- + Key points: Overview of hospitalisations
• Between 2001-02 and 2014-15, the age-standardised hospital separation rate in NSW increased by 21%, and from 2010-11 (i.e. in the last five years of data) the rate increased by 7.3%.
• Hospitalisation rates are consistently higher in females of all ages greater than 16 years. In 2014-15 the most common causes of hospital separations for all ages were: dialysis; digestive system diseases; and symptoms and abnormal findings.
- + 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 (NSW Ministry of Health 2013).
NSW Ministry of Health. Hospital in the Home (HITH) Guideline. Sydney: NSW MoH, 2013. Available at: http://www0.health.nsw.gov.au/policies/gl/2013/GL2013_006.html