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Day hospital care grows strongly

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Private day hospitals are becoming an increasingly significant and lucrative part of the health system, providing more than one million patient days of care a year, official figures show.

As the Federal Government looks for ways to increase private sector involvement in the provision of health care, Australian Bureau of Statistics data show the number of free-standing private day hospitals is growing strongly, with eight new facilities added in 2012-13 to lift the total complement to 319, compared with 282 private acute and psychiatric hospitals.

Private day hospitals are benefiting from the increasing tendency toward same-day treatment – while there was an overall 4.3 per cent rise in overall hospitalisation rates in the private sector in 2012-13, this included a huge 16.3 per cent jump in the number of same-day patients for day hospitals.

The official figures show private day hospitals were much less costly to operate than their acute counterparts – the average day hospital running cost per patient was $709 in 2012-13, compared with $1188 for private acute and psychiatric hospitals – and their wages bill as a proportion of total expenditure was 41.4 per cent, compared with 49.2 per cent for acute hospitals.

Unsurprisingly, given these results, day hospitals boasted a much better net operating margin than their acute counterparts – 18.7 per cent in 2012-13, compared with 9.2 per cent.

The most common cited reason for attending a private day hospital was the generic ‘factors influencing health status’ descriptor, accounting for 36 per cent of visits, followed by treatment for digestive system diseases (16.2 per cent) and – reflecting the boom in laser eye surgery – eye procedures (14.1 per cent).

Among private acute and psychiatric hospitals, the most common procedures were non-invasive cognitive interventions (53.6 per cent), followed by digestive system surgery (10.6 per cent) and musculo-skeletal work (6.8 per cent).

Among patients hospitalised for more than a day, the average length of stay was 5.2 days, though the proportion of patients coming in for same-day treatment has grown steadily, from 51.8 per cent in 2002-03 to 59.5 per cent 10 years later.

In a sign that private facilities are running at a reasonably high tempo, the bed occupancy rate is close to 85 per cent, while the number of full-time equivalent staff grew by 4.6 per cent in 2012-13 to up almost 24 per cent from a decade earlier.

Underlining the growing importance of the private sector in the provision of psychiatric care, figures compiled by the Private Mental Health Alliance show it provided 2339 psychiatric beds – spread across 30 stand-alone hospitals and 26 in-hospital psychiatric units – in 2012-13.

In all, almost 32,000 patients were treated during the financial year, with an average length of stay of 19 days.

The most common problem by far was major affective and other mood disorders (48 per cent of overnight stay episodes), followed by problems stemming from abuse of alcohol and other drugs (20 per cent), post-traumatic stress disorder (10 per cent), schizophrenia and psychosis (7 per cent) and anxiety disorders (7 per cent).

Adrian Rollins