Provision of Services in Private Hospitals

Private hospitals are a vital partner with the public sector in the provision of a wide range of services. The private hospitals sector is very diverse and includes a wide range of facilities and ownership structures.

While some of the large acute medical/surgical private hospitals provide similar services to their public sector counterparts, this holds true largely in the densely populated metropolitan areas. For the most part, private hospitals are quite different from public hospitals in size and types of services offered.

For example, private facilities in the mental health sector provide treatment for quite distinct conditions to those treated in the public sector. The majority of chemotherapy treatment for people with cancer is delivered in the private sector. Most of the rehabilitation for people who have had accidents, injuries or falls is provided in private hospitals, where patients needing in-hospital rehabilitation are transferred after surgery and recovery in the public or private sectors to a private rehabilitation hospital. And nearly all in-hospital palliative care services for the dying are private hospitals, especially in regional Australia.

Contrary to the views expressed by some commentators, the private hospitals sector DOES provide a comprehensive range of services; DOES treat older patients; DOES NOT merely provide ‘profitable’ services (whatever these may actually be); DOES provide training for medical staff; DOES provide safe and quality services; and DOES contribute significantly to the balance and sustainability of the Australian health system, as is illustrated by the data below.

  • Private hospitals treat 40% of all patients in Australia. (AIHW, 2009-10a, pp. 139, Table 7.1)
  • In 2009-10, private hospitals admitted 3.5 million patients. (AIHW, 2009-10a, pp. 139, Table 7.1)
  • From 2008-09 to 2009-10, the number of patients admitted to private hospitals rose by 5.1%. Over the same period the number of patients admitted to public hospitals rose by 3.7%. (AIHW, 2009-10a, pp. 139, Table 7.1) 
  • Private hospitals perform the majority of elective surgery in Australia – 65%. (AIHW, 2009-10a, pp. 250, Table 10.2)
    •  In 2009–10, there were 2.1 million occasions of service in non-admitted patients services in Acute and psychiatric private hospitals in Australia. Of these the most common services provided were Accident and emergency (527,000 occasions of service). (ABS, 2009-10, p. 18)
    • Private hospitals provided 8.4 million days of hospitalisation to patients in 2009–10, up 3.7% on 2008–09 (8.1 million). (ABS, 2009-10, p. 6)
    • In 2009-10, a total of 3.2 million patients age 65+ were admitted to both public and private hospital. Private hospitals treated over 41% (that is, over 1.3 million) patients from this group age. Further, this age group represented over 38% of all private hospital admissions in 2009-10, slightly higher than public hospitals at just under 37% over the same period. (AIHW, 2009-10a, pp. 180-1, Tables S7.11 and S7.12)
    • In 2009-10, 5.7% of total private hospital treatments were for patients aged 85 years and older. Over the same period, 6.0% of total public hospital treatments were for this age group. (AIHW, 2009-10a, pp. 180-1, Tables S7.11 and S7.12)
    • In 2009-10, private hospitals treated 84.7% (over 2.7 million) of total patients with private health insurance, 83% (over 280,000) of self funded patients, and 62.8% (nearly 200,000) of Department of Veterans’ Affairs (DVA) patients. (AIHW, 2009-10a, pp. 163, Table 7.20)
    • In 2009-10, public hospitals treated nearly 15.3% (over 500,000) privately insured patients. In the same period, private hospitals treated 2.3% (over 100,000) public patients. (AIHW, 2009-10a, pp. 163, Table 7.20)
    • In 2009-10, 7.3 million procedures were reported for same-day acute separations, with nearly 4.2 million in private sector. This accounts for more than half (that is, more than 57%) of the same-day acute separation for which a procedure was reported. (AIHW, 2009-10a, pp. 197-8, Table 8.12)
    • In 2009-10, there were almost 3.5 million overnight acute admitted patients, accounting for 40.5% of all admissions. This was an increase of 3.7% (in private hospitals) and 2.7% (in public hospitals) since 2008-09. (AIHW, 2009-10a, pp. 216, Table 9.1)
    • Between 2005-06 and 2009-10, the number of separations for non-acute care in both private and public hospital sectors increased by 10.1% per year. Over this period, the average rate of increase was higher in private hospitals (15.6%) than in public hospitals (4.8%). (AIHW, 2009-10a, pp. 270, Table 11.1)
  • Of the top 10 (in volume) treatments provided by both public and private hospitals, five are identical procedures – with private hospitals performing the majority in four of the five. (AIHW, 2009-10a, pp. 149, Table 7.6)
  • In 2009-10, the majority of activities reported for 16 of the top 20 most common Australian Refined Diagnoses Related Groups (AR-DRGs), with the highest number of same-day acute-separations, were occurred in private hospitals. (AIHW, 2009-10a, pp. 197, Table 8.11).