Centre for Health Services Research, the University of Queensland, Brisbane, QLD.
The University of Melbourne, Melbourne, VIC.
Med J Aust. 2023 Aug 7;219(3):113-119. doi: 10.5694/mja2.52026. Epub 2023 Jul 6.
To assess Australian hospital utilisation, 1993-2020, with a focus on use by people aged 75 years or more.
Review of Australian Institute of Health and Welfare (AIHW) hospital utilisation data.
SETTING, PARTICIPANTS: Tertiary data from all Australian public and private hospitals for the financial years 1993-94 to 2019-20.
Numbers and population-based rates of hospital separations and bed utilisation (bed-days) (all and multiple day admissions) and mean hospital length of day (multiple day admissions), overall and by age group (under 65 years, 65-74 years, 75 years or more).
Between 1993-94 and 2019-20, the Australian population grew by 44%; the number of people aged 75 years or more increased from 4.6% to 6.9% of the population. The annual number of hospital separations increased from 4.61 million to 11.33 million (146% increase); the annual hospital separation rate increased from 261 to 435 per 1000 people (66% increase), most markedly for people aged 75 years or more (from 745 to 1441 per 1000 people; 94% increase). Total bed utilisation increased from 21.0 million to 29.9 million bed-days (42% increase), but the bed utilisation rate did not change markedly (1993-94, 1192 bed-days per 1000 people; 2019-20, 1179 bed-days per 1000 people), primarily because the mean hospital length of stay for multiple day admissions declined from 6.6 days to 5.4 days; for people aged 75 years or more it declined from 12.2 to 7.1 days. However, declines in stay length have slowed markedly since 2017-18. Total bed utilisation was 16.8% lower than projected from 1993-94 rates, and was 37.3% lower for people aged 75 years or more.
Hospital bed utilisation rates declined although admission rates increased during 1993-94 to 2019-20; the proportion of beds occupied by people aged 75 years or more increased slightly during this period. Containing hospital costs by limiting bed availability and reducing length of stay may no longer be a viable strategy.
评估 1993 年至 2020 年澳大利亚医院的利用情况，重点关注 75 岁及以上人群的使用情况。
对澳大利亚卫生和福利研究所（AIHW）医院利用数据进行综述。
地点、参与者：澳大利亚所有公立和私立医院的三级数据，涵盖 1993-94 财年至 2019-20 财年。
医院出院人数和床位利用（所有和多天住院）以及多天住院的平均住院日（多天住院）的数量和基于人口的比率（65 岁以下、65-74 岁、75 岁及以上），总体和按年龄组（65 岁以下、65-74 岁、75 岁及以上）。
在 1993-94 年至 2019-20 年期间，澳大利亚人口增长了 44%；75 岁及以上人口占总人口的比例从 4.6%增加到 6.9%。医院出院人数从 461 万增加到 1133 万（增加 146%）；医院出院率从每 1000 人 261 人增加到每 1000 人 435 人（增加 66%），75 岁及以上人群的增幅最为显著（从每 1000 人 745 人增加到每 1000 人 1441 人，增加 94%）。总床位利用从 2100 万增加到 2990 万床位日（增加 42%），但床位利用率没有明显变化（1993-94 年，每 1000 人 1192 个床位日；2019-20 年，每 1000 人 1179 个床位日），主要是因为多天住院的平均住院时间从 6.6 天减少到 5.4 天；对于 75 岁及以上的人，这一数字从 12.2 天减少到 7.1 天。然而，自 2017-18 年以来，住院时间的下降速度明显放缓。与 1993-94 年的预测相比，总床位利用率下降了 16.8%，75 岁及以上人群的床位利用率下降了 37.3%。
尽管 1993-94 年至 2019-20 年期间入院率有所上升，但医院床位利用率有所下降；在此期间，75 岁及以上人群占用的床位比例略有增加。通过限制床位供应和减少住院时间来控制医院成本可能不再是可行的策略。
