Spotlight on elective surgery
Most elective surgery occurs in private hospitals but there’s been a record number of public hospital operations. How has that affected wait times?
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Public hospital admissions for elective surgery were the highest on record in 2023–24, indicating a return to pre-COVID elective surgical activity plus some.
There were 778,500 admissions from public hospital elective surgery waitlists in 2023–24, a 5.8% increase on the previous year.
Elective surgeries are procedures that are deemed medically necessary but are planned surgeries that are not conducted because of an emergency presentation, and as a result, may be subject to delays.
Cataract extraction was the most common procedure for those admitted from an elective surgery waitlist, accounting for 11% of all intended procedures.
Most elective surgeries performed in Australia are undertaken in private hospitals, so this update from the Australian Institute of Health and Welfare (AIHW) provides an insight into public demand for elective surgery in the public system and how our public hospitals are responding to that.
The AIHW says the increase in the number of admissions from public hospital elective surgery waitlists follows disruption to the health system because of the pandemic. Over that period, there were fluctuations in the numbers of elective surgeries as COVID outbreaks affected patients and the availability of hospital staff and resources.
Nationally, elective surgery admissions rose nearly 5.8% to 778,500.
The largest increases compared with 2022–23 were in the Australian Capital Territory (19%) and Victoria (10%). Surprisingly, admissions from public hospital elective surgery waiting lists in the Northern Territory dropped 3.6% from 2022–23.
Over a five-year period, the largest increases in admissions were in Tasmania (10% annual average increase since 2019–20) and Victoria (4.9%).
Although the most common surgical specialty associated with admissions was “general surgery”, representing 20% of all surgeries, the areas of speciality that have seen the greatest percentage increases in admissions from elective surgery waitlists were vascular surgery (14% increase compared with 2022–23) and paediatric surgery (8.2% annual average growth since 2019–20).
In a surprise finding, waiting times for elective surgery waitlist admissions have improved.
Half (50%) of all patients were admitted within 46 days in 2023–24 – an improvement from 49 days in 2022–23. Nine in 10 (90%) patients were admitted within 329 days – down from 361 days in 2022–23. Around 6.4% of patients waited more than a year – down from 9.6% in the previous reporting period (2022–23).
The number of emergency department presentations increased by 0.4% in 2023–24, with 8.83 million emergency department presentations (excluding the Northern Territory) compared with 8.80 million in 2022–23.
Around two in three (67%) emergency department patients were “seen on time” for their urgency category, a slight increase from 65% in 2022–23.
Nearly 100% of resuscitation patients were seen immediately, and 67% of those categorised as emergency cases (where clinical care should start within 10 minutes) were seen on time. These patients accounted for 18% of all emergency department presentations; the remaining 82% were categorised as urgent, semi-urgent, or non-urgent patients.
In 2023–24, there were 9 million emergency department presentations across the nation – a 2.5% increase on 2022–23.
National Seniors Australia (NSA) is campaigning to cut the ever-increasing cost of health care by focusing on key areas that concern older Australians have told us through feedback and research surveys. (See this report.)
Our campaign calls for:
Review of the private health insurance system
With premiums rising and out-of-pocket costs spiralling, NSA is calling for a full Productivity Commission review of the private health insurance system, with a focus on identifying ways to improve the value proposition of private health and reduce out-of-pocket expenses for policy holders.
Increase the Private Health Insurance Rebate for people on low incomes
As premiums rise and out-of-pocket costs increase, older people struggle to hold onto their private health insurance. There is a need to take urgent action to reduce the cost of private health to ensure ongoing coverage. This will help seniors maintain choice and control.
Create a targeted Seniors Dental Benefits Scheme
Establishing a Seniors Dental Benefit Scheme providing $500 per year towards interventions to improve oral health outcomes among older people will reduce pressure on public dental and ensure older people do not go without vital oral health care.
Minister for Older Australians
NSA is calling for a dedicated Minister within the Federal Government to champion the diverse issues facing older Australians, such as discrimination, elder abuse, retirement income, health care and aged care.
Related reading: NSA, AIHW, NSA report
