- + Key points: Overview of hospitalisations
• Over the 10 years between 2009-10 and 2018-19, the number of hospitalisations has increased in NSW by 31% (from 2,337,027 in 2009-10 to 3,063,914 in 2018-19) but the age-standardised hospital rate has increased by only 11% (from 31,240 per 100,000 population in 2008-09 to 34,818 per 100,000 population in 2018-19). Age-standardisation adjusts for the impact of the known effect of an ageing population on increasing hospitalisation rates over time.
• Age-standardised hospitalisation rates for females are consistently higher than those for males over time and were 3.3% higher than males in 2018-19.
• Apart from population ageing and differences in the age structures of population groups (such as Aboriginal peoples and those living in rural areas), rates of hospitalisation are influenced by the incidence (new cases) and prevalence (existing cases) of chronic and acute disease, as well as injury in the population, availability of and access to health services, and availability of treatment options for diseases and injuries.
- + Background: Overview of hospitalisations
The term 'hospitalisation' refers to a period of time during which a person stayed in a hospital for a defined purpose, which could be diagnostic, curative or palliative. A hospital stay starts with a formal process of admission and ends with a formal separation.
Hospitalisations are described in hospital statistics, which measure hospital activity. The number of patients in a period of time, number of beds, types of beds (for acute or chronic cases etc) and bed occupancy levels are measured among other variables. These statistics are compared to staffing levels, available funds and population size and are used to monitor the distribution and utilisation of hospital services. Hospitalisations can also be analysed by a patient's demographic and clinical characteristics such as their age and their clinical diagnosis.
Sources of data in NSW
Sources of data on hospitalisations in NSW include the NSW Combined Admitted Patient Epidemiology Data (CAPED) and NSW Population Health Survey.
In HealthStats NSW, hospitalisations are analysed on the basis of separations (i.e. the date the person completed that hospital episode, rather than the date that person was admitted into that hospital episode). The reason for this is that the coding of a patient's clinical diagnosis during a hospitalisation is done after separating from that hospital. This diagnosis may be different from the reason the person was admitted. Expert medical coders decide on the principal and associated diagnoses after separation based on the whole medical records of the patient.
- + Interventions: Overview of hospitalisations
Interventions aiming to reduce hospitalisation rates are embedded in strategies dealing with specific health issues or specific disadvantaged populations.
These strategies focus on reduction of prevalence of conditions in the community (prevention of conditions arising in the first place) or on reduction of hospitalisations for these conditions via two different methods. One method focuses on preventing worsening of conditions and managing these conditions via primary care system and thus preventing admission to hospital. The topic of Potentially Preventable Hospitalisations (Ambulatory Care Sensitive Conditions) contains a discussion of details concerning these conditions. The NSW Chronic Care Program covers many such conditions requiring hospitalisation.
The other approach reduces the burden of hospitalisations on the health system by reducing the number of beds required at any point in time. It is based on the concept of out-of-hospital care, which includes hospital care at home. NSW Ministry of Health delivers an increasing type and number of services in out of hospital environment.