Hospital admissions in Australia rose as COVID-19 restrictions eased in most states and territories in 2020–21

Public and private hospital admissions rebounded in 2020–21, following a decline in the previous reporting period, according to new information from the Australian Institute of Health and Welfare (AIHW).

The latest MyHospitals update provides the first chance to fully investigate the impact of the pandemic on hospital admissions in 2020–21. The release shows there were 11.8 million hospitalizations in Australia in 2020–21, up from 11.1 million in 2019–20.

Following steady annual growth of 3.3% between 2014–15 and 2018–19, and a dip of 2.8% in 2019–20, hospitalizations increased by 6.3% nationally in 2020–21. This saw hospitalizations returning the trend to pre-pandemic years in most jurisdictions.

Not all states and territories experienced the substantial increase in hospital admissions. For example, in Victoria, overall hospitalizations increased by just 1.3% since 2019–20 associated with ongoing COVID-19 outbreaks in that state.

"The significant increase in hospitalizations at the national level can be largely attributed to the easing of restrictions following the first waves of the pandemic in most states and territories, particularly restrictions on elective (or non-emergency) surgery. The increase also reflects efforts to clear the backlog of surgeries that had been created the previous year," said AIHW spokesperson Dr. Adrian Webster (Ph.D.).

Overall, there were 7.4 million same-day hospitalizations and 4.4 million overnight hospitalizations in 2020–21. This shows increases of 8.1% and 3.3%, respectively since 2019–20.

The length of overnight hospitalizations in public hospitals remained unchanged between 2019–20 and 2020–21, while in private hospitals the length of stay decreased 4.8%.

Shorter hospital stays generally indicate less intensive surgery, aligned with a particular effort to catch-up on delayed procedures, largely provided in private hospitals.

"Private hospitals had a significant increase in admissions (10.5%) compared to public hospitals (3.6%) in 2020–21, coming from a relatively lower base due to the private sector experiencing a larger decrease in activity the previous year," Dr. Webster said.

Dr. Webster noted that a number of jurisdictions may have contracted care to private hospitals in an effort to catch up on surgeries that had been delayed due to COVID-19 restrictions, so many public patients were treated in private hospitals.

"The largest increase in hospitalizations was for principal diagnoses related to diseases of the eye and adnexa (19%), likely related to catch-up cataract surgery," Dr. Webster said.

Today's release also includes information on people hospitalized with a diagnosis of COVID-19. There were over 4,700 hospitalizations involving a COVID-19 diagnosis in 2020–21, with about 4 in 10 (42%) having one or more comorbid chronic condition (such as type 2 diabetes or cardiovascular disease).

"Of the 4,700 hospitalized patients with a COVID-19 diagnosis, 329 (7%) involved a stay in an Intensive Care Unit (ICU), 180 (3.8%) required ventilation, and 487 (10.3%) died in hospital.

"Two-thirds (66%) of these hospitalizations were for people aged 45 or older and 4.4% were for children aged 0–14," Dr. Webster said.