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Hospital Performance: Costs of acute admitted patients in public hospitals from 2011–12 to 2013–14

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Key findings
Cost per NWAU, 2011–12 to 2013–14

For the first time, this report presents the change in the average cost of care for acute admitted patients in Australia’s largest public hospitals across three years.

This report presents findings for major metropolitan public hospitals across Australia. From 2011–12 to 2013–14, on average the expenditure at hospitals to provide acute care increased by 6%. However, this was accompanied by a 5% increase in the number of activity units (NWAUs) for acute admitted patients (Table 1).

This means that the average cost of care (unadjusted for inflation) at major metropolitan public hospitals remained relatively unchanged over this period (1% growth). This growth was slower than inflation (approximately 5%4). This demonstrates that as a group, major metropolitan public hospitals have achieved improvements in efficiency (Table 1).

Across three years, from 2011–12 to 2013–14, eight major metropolitan public hospitals decreased their Cost per NWAU for acute admitted patients by at least 5%. At the same time, six major metropolitan public hospitals increased their Cost per NWAU by at least 10% (Figure 2).

A decrease in Cost per NWAU from 2011–12 to 2013–14 implies an improvement in a hospital’s efficiency. This may be due to initiatives by the hospital, such as a decrease in spending or by increasing the volume of services provided, or a combination of both (Table 3). One way a hospital may ensure more services are provided within its existing expenditure is to treat more patients by decreasing the average length of a patient’s stay in hospital.

Although improvements in data quality may lead to an apparent decrease in a hospital’s Cost per NWAU, state and territory governments have confirmed that the hospitals listed in Table 3 were not affected by changes in data recording practices.

While this report presents results on the efficiency of hospitals, it does not consider other aspects of the quality of care such as access, appropriateness or health outcomes.

Table 3: Major metropolitan public hospitals that improved efficiency by decreasing the average cost of care by at least 5%, 2011–12 to 2013–14

Major metropolitan public hospitals Reduced spending Increased number of activity units (NWAUs) Reduced spending & increased no. of activity units (NWAUs)
Caboolture Hospital (Qld) Yes
Campbelltown Hospital (NSW) Yes
Mater Adult Hospital (Qld) Yes
Royal Brisbane & Women’s Hospital (Qld) Yes
St George Hospital (NSW) Yes
The Alfred (Vic) Yes
Western Hospital [Footscray] (Vic) Yes
Westmead Hospital (NSW) Yes
Sources
National Health Performance Authority analysis of results calculated using the National Hospital Cost Data Collection, the Admitted Patient Care National Minimum Data Set and the Hospital Casemix Protocol Data Collection. Data supplied 18 and 28 October 2014 (2011–12 data) and 27 November 2015 (2012–13 and 2013–14 data).

Figure 2: Cost per National Weighted Activity Unit (NWAU)* or acute admitted patients, major metropolitan public hospitals, 2011–12 to 2013–14, sorted by Cost per NWAU in 2013–14

An infographic image showing the Cost per NWAU for acute admitted patients in public hospitals in 2011-12

Hospital Cost per NWAU from 2011–12 to 2013–14*
(Rounded and unadjusted for inflation)
Percentage change Cost per NWAU 2011–12 to 2013–14
2011–12 2012–13 2013–14
The Canberra Hospital (ACT) $5,800 $5,800 $6,100 +7%
Calvary Public Hospital (ACT) $5,300 $5,500 $5,800 +10%
Sir Charles Gairdner Hospital (WA) $5,500 $5,600 $5,600 +1%
Fremantle Hospital (WA) $5,100 $5,200 $5,500 +9%
Royal Perth Hospital Wellington St. (WA) $5,100 $5,100 $5,400 +7%
The Prince Charles Hospital (Qld) $5,200 $5,300 $5,200 0%
The Queen Elizabeth Hospital (SA) $5,100 $4,900 $5,200 +2%
Royal Adelaide Hospital (SA) $4,600 $4,800 $5,000 +8%
Hornsby Ku-ring-gai Hospital (NSW) $4,200 $4,200 $4,900 +17%
Prince of Wales Hospital (NSW) $4,800 $4,700 $4,800 -1%
Princess Alexandra Hospital (Qld) $4,500 $4,900 $4,800 +6%
St Vincent’s Hospital (NSW) $4,400 $4,400 $4,800 +9%
John Hunter Hospital (NSW) $4,100 $4,400 $4,700 +15%
Mater Adult Hospital (Qld) $4,900 $4,900 $4,700# -5%
Royal Brisbane & Women’s Hospital (Qld) $5,000 $4,900 $4,700# -5%
Royal Prince Alfred Hospital (NSW) $4,200 $4,200 $4,600 +10%
Bankstown Lidcombe Hospital (NSW) $3,900 $4,000 $4,400 +11%
Gosford Hospital (NSW) $4,300 $4,400 $4,400 +2%
The Tweed Hospital (NSW) $4,400 $4,500 $4,400 0%
Caboolture Hospital (Qld) $4,700 $4,600 $4,300# -8%
Sutherland Hospital (NSW) $4,200 $4,200 $4,300 +4%
Westmead Hospital (NSW) $4,700 $4,500 $4,300# -9%
Wollongong Hospital (NSW) $4,300 $4,300 $4,300 -1%
Wyong Hospital (NSW) $4,400 $4,400 $4,300 -1%
Liverpool Hospital (NSW) $4,100 $4,100 $4,200 +3%
Lyell McEwin Hospital (SA) $4,100 $4,100 $4,200 +1%
Nepean Hospital (NSW) $4,100 $4,200 $4,200 +2%
Campbelltown Hospital (NSW) $4,300 $4,400 $4,100# -5%
St George Hospital (NSW) $4,400 $4,100 $4,100# -6%
St Vincent’s Hospital [Fitzroy] (Vic) $4,000 $4,000 $4,100 +3%
Austin Hospital [Heidelberg] (Vic) $3,900 $4,000 $4,000 +4%
Box Hill Hospital (Vic) $3,900 $3,600 $3,800 -2%
Monash Medical Centre [Clayton] (Vic) $3,900 $3,600 $3,800 -2%
Geelong Hospital (Vic) $3,700 $3,800 $3,700 0%
The Alfred (Vic) $3,900 $3,700 $3,700# -5%
Royal Melbourne Hospital [Parkville] (Vic) $3,400 $3,600 $3,600 +6%
Maroondah Hospital [East Ringwood] (Vic) $3,100 $3,600 $3,500 +14%
Sunshine Hospital (Vic) $3,400 $3,400 $3,500 +2%
The Northern Hospital [Epping] (Vic) $3,400 $3,300 $3,500 +3%
Dandenong Campus (Vic) $3,400 $3,400 $3,400 +1%
Western Hospital [Footscray] (Vic) $3,600 $3,400 $3,300# -9%
Other Hospitals
Logan Hospital (Qld) $5,300 NP $5,000
Concord Hospital (NSW) NP NP $4,800
Flinders Medical Centre (SA) $4,700 $4,800 $4,800
Royal North Shore Hospital (NSW) NP $4,300 $4,500
Casey Hospital (Vic) NP $3,600 $3,200
Frankston Hospital (Vic) NP $3,100 $3,100
Blacktown Hospital (NSW) NP NP NP
Gold Coast Hospital (Qld) $4,800 $4,800 NP
Ipswich Hospital (Qld) $4,300 NP NP
Redcliffe Hospital (Qld) $4,200 NP NP
Joondalup Health Campus [Public] (WA) NA NA NA
Robina Hospital (Qld) NA NA NA

# $X,XXX 2013–14 result was at least 5% lower than the 2011–12 result

Note: Percentage change results may differ from plotted results due to rounding.

*
Further information on Cost per NWAU and change over time can be found in the Technical Supplement
It is recommended that for this hospital the Cost per NWAU 2011–12 results are not compared to 2012–13 and 2013–14 (see the Technical Supplement).
Percentage change 2011–12 to 2013–14 was calculated on unrounded Cost per NWAU.
NA
Data not available at time of publication.
NP
Data did not meet minimum reporting requirements as detailed in the Technical Supplement.
Sources
National Health Performance Authority analysis of results calculated using the National Hospital Cost Data Collection, the Admitted Patient Care National Minimum Data Set and the Hospital Casemix Protocol Data Collection. Data supplied 18 and 28 October 2014(2011–12 data) and 27 November 2015 (2012–13 and 2013–14 data).
4
Australian Bureau of Statistics (ABS). 6401.0 - Consumer Price Index, Australia, Dec 2015 [Internet]. Canberra: ABS; 2016 Jan 27 [cited 2016 Feb 15]. 6401.0 – Consumer Price Index, Australia, TABLES 1 and 2. CPI: All Groups, Index Numbers and Percentage Changes. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6401.0Dec%202015?OpenDocument#Publications
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