HealthStats NSW

Influenza and pneumonia hospitalisations

Males, 0-4, 2011-12
570.5Males, 0-4, 2010-11
593.4Males, 0-4, 2009-10
615.8Males, 0-4, 2008-09
610.1Males, 0-4, 2007-08
640.2Males, 0-4, 2006-07
568.4Males, 0-4, 2005-06
638.2Males, 0-4, 2004-05
692.9Males, 0-4, 2003-04
913.9Males, 0-4, 2002-03
804Males, 0-4, 2001-02
786.3Males, 0-4, 2000-01
735.6Males, 0-4, 1999-00
758.4Males, 0-4, 1998-99
887.2Males, 0-4, 1997-98
836.2Males, 0-4, 1996-97
722.3Males, 0-4, 1995-96
611.3Males, 0-4, 1994-95
607.9Males, 0-4, 1993-94
569.6Males, All ages, 2011-12
365.7Males, All ages, 2010-11
352.2Males, All ages, 2009-10
336.4Males, All ages, 2008-09
340.8Males, All ages, 2007-08
358.5Males, All ages, 2006-07
329.7Males, All ages, 2005-06
340.8Males, All ages, 2004-05
357.9Males, All ages, 2003-04
376.9Males, All ages, 2002-03
368.3Males, All ages, 2001-02
362Males, All ages, 2000-01
371.7Males, All ages, 1999-00
377.8Males, All ages, 1998-99
431.4Males, All ages, 1997-98
424.9Males, All ages, 1996-97
374.7Males, All ages, 1995-96
339Males, All ages, 1994-95
323.9Males, All ages, 1993-94
301.5Females, 0-4, 2011-12
538.5Females, 0-4, 2010-11
563.8Females, 0-4, 2009-10
582.7Females, 0-4, 2008-09
518.9Females, 0-4, 2007-08
590Females, 0-4, 2006-07
485.6Females, 0-4, 2005-06
479.1Females, 0-4, 2004-05
604.1Females, 0-4, 2003-04
755.4Females, 0-4, 2002-03
680.1Females, 0-4, 2001-02
677.3Females, 0-4, 2000-01
632.4Females, 0-4, 1999-00
669.8Females, 0-4, 1998-99
740.8Females, 0-4, 1997-98
720.2Females, 0-4, 1996-97
580.5Females, 0-4, 1995-96
479Females, 0-4, 1994-95
479.8Females, 0-4, 1993-94
429.3Females, All ages, 2011-12
282.3Females, All ages, 2010-11
284.1Females, All ages, 2009-10
263.6Females, All ages, 2008-09
264.2Females, All ages, 2007-08
272Females, All ages, 2006-07
240Females, All ages, 2005-06
259.1Females, All ages, 2004-05
265Females, All ages, 2003-04
282Females, All ages, 2002-03
273.3Females, All ages, 2001-02
258.1Females, All ages, 2000-01
270.9Females, All ages, 1999-00
283.8Females, All ages, 1998-99
312.7Females, All ages, 1997-98
320.2Females, All ages, 1996-97
267.8Females, All ages, 1995-96
229.2Females, All ages, 1994-95
222.5Females, All ages, 1993-94
  • + Source

    NSW Admitted Patient Data Collection and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.

  • + Notes

    Only NSW residents are included. Figures are based on where a person resides, not where they are treated. Hospital separations were classified using ICD-10-AM. Rates were age-adjusted using the Australian population as at 30 June 2001.

    Numbers for the two latest years include an estimate of the small number of hospitalisations of NSW residents in interstate public hospitals, data for which were unavailable at the time of production.

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  • + Methods
  • + Codes
    • Codes: Influenza and pneumonia

      The International Statistical Classification of Diseases and Related Health Problems

      National Centre for Classification in Health, Australia; CM - Clinical Modification; AM - Australian Modification

      DescriptionICD-9 & ICD-9-CMICD-10 & ICD-10-AMComments
      Influenza and pneumonia 480-487 J09-J18 All records are included, NSW residents only, all ages.


      In 2009, the WHO recommended that ICD-10-AM J09 code be used to cover influenza A/H1N1 (initially called ‘swine flu’) responsible for the pandemic 2009 and the code has been added to the set of codes above.

  • + Related Indicators

    Respiratory diseases hospitalisations

    Number and rate by disease type,sex, Local Health District, Medicare Local, remoteness from service centres and year
  • + Associated Information
    • Key points: Influenza and pneumonia


      Influenza and pneumonia are a group of acute respiratory infections that can be very severe and, in persons at high risk, lead to death. They are usually presented together as influenza can lead to pneumonia and, in most cases of hospitalisation and death from pneumonia, the responsible organism is not identified. Each year, 75-85 % of all hospitalisations for influenza and pneumonia are due to 'unspecified pneumonia'.

      Severe virus-related complications of influenza require hospitalisation and threaten life most frequently in the very young and elderly (children under 1 year old and persons over 65) and among persons with chronic heart or, especially, lung conditions. Appropriate antibacterial therapy decreases the mortality rate from secondary bacterial pneumonia.

      In 2009, the WHO recommended that ICD-10-AM J09 code be used to cover influenza A/H1N1 (initially called ‘swine flu’) responsible for the pandemic 2009 and the code has been added to the set of codes relevant here.

      There were 24,295 hospitalisations due to influenza and pneumonia in 2012-13 (289.4 per 100,000 population), of which 14,641 were patients aged 65 years and older (1272.2 per 100,000 population in that age group). Males accounted for almost 53% of all influenza and pneumonia hospitalisations. 


      There were 788 deaths from influenza and pneumonia in 2011 (8.4 deaths per 100,000 population) and almost 92% of these were in persons aged 65 years and over (60.4 deaths per 100,000 population in that age group). Death rates from influenza or pneumonia are very low in all other age groups. The death rate in 2009 was the lowest since 1993 for all ages and for people aged 65 years and older. A slight increase was subsequently observed in years 2010 and 2011.

    • Introduction: Respiratory disease

       Respiratory diseases

      Respiratory diseases include acute diseases, such as influenza and pneumonia, and chronic respiratory diseases (specifically asthma, chronic obstructive pulmonary disease, asbestosis, and respiratory tuberculosis), where preventive measures and better management of conditions can reduce the burden of disease and reduce associated healthcare costs.

      Chronic respiratory diseases were responsible for 7.1% of total burden of disease and injury in Australia in 2003, with chronic obstructive pulmonary disease and asthma accounting for 46% and 34% of this burden, respectively (Begg et al. 2007).

      Influenza and pneumonia

      Influenza and pneumonia are acute respiratory diseases that can be very severe and, in persons at high risk, can lead to death. Influenza and pneumonia cause around 1.8% of all deaths and around 0.9% of hospital separations and are an important cause of hospitalisations in the very young, and of death and hospitalisations among older age groups.


      Asthma is a significant public health problem in Australia and it is estimated that Australian prevalence rates are among the highest in the world. Fortunately, recent studies in children show no further increase in prevalence. In Australia in 2003, asthma was estimated to account for 2.3% of the disease burden (Begg et al. 2007).

      Chronic obstructive pulmonary disease

      Chronic bronchitis and emphysema are the two main conditions comprising chronic obstructive pulmonary disease (COPD). In Australia in 2003, COPD was estimated to account for 2.9% of the disease burden (Begg et al. 2007).


      Tuberculosis (TB) is caused by the bacterial organism Mycobacterium tuberculosis. Despite the increasing burden from respiratory tuberculosis globally, it is not a major public health problem in NSW. In fact the mortality and morbidity from all types of tuberculosis in NSW is one of the lowest in the world.

      Lung cancer

      Lung cancer is excluded from analyses of respiratory diseases, as it is classified with cancers, and not with respiratory diseases, in the International Classification of Diseases (the coding system used for health data in NSW). However, some indicators analysing respiratory diseases explicitly include lung cancer to provide a more appropriate measure of the burden of respiratory disease from a clinical and health services planning perspective.

      Risk factors

      Cigarette smoking is the main risk factor for both COPD and lung cancer and the current incidence rates of these conditions reflect smoking rates 20 years and more in the past. Lung cancer is one of the leading causes of death in Australia.


      Begg S, Vos T, Barker B. The burden of disease and injury in Australia, 2003. Cat. no. PHE 82 edition. Canberra: AIHW, 2007.


    • Interventions: Respiratory diseases

      Potentially preventable hospitalisations for chronic conditions

      The most common chronic conditions defined as potentially preventable hospitalisations or ambulatory care sensitive hospitalisations are included in the NSW Chronic Disease Management Program (MoH, 2014).

      In response to the Garling Report 2008, the NSW Department of Health implemented the NSW Severe Chronic Disease Management Program. The continuation of this program, the Chronic Disease Management Program, is being overseen by the NSW Ministry of Health and NSW Agency for Clinical Innovation. The program provides care coordination and self-management support to help people with chronic disease to better manage their condition and access appropriate services in order to improve health outcomes, prevent complications and reduce the need for hospitalisation.

      The Chronic Diseases Management Program targets five major chronic diseases of interest that are recognised as having a major impact on the burden of disease in NSW. Furthermore, these conditions have been demonstrated to have improved outcomes through CDM approaches. The diseases of interest are Chronic Obstructive Pulmonary Disease (mainly emphysema and chronic bronchitis); Coronary Heart Disease (also known as coronary or ischaemic heart disease); Diabetes; Hypertension (high blood pressure); and Congestive Heart Failure.

      People who are diagnosed with these diseases and who are experiencing repeated episodes in hospitalisation are offered enrolment to the program. People with these conditions, who are not being admitted to hospital frequently but experience difficulties in managing their conditions, are also eligible for enrolment. The focus is on prevention of deterioration, recognising that people suffering from these diseases often have comorbidities such as depression, arthritis and dementia.


      Written asthma management plans are recommended as part of the national guidelines for the management of asthma: Asthma handbook (NACA 2014). They enable people with asthma to recognise a deterioration in their condition and initiate appropriate treatment, thereby reducing the severity of acute episodes.

      The Asthma handbook promotes preventive care activities, proper inhaler technique and adherence and stepped medical management where the use of medicines can be increased or decreased depending on circumstances and the therapy combinations.


      The NSW Tuberculosis Program is successful as the incidence of tuberculosis in NSW has remained stable over the last decade despite large-scale migration from high-prevalence countries and the treatment success rates have been high, with the absence of treatment failures and low rates of relapse of cases initially treated in Australia.

      The main challenges to the NSW Tuberculosis Program are similar to those that face tuberculosis control globally. They include control of multi-drug resistant and extreme drug-resistant tuberculosis and identification and management of tuberculosis-HIV coinfection (O'Connor et al. 2009).

      Influenza and Pneumonia

      Influenza and pneumococcal disease are covered by the National Immunisation Programs in NSW.

      Influenza has been a notifiable disease by all laboratories under the Public Health Act in NSW since 2001. Surveillance is enhanced in winter months when the NSW Ministry of Health collects and reports weekly on influenza-like illness presentations to Emergency Departments , through the Public Health Real-time Emergency Department Surveillance System (PHREDSS), and laboratory confirmed diagnoses of influenza virus infections.

      Emergency Departments in NSW are prepared for influenza epidemics with peak visit plans and similar measures in winter months.


      NSW Ministry of Health. Chronic Disease Management Program. Sydney: NSW Ministry of Health, 2014.

      National Asthma Council Australia. Asthma handbook. NACA, 2014

      O'Connor B, Fritsche L, Christensen A, McAnulty J. EpiReview: Tuberculosis in New South Wales, 2003-2007. 2009. Available at

    • For more information: Respiratory diseases

      Useful websites include:

      Australian Centre for Asthma Monitoring at

      National Asthma Council Australia at

      Australian Bureau of Statistics at

      Australian Institute of Health and Welfare at

      healthdirect at