Hospital Services Report

June 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.

June 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 understand the health care system, it assists providers of health services in from 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 Angliss Hospital data for the June quarter 2002, which covers the months of April, May and Austin & Repatriation Medical Centre June. - 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 Frankston Hospital the health care system. Department staff, hospital staff, general practitioners Maroondah Hospital and other health care professionals may be able to assist you to interpret this Monash Medical Centre report. - Clayton campus - Moorabbin campus Royal Melbourne Hospital St Vincent's Hospital Sunshine Hospital The Alfred The Northern Hospital Western Hospital

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 3

Patients 614 600 574 128 123 500 453

400

278 Interim Care 261 300 298 Sub Acute Acute 200

100 190 208 155

0 Dec-01 Mar-02 Jun-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. 3 Interim Care is a new type of care funded under the Hospital Demand Management Strategy at Eastern, Melbourne, Northern, Southern and Sisters of Charity Health Services. Interim Care provides patients who have completed their episodes of acute or sub-acute care with a less intensive service while appropriate long-term Commonwealth aged care accommodation is secured. 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 27,733 28,000

22,957 24,000 9,817 20,534 20,000 6,173 Interim Care Sub Acute 16,000 Acute

14,445 12,000 11,225 11,971

8,000

4,000 6,089 5,559 5,945

0 Dec-01 Mar-02 Jun-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

June March June % Change June 2001 Hospital quarter 2001 quarter 2002 quarter 2002 to June 2002 t31B_AllMajor metropolitan hospItals 3 Angliss Hospital 5,733 5,269 5,709 -0.4% Austin & Repatriation Medical Centre 16,007 16,160 17,139 7.1% Box Hill Hospital 8,958 8,896 9,429 5.3% Dandenong Hospital 7,112 6,956 7,407 4.1% Frankston Hospital 9,964 9,895 10,240 2.8% Maroondah Hospital 4,394 4,739 4,979 13.3% Monash Medical Centre 19,749 18,763 19,229 -2.6% Royal Melbourne Hospital 17,972 18,407 19,940 11.0% St Vincent's Hospital 4 10,873 10,361 10,873 n.a. Sunshine Hospital 5 4,263 6,896 7,968 86.9% The Alfred 13,353 14,104 14,405 7.9% The Northern Hospital 6,456 6,365 7,010 8.6% Western Hospital 5 8,748 7,897 8,070 -7.8% Other metropolitan hospitals Caulfield General Medical Centre 460 399 410 -10.9% Mercy Public Hospital, East Melbourne 4,599 4,270 4,412 -4.1% Peter MacCallum Cancer Institute 3,587 3,243 3,825 6.6% Royal Children's Hospital 6 7,188 6,434 7,188 n.a. Royal Women's Hospital 6,765 6,363 6,695 -1.0% Sandringham & District Memorial Hospital 3,592 3,562 3,986 11.0% The Royal Victorian Eye and Ear Hospital 3,199 2,769 3,257 1.8% Other metropolitan hospitals 11,357 11,560 12,527 10.3%

1 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 2 2001/2002 data are provisional. 3 Major metropolitan hospitals contain the campuses listed in the Introduction. 4 June quarter 2002 data for St Vincent's Hospital are currently not available. Estimates have been included for comparative purposes. 5 Change in activity is as a result of the opening of new beds at Sunshine since 2 July 2001. 4 6 March and June quarters 2002 data for Royal Children's Hospital are currently not available. Estimates have been included for comparative purposes.

Table 2.1 Admitted patients by individual hospital (continued)

June March June % Change June 2001 Hospital quarter 2001 quarter 2002 quarter 2002 to June 2002 Major regional hospitals Ballarat Health Services 5,964 5,885 6,065 1.7% Barwon Health 12,000 12,288 13,218 10.2% Bendigo Health Care Group 5,312 5,327 6,022 13.4% Goulburn Valley Health 4,369 4,596 4,858 11.2% Latrobe Regional Hospital 5,417 5,523 5,465 0.9% Other rural hospitals Central Gippsland Health Service 2,380 2,504 2,511 5.5% South West Healthcare 3,377 3,341 3,660 8.4% Wangaratta District Base Hospital 3,229 2,925 3,126 -3.2% Wimmera Health Care Group 2,226 2,108 2,248 1.0% Wodonga Regional Health Service 3,535 4,033 4,232 19.7% Other rural hospitals 35,660 33,658 36,170 1.4%

Grand total 257,798 255,496 272,273 5.6%

Source: Victorian Admitted Episode Dataset (21 August 2002 update).

5 How many emergency patients are admitted to hospital?

Table 3.1 Emergency admissions 1 2 3

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

Angliss Hospital 2,211 2,042 2,146 5.1% -2.9% Austin and Repatriation Medical Centre 3,925 4,156 4,581 10.2% 16.7% Box Hill Hospital 3,976 4,125 4,493 8.9% 13.0% Dandenong Hospital 4,436 4,594 4,870 6.0% 9.8% Frankston Hospital 5,298 5,365 5,548 3.4% 4.7% Maroondah Hospital 2,564 2,928 3,018 3.1% 17.7% Monash Medical Centre 6,692 6,166 6,026 -2.3% -10.0% Royal Melbourne Hospital 5,749 5,692 5,962 4.7% 3.7% 5 St Vincent's Hospital 3,525 3,772 3,525 n.a. n.a. 6 Sunshine Hospital 1,119 3,359 3,937 17.2% 251.8% The Alfred 5,331 6,027 5,614 -6.9% 5.3% The Northern Hospital 3,313 3,389 3,665 8.1% 10.6% 6 Western Hospital 4,882 3,819 3,898 2.1% -20.2% Major hospitals total 53,021 55,434 57,283 3.3% 8.0% Other hospitals total 7 34,651 34,254 36,727 7.2% 6.0%

Grand total 87,672 89,688 94,010 4.8% 7.2% 1 2001/2002 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 June quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. 6 Changes in activity reflect the opening of an adult emergency department at Sunshine on 2 July 2001. 7 March and June quarters 2002 data are currently not available for Royal Children's Hospital. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (21 August 2002 update).

6 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 93,480 94,010 90,172 89,688 90,000 87,672 85,775 85,685 81,969 82,511 80,000 All hospitals Major metropolitan hospitals

70,000 Other hospitals

60,000 57,844 57,283 55,256 55,434 53,021 50,808 51,338 49,018 49,383 50,000

36,727 40,000 34,916 35,636 34,967 34,347 34,651 34,254 32,951 33,128

30,000 Jun-00 Sep-00 Dec-00 Mar-01 Jun-01 Sep-01 Dec-01 Mar-02 Jun-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 2001/2002 data are provisional. 4 March and June quarters 2002 data for Royal Children's Hospital and June quarter 2002 data for St Vincent's Hospital are currently not available . Estimates have been included for comparative purposes.. Source: Victorian Admitted Episode Dataset (21 August 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 June 2001 Hospital June quarter 2001 March quarter 2002 June quarter 2002 to June 2002 Major metropolitan hospitals 3 Angliss Hospital 8,263 8,543 9,224 11.6% Austin and Repatriation Medical Centre 8,801 9,227 10,083 14.6% Box Hill Hospital 8,670 8,708 9,154 5.6% Dandenong Hospital 9,721 10,598 11,307 16.3% Frankston Hospital 9,617 9,928 10,701 11.3% Maroondah Hospital 7,414 7,665 8,229 11.0% Monash Medical Centre 12,385 12,328 13,392 8.1% Royal Melbourne Hospital 11,038 11,982 11,915 7.9% St Vincent's Hospital 4 7,418 7,788 7,825 n.a. Sunshine Hospital 5 7,041 12,037 13,643 93.8% The Alfred 9,066 9,387 9,257 2.1% The Northern Hospital 10,738 11,193 11,525 7.3% Western Hospital 10,210 7,596 7,328 -28.2% Other metropolitan hospitals Royal Children's Hospital 13,868 12,223 16,242 17.1% Major regional hospitals Ballarat Health Services 7,584 8,659 8,879 17.1% Barwon Health 8,279 9,962 10,205 23.3% Bendigo Health Care Group 7,936 7,786 7,675 -3.3% Goulburn Valley Health 6,603 6,745 7,313 10.8% Latrobe Regional Hospital 6,707 6,575 7,121 6.2% Total 4 171,359 178,930 191,018 11.5% 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 June quarter 2002 data are provisional. 3 Major metropolitan hospitals include the campuses listed in the Introduction. 4 June quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. 5 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 How many patients stay for an extended period in the emergency department? 1 2 3 4 Figure 3.2 Patients staying in emergency departments for over 12 hours while waiting for a hospital bed

Patients 70,000 65,385 62,795 64,673 64,407 61,226 59,851 58,355 59,851 59,545 60,000 57,569 57,447 57,771 58,048 56,343 54,712

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

1,918 2,379 2,506 2,359 2,498 2,012 2,461 1,878 1,757 1,664 1,845 1,592 1,960 2,429 2,498 0 Apr-01 May-01 Jun-01 Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-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 Patients treated in DHS sponsored Chest Pain Evaluation Area Pilots are excluded from these figures – up to 30 June 2001. 3 A new adult emergency department opened at Sunshine Hospital on 2 July 2001. 4 June quarter 2002 data are provisional. Source: Pre-January 2002 – Hospital Access Program reports Post-January 2002 - Victorian Emergency Minimum Dataset. 9 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

June quarter 2001 March quarter 2002 June quarter 2002 Hospital Numbers Percentage Numbers Percentage Numbers Percentage Major metropolitan hospitals 5 Angliss Hospital 184 13.8% 86 6.9% 123 8.9% Austin and Repatriation Medical Centre 660 26.7% 296 10.2% 422 12.6% Box Hill Hospital 366 15.7% 348 14.2% 553 22.1% Dandenong Hospital 503 23.5% 572 25.0% 584 25.3% Frankston Hospital 714 26.7% 511 18.7% 407 14.6% Maroondah Hospital 316 23.2% 373 19.4% 278 13.7% Monash Medical Centre 716 24.0% 660 23.5% 829 28.6% Royal Melbourne Hospital 1,066 40.3% 698 22.2% 1,068 33.3% St Vincent's Hospital 6 645 34.0% 73 4.0% 258 12.4% Sunshine Hospital 7 1 0.13% 168 10.1% 171 8.6% The Alfred 721 35.4% 553 26.6% 750 34.9% The Northern Hospital 682 34.8% 298 14.9% 638 31.6% Western Hospital 153 5.1% 209 10.4% 266 13.5% Other metropolitan hospitals Royal Children's Hospital 1 0.0% 7 0.3% 17 0.6% Major regional hospitals Ballarat Health Services 0 0.0% 12 0.8% 32 2.0% Barwon Health 67 2.1% 149 3.9% 276 6.7% Bendigo Health Care Group 0 0.0% 60 3.3% 124 6.4% Goulburn Valley Health 0 0.0% 0 0.0% 0 0.0% Latrobe Regional Hospital 8 0.7% 28 2.8% 91 8.4% Total 6,803 17.8% 5,101 12.4% 6,887 15.7% 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 Patients treated in DHS sponsored Chest Pain Evaluation Area Pilots are excluded from these figures – up to 30 June 2001. 3 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 June quarter 2002 data are provisional. 5 Major metropolitan hospitals include the campuses listed in the Introduction. 6 June quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. 7 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. 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% Apr-01 May-01 Jun-01 Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-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 June 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: June 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 21 100% 532 86% 2,179 82% Austin and Repatriation Medical Centre 107 100% 731 79% 3,338 69% Box Hill Hospital 88 100% 323 80% 3,331 53% Dandenong Hospital 93 100% 911 90% 3,095 65% Frankston Hospital 113 100% 2,231 77% 4,776 55% Maroondah Hospital 63 100% 530 81% 2,361 73% Monash Medical Centre 176 100% 1,516 72% 4,278 70% Royal Melbourne Hospital 190 100% 1,328 80% 3,480 79% St Vincent's Hospital 4 108 100% 708 78% 3,270 76% Sunshine Hospital 5 58 100% 832 66% 4,046 63% The Alfred 280 100% 1,140 57% 3,298 54% The Northern Hospital 115 100% 766 73% 3,862 59% Western Hospital 110 100% 762 88% 2,274 88% Other metropolitan hospitals Royal Children's Hospital 36 100% 329 84% 3,461 76% Major regional hospitals Ballarat Health Services 53 100% 331 85% 1,750 93% Barwon Health 73 100% 763 70% 2,908 64% Bendigo Health Care Group 27 100% 435 82% 2,037 71% Goulburn Valley Health 23 100% 383 80% 1,920 76% Latrobe Regional Hospital 39 100% 356 86% 1,534 74% Total 1,773 100% 14,907 77% 57,198 68%

1 Australasian College for Emergency Medicine (ACEM). 2 June quarter 2002 data are provisional. 3 Major metropolitan hospitals include the campuses listed in the Introduction. 4 June quarter 2002 data are currently not available for St Vincent's Hospital. Estimates have been included for comparative purposes. 5 A new adult emergency department opened at Sunshine Hospital on 2 July 2001. 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

900 756

614 600 416 322

300 189

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

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

Angliss Hospital 21 9 6 5 3 Austin & Repatriation Medical Centre 51 48 18 1 23 Box Hill Hospital 45 42 18 9 17 Dandenong Hospital 49 25 41 11 27 Frankston Hospital 56 69 37 40 42 Maroondah Hospital 76 57 32 15 11 Monash Medical Centre 111 54 49 43 106 Royal Melbourne Hospital 173 137 26 5 60 St Vincent's Hospital 62 34 23 3 17 Sunshine Hospital 4 n.a. 0 6 4 28 The Alfred 30 74 50 24 15 The Northern Hospital 68 62 14 5 21 Western Hospital 14 3 2 24 46 Total 756 614 322 189 416

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 and, due to ambulance industrial dispute in May and June 2001, the Metropolitan Health Services.

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 4

Apr-01 May-01 Jun-01 Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Available 5 4.6 2.9 4.9 2.3 3.2 2.8 4.6 4.4 5.8 4.4 5.9 6.3 5.1 4.0 3.1 Total Open 6 105.8 107.8 105.6 105.3 102.8 104.4 98.6 99.5 97.2 96.7 95.0 96.3 95.0 97.9 97.9

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 Excludes high dependency beds

4 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.

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

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

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

Apr-01 May-01 Jun-01 Jul-01 Aug-01 Sep-01 Oct-01 Nov-01 Dec-01 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Available 7.4 6.4 6.5 5.3 4.0 6.0 6.1 6.4 7.6 7.7 8.1 10.2 7.8 5.1 5.2 Total Open 73.3 72.3 72.9 71.8 72.6 73.2 73.8 74.0 73.6 71.7 73.0 74.6 72.9 74.4 72.5

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 1 2 3

June quarter 2002 Hospital Available 4 Total Open 5 Major metropolitan hospitals 6 Austin and Repatriation Medical Centre 0.3 11.1 Box Hill Hospital 0.1 5.2 Dandenong Hospital 0.3 6.9 Frankston Hospital 0.3 6.4 Maroondah Hospital 0.5 2.9 Monash Medical Centre 1.2 11.4 Royal Melbourne Hospital 0.2 12.8 St Vincent's Hospital 0.1 9.3 Sunshine Hospital 0.3 2.2 The Alfred 0.2 21.1 The Northern Hospital 0.1 3.5 Western Hospital 0.6 4.2

Total 7 4.3 96.9

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

2 Excludes high dependency beds.

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. Cardio thoracic beds at Royal Melbourne Hospital and The Alfred have been included in total open beds since November 2000. 6 Major metropolitan hospitals include the campuses listed in the Introduction.

7 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

50,000 41,841 45,000 40,779 40,196 40,000

35,000

30,000 26,309 25,333 25,064 Total waiting list

25,000 Non-urgent cases Patients 20,000 Semi-urgent cases

15,000 Urgent cases

10,000 14,834 14,800 14,474 5,000

0 698 646 658 At 30 June 2001 At 31 March 2002 At 30 June 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 June quarter 2001 and March quarter 2002 data have been amended from the previous reports. 4 2001/2002 data are provisional.

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 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 Major metropolitan hospitals 4 Angliss Hospital 21 23 27 191 197 177 229 233 224 Austin and Repatriation Medical Centre 51 35 59 1,219 1,457 1,145 1,400 1,174 1,205 Box Hill Hospital 25 41 38 507 512 553 712 696 740 Dandenong Hospital 30 29 53 707 905 1,067 1,732 2,181 2,427 Frankston Hospital 57 83 64 1,686 2,248 2,292 1,534 1,241 1,174 Maroondah Hospital 13 15 19 267 169 157 631 722 855 Monash Medical Centre 90 65 76 951 1,273 1,366 2,776 2,946 2,990 Royal Melbourne Hospital 55 36 38 908 948 847 1,787 1,727 1,502 St Vincent's Hospital 5 46 44 37 1,182 935 844 822 798 704 Sunshine Hospital 3 5 5 62 180 256 266 441 549 The Alfred 87 72 85 1,937 1,442 1,325 1,541 1,264 1,145 The Northern Hospital 26 33 39 949 736 859 2,091 1,841 1,863 Western Hospital 24 22 20 714 610 529 921 825 891 Other metropolitan hospitals Royal Children's Hospital 5 20 28 7 175 264 173 1,117 1,184 1,271 Royal Women's Hospital 29 9 17 190 198 182 461 240 197 Sandringham & District Memorial Hospital 6 5 6 198 181 163 539 388 340 The Royal Victorian Eye and Ear Hospital 21 12 10 1,163 647 498 1,998 2,342 2,180

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions. 2 June quarter 2001 and March quarter 2002 data have been amended from the previous reports. 3 June quarter 2002 data are provisional. 4 Major metropolitan hospitals include the campuses listed in the Introduction. 5 Aggregate waiting list figures provided by Royal Children's Hospital for March and June quarters 2002 and St Vincent's Hospital for June 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 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 Major regional hospitals Ballarat Health Services 0 3 1 304 267 253 1,174 1,171 1,051 Barwon Health 12 20 7 544 656 651 1,922 1,834 1,660 Bendigo Health Care Group 11 28 9 426 390 395 774 739 711 Goulburn Valley Health 18 19 17 162 195 325 320 154 191 Latrobe Regional Hospital 22 7 9 139 117 114 656 517 465 Other rural hospitals Wangaratta District Base Hospital 11 1 5 97 113 105 274 272 301 West Gippsland Hospital 20 11 10 156 160 198 632 403 428 Total 698 646 658 14,834 14,800 14,474 26,309 25,333 25,064

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 Jun 2001 at 31 Mar 2002 at 30 Jun 2002 Jun-01 Mar-02 Jun-02 Jun-01 Mar-02 Jun-02 Major metropolitan hospitals 4 Angliss Hospital 441 453 428 698 544 743 66 82 135 Austin and Repatriation Medical Centre 2,670 2,666 2,409 1,838 1,715 2,077 311 299 497 Box Hill Hospital 1,244 1,249 1,331 1,368 1,115 1,346 203 241 216 Dandenong Hospital 2,469 3,115 3,547 985 982 1,188 547 245 217 Frankston Hospital 3,277 3,572 3,530 1,373 1,231 1,389 615 313 556 Maroondah Hospital 911 906 1,031 832 766 780 145 176 118 Monash Medical Centre 3,817 4,284 4,432 2,388 1,752 1,814 709 408 440 Royal Melbourne Hospital 2,750 2,711 2,387 1,817 1,614 1,942 432 437 610 St Vincent's Hospital 5 2,050 1,777 1,585 1,365 1,021 1,345 278 220 225 Sunshine Hospital 331 626 810 684 1,002 1,172 122 203 231 The Alfred 3,565 2,778 2,555 1,690 1,050 1,374 415 504 412 The Northern Hospital 3,066 2,610 2,761 1,142 1,069 1,139 295 683 272 Western Hospital 1,659 1,457 1,440 1,323 1,129 1,254 391 190 223 Other metropolitan hospitals

Royal Children's Hospital 5 1,312 1,476 1,451 2,558 2,131 2,458 237 247 225 Royal Women's Hospital 680 447 396 820 712 725 242 166 189 Sandringham & District Memorial Hospital 743 574 509 627 579 671 226 122 231 The Royal Victorian Eye and Ear Hospital 3,182 3,001 2,688 2,770 2,337 2,803 376 425 342

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 Jun 2001 at 31 Mar 2002 at 30 Jun 2002 Jun-01 Mar-02 Jun-02 Jun-01 Mar-02 Jun-02 Major regional hospitals Ballarat Health Services 1,478 1,441 1,305 683 607 647 249 80 229 Barwon Health 2,478 2,510 2,318 858 967 1,127 247 508 203 Bendigo Health Care Group 1,211 1,157 1,115 643 1,051 1,205 105 120 122 Goulburn Valley Health 500 368 533 628 536 609 86 79 90 Latrobe Regional Hospital 817 641 588 1,092 969 1,026 82 86 82 Other rural hospitals Wangaratta District Base Hospital 382 386 411 619 482 569 51 37 40 West Gippsland Hospital 808 574 636 542 478 535 81 65 56 Total 41,841 40,779 40,196 29,343 25,839 29,938 6,511 5,936 5,961

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 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 Major metropolitan hospitals 4 Angliss Hospital 0 0 0 0 0 0 Austin & Repatriation Medical Centre 0 0 0 590 720 476 Box Hill Hospital 0 0 0 112 70 89 Dandenong Hospital 0 0 0 347 567 633 Frankston Hospital 0 0 0 892 1,447 1,440 Maroondah Hospital 0 0 0 59 19 35 Monash Medical Centre 0 0 0 357 568 663 Royal Melbourne Hospital 0 0 0 427 473 344 St Vincent's Hospital 5 0 0 0 636 463 414 Sunshine Hospital 0 0 0 12 17 27 The Alfred 0 0 0 1,350 1,012 836 The Northern Hospital 0 0 0 457 242 264 Western Hospital 0 0 0 286 261 196 Other metropolitan hospitals Royal Children's Hospital 5 0 0 0 0 0 0 Royal Women's Hospital 0 0 0 0 0 0 Sandringham & District Memorial Hospital 0 0 0 94 46 19 The Royal Victorian Eye and Ear Hospital 0 0 0 405 195 110

4 Major metropolitan hospitals include the campuses listed in the Introduction. 5 Aggregate waiting list figures provided by Royal Children's Hospital for March and June quarters 2002 and St Vincent's Hospital for June 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 Jun 2001 31 Mar 2002 30 Jun 2002 30 Jun 2001 31 Mar 2002 30 Jun 2002 Major regional hospitals Ballarat Health Services 0 0 0 121 103 73 Barwon Health 0 0 0 180 322 321 Bendigo Health Care Group 0 0 0 191 187 207 Goulburn Valley Health 0 0 0 0 13 37 Latrobe Regional Hospital 0 0 0 7 8 0 Other rural hospitals Wangaratta District Base Hospital 0 0 0 20 22 20 West Gippsland Hospital 1 0 0 16 43 48 Total 1 0 0 6,559 6,798 6,252

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

Quarters

1 June quarter 2001 and March quarter 2002 data have been amended from the previous reports. 2 June 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 March 2002 June 2002 March 2002 June 2002 Hospital Number Percentage Number Percentage Number Percentage Number Percentage Major metropolitan hospitals 3 Angliss Hospital 81 100.00% 116 100.00% 288 99.65% 383 100.00% Austin & Repatriation Medical Centre 519 100.00% 546 100.00% 525 62.20% 740 67.15% Box Hill Hospital 313 100.00% 361 100.00% 540 83.08% 626 86.82% Dandenong Hospital 304 100.00% 375 100.00% 178 57.05% 215 62.14% Frankston Hospital 300 100.00% 372 100.00% 372 54.95% 418 57.98% Maroondah Hospital 154 100.00% 208 100.00% 258 83.50% 283 92.18% Monash Medical Centre 528 100.00% 605 100.00% 474 71.82% 509 71.19% Royal Melbourne Hospital 608 100.00% 709 100.00% 431 65.70% 539 69.82% St Vincent's Hospital 4 246 100.00% 311 100.00% 485 69.78% 720 70.27% Sunshine Hospital 40 100.00% 59 100.00% 345 93.75% 399 94.77% The Alfred 538 100.00% 635 100.00% 290 68.72% 332 58.76% The Northern Hospital 203 100.00% 298 100.00% 456 67.86% 429 69.64% Western Hospital 160 100.00% 205 100.00% 460 73.84% 498 77.81% Other metropolitan hospitals Royal Children's Hospital 4 271 100.00% 384 100.00% 545 100.00% 556 100.00% Royal Women's Hospital 162 100.00% 139 100.00% 397 99.75% 427 100.00% Sandringham & District Memorial Hospital 91 100.00% 99 100.00% 332 92.74% 319 89.86% The Royal Victorian Eye and Ear Hospital 105 100.00% 88 100.00% 844 81.31% 1,506 87.92%

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

Emergency 35% admissions 44% Other elective 94,010 admissions 5

122,030 10% 11%

Other admissions7 Elective admissions 26,295 from the waiting list6

29,938 1 Percentages may not add due to rounding. 2 2001/2002 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 and St Vincent's Hospital. The aggregate data and estimates have been used for comparative purposes 6 Patients admitted from the elective surgery waiting list during the quarter (ESIS). 7 Includes maternity, newborn and statistical (change in patient care type) admissions.

Source: Victorian Admitted Episode Dataset (21 August 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

55.9% of 56.2% of 3,500,000 55.2% of With private health insurance population population hospital cover population without private without private without private health insurance health insurance 3,000,000 health insurance 44.8% of 44.1% of 43.8% of hospital cover hospital cover hospital cover population with population with population with private health private health private health 2,500,000 2,746,000 2,660,000 insurance 2,725,000 insurance insurance hospital cover hospital cover hospital cover 2,000,000 2,159,000 2,150,000 2,140,000

1,500,000

1,000,000

500,000

0 At 30 June 2001 At 31 March 2002 At 30 June 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 (20 August 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 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. 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 need Coronary Care 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 A planned admission to hospital. Emergency admissions and transfers from other hospitals specialised treatment not available at the first hospital or because of the patient’s 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.