preferences. Emergency Admission Waiting List Hospital An unplanned admission to hospital due to unexpected illness or injury that requires urgent A major public hospital that performs elective surgery for public patients and uses a waiting care. list to properly keep track of people who require elective surgery. 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. 33