Ministry of Health
Hospital Events
2008/09 and 2009/10
Citation: Ministry of Health. 2012. Hospital Events 2008/09 and 2009/10. Wellington: Ministry of Health.
Published in November 2012 by the
Ministry of Health
PO Box 5013, Wellington 6145, New Zealand
ISBN 978-0-478-40209-4 (print)
ISBN 978-0-473-40210-0 (online)
HP 5584
This document is available at t.nz
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[pic] This work is licensed under the Creative Commons Attribution 4.0 International licence. In essence, you are free to: share ie, copy and redistribute the material in any medium or format; adapt ie, remix, transform and build upon the material. You must give appropriate credit, provide a link to the licence and indicate if changes were made.
Acknowledgements
Many people have assisted in the production of this publication. In particular, the Ministry of Health thanks the peer reviewers for their valuable contribution.
Source
Hospital data for this publication are sourced from the National Minimum Dataset held by the Ministry of Health.
Disclaimer
The purpose of this publication is to inform discussion and assist policy development. The opinions expressed in the publication do not necessarily reflect the official views of the Ministry of Health.
All care has been taken in the production of this publication. The data are deemed to be accurate at the time of publication, but may be subject to slight changes over time as further information is received. It is advisable to check the current status of figures given here with the Ministry of Health before quoting or using them in further analysis.
National collection, coding and collation of hospital event data is a complex process. This is because the information in the National Minimum Dataset cannot be finalised until data have become available from all hospitals that report to the Ministry of Health. In addition, several steps are required to ensure the final information is of good quality.
The Ministry of Health makes no warranty, expressed or implied, nor assumes any legal liability or responsibility for the accuracy, correctness, completeness or use of the information or data in this publication. Further, the Ministry of Health shall not be liable for any loss or damage arising directly or indirectly from the information or data presented in this publication.
The Ministry of Health welcomes comments and suggestions about this publication.
Contents
Key points xi
Introduction 1
Purpose 1
Data sources, data quality and timing issues 1
Hospital discharges 4
Overview 4
Sex 5
Age 8
Ethnicity 12
Deprivation 18
District health board region 20
Selected diagnoses 27
Length of stay and bed days 35
Inpatients and day cases 39
Hospital procedures 46
Overview 46
Sex 46
Age 48
Ethnicity 53
Deprivation 59
District health board region 61
Selected procedures 67
Length of stay 73
Inpatients and day cases 76
Hospital discharges involving injury and poisoning 83
Overview 83
Sex 84
Age 86
Ethnicity 88
Deprivation 94
District health board region 96
Selected causes 102
Length of stay and bed days 105
Inpatients and day cases 110
Further hospital-related information 115
Electronic version of this Hospital Events publication 115
Other hospital-related Ministry of Health publications 115
Other publications containing data from the National Minimum Dataset 116
Other hospital-related publications 116
Population and demographic data 116
Hospital data available from the Ministry of Health 117
Additional information available from the Ministry of Health 118
Definitions 119
Technical notes 122
Rate calculations 122
Confidence intervals 124
Procedure codes 124
References 126
List of tables
Table 1: Hospital discharges by hospital type and funding type, 2004/05–2009/10 2
Table 2: Hospital discharges and age-standardised rates by sex, 1995/96–2009/10 6
Table 3: Publicly funded hospital discharges by five-year age group and sex, 2009/10 8
Table 4: Privately funded hospital discharges by five-year age group and sex, 2009/10 9
Table 5: Publicly funded hospital discharges and age-standardised rates by ethnicity, 1995/96–2009/10 12
Table 6: Publicly funded hospital discharges and age-standardised rates by ethnicity and sex, 1995/96–2009/10 14
Table 7: Publicly funded hospital discharges by DHB region, 2009/10 21
Table 8: Publicly funded hospital discharges by DHB region, Māori population, 2009/10 24
Table 9: Age-standardised publicly funded hospital discharge rates for selected diagnoses by sex and ethnicity, 2009/10 29
Table 10: Age-standardised privately funded hospital discharge rates for selected diagnoses by sex, 2009/10 33
Table 11: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital discharges, 1995/96 and 2009/10 35
Table 12: Average length of stay and total bed days by sex, privately funded hospital discharges, 2004/05 and 2009/10 36
Table 13: Average length of stay and total bed days by DHB region, total population, publicly funded hospital discharges, 2009/10 37
Table 14: Average length of stay and total bed days by DHB region, Māori population, publicly funded hospital discharges, 2009/10 38
Table 15: Hospital discharges by patient type, 1995/96–2009/10 39
Table 16: Hospital procedures and age-standardised rates by sex, 1995/96–2009/10 47
Table 17: Publicly funded hospital procedures by five-year age group and sex, 2009/10 49
Table 18: Privately funded hospital procedures by five-year age group and sex, 2009/10 50
Table 19: Publicly funded hospital procedures and age-standardised rates by ethnicity, 1995/96–2009/10 53
Table 20: Publicly funded hospital procedures and age-standardised rates by ethnicity and sex, 1995/96–2009/10 55
Table 21: Publicly funded hospital procedures by DHB region, 2009/10 61
Table 22: Publicly funded hospital procedures by DHB region, Māori population, 2009/10 64
Table 23: Age-standardised publicly funded hospital procedure rates for selected procedures by sex and ethnicity, 2009/10 68
Table 24: Age-standardised privately funded hospital procedure rates for selected procedures by sex, 2009/10 71
Table 25: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital procedures, 1995/96 and 2009/10 73
Table 26: Average length of stay and total bed days by sex and ethnicity, privately funded hospital procedures, 2004/05 and 2009/10 73
Table 27: Average length of stay by ethnicity and DHB region, publicly funded hospital procedures, 2009/10 75
Table 28: Hospital procedures by patient type, 1995/96–2009/10 76
Table 29: Hospital discharges involving injury and poisoning and age-standardised rates by sex, 1995/96–2009/10 84
Table 30: Hospital discharges involving injury and poisoning by five-year age group and sex, 2009/10 86
Table 31: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity, 1995/96–2009/10 88
Table 32: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity and sex, 1995/96–2009/10 90
Table 33: Hospital discharges involving injury and poisoning by DHB region, 2009/10 96
Table 34: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10 99
Table 35: Age-standardised rates for hospital discharges involving injury and poisoning for selected causes by sex and ethnicity, 2009/10 102
Table 36: Average length of stay and total bed days by sex and ethnicity, hospital discharges involving injury and poisoning, 1995/96 and 2009/10 105
Table 37: Average length of stay and total bed days by DHB region, total population, hospital discharges involving injury and poisoning, 2009/10 108
Table 38: Average length of stay and total bed days by DHB region, Māori population, hospital discharges involving injury and poisoning, 2009/10 109
Table 39: Hospital discharges involving injury and poisoning by patient type,
1995/96–2009/10 110
Table N-1: Population data, 2009/10 122
Table N-2: World Health Organization world standard population 123
Table N-3: ICD-10-AM 6th Edition procedure codes for selected procedures 124
List of figures
Figure 1: Number of hospital discharges by hospital type and funding type, 2009/10 2
Figure 2: Number of patients discharged from hospital by funding type, 2009/10 5
Figure 3: Age-standardised hospital discharge rates by sex, 1999/00–2009/10 7
Figure 4: Age-specific publicly funded hospital discharge rates by sex, 2009/10 10
Figure 5: Age-specific privately funded hospital discharge rates by sex, 2009/10 11
Figure 6: Age-standardised publicly funded hospital discharge rates by ethnicity, 1999/00–2009/10 13
Figure 7: Age-specific publicly funded hospital discharge rates by ethnicity, 2009/10 15
Figure 8: Age-specific publicly funded hospital discharge rates by ethnicity, males, 2009/10 16
Figure 9: Age-specific publicly funded hospital discharge rates by ethnicity, females, 2009/10 17
Figure 10: Publicly and privately funded hospital discharge rates by deprivation quintile, 2009/10 18
Figure 11: Publicly funded hospital discharge rates by ethnicity and deprivation quintile, 2009/10 19
Figure 12: Publicly funded hospital discharge rates by DHB region, 2009/10 22
Figure 13: Publicly funded hospital discharge rates by DHB region, 2009/10 23
Figure 14: Publicly funded hospital discharge rates by DHB region, Māori population, 2009/10 25
Figure 15: Publicly funded hospital discharge rates by DHB region, Māori population, 2009/10 26
Figure 16: Publicly funded hospital discharges by sex and ICD chapter, 2009/10 27
Figure 17: Privately funded hospital discharges by sex and ICD chapter, 2009/10 32
Figure 18: Age-specific publicly funded hospital discharge rates by patient type, 2009/10 40
Figure 19: Age-specific privately funded hospital discharge rates by patient type, 2009/10 41
Figure 20: Age-specific publicly funded hospital discharge rates by ethnicity, inpatients, 2007/08 42
Figure 21: Age-specific publicly funded hospital discharge rates by ethnicity, day cases, 2009/10 43
Figure 22: Publicly funded hospital discharges by deprivation quintile and patient type, 2009/10 44
Figure 23: Privately funded hospital discharges by deprivation quintile and patient type, 2009/10 45
Figure 24: Age-standardised hospital procedure rates by sex, 1999/00–2009/10 48
Figure 25: Age-specific publicly funded hospital procedure rates by sex, 2009/10 51
Figure 26: Age-specific privately funded hospital procedure rates by sex, 2009/10 52
Figure 27: Age-standardised hospital procedure rates by ethnicity, 1999/00–2009/10 54
Figure 28: Age-specific publicly funded hospital procedure rates by ethnicity, 2009/10 56
Figure 29: Age-specific publicly funded hospital procedure rates by ethnicity, males, 2009/10 57
Figure 30: Age-specific publicly funded hospital procedure rates by ethnicity, females, 2009/10 58
Figure 31: Publicly and privately funded procedure rates by deprivation quintile, 2009/10 59
Figure 32: Publicly funded hospital procedure rates by ethnicity and deprivation quintile, 2009/10 60
Figure 33: Publicly funded hospital procedure rates by DHB region, 2009/10 62
Figure 34: Publicly funded hospital procedure rates by DHB region, 2009/10 63
Figure 35: Publicly funded hospital procedure rates by DHB region, Māori population, 2009/10 65
Figure 36: Publicly funded hospital procedure rates by DHB region, Māori population, 2009/10 66
Figure 37: Publicly funded hospital procedures by sex and ICD chapter, 2009/10 67
Figure 38: Privately funded hospital procedures by sex and ICD chapter, 2009/10 70
Figure 39: Average length of stay, hospital procedures, 2009/10 74
Figure 40: Age-specific publicly funded hospital procedure rates by patient type, 2009/10 77
Figure 41: Age-specific privately funded hospital procedure rates by patient type, 2009/10 78
Figure 42: Age-specific publicly funded hospital procedure rates by ethnicity, inpatients, 2009/10 79
Figure 43: Age-specific publicly funded hospital procedure rates by ethnicity, day cases, 2009/10 80
Figure 44: Publicly funded hospital procedures by deprivation quintile and patient type, 2009/10 81
Figure 45: Privately funded hospital procedures by deprivation quintile and patient type, 2009/10 82
Figure 46: Age-standardised hospital discharge rates involving injury and poisoning by sex, 1995/96–2009/10 85
Figure 47: Age-specific rates for hospital discharges involving injury and poisoning by sex, 2009/10 87
Figure 48: Age-standardised rates for hospital discharges involving injury and poisoning by ethnicity, 1999/00–2009/10 89
Figure 49: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, 2009/10 91
Figure 50: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, males, 2009/10 92
Figure 51: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, females, 2009/10 93
Figure 52: Rates for hospital discharges involving injury and poisoning by deprivation quintile, 2009/10 94
Figure 53: Rates for hospital discharges involving injury and poisoning by ethnicity and deprivation quintile, 2009/10 95
Figure 54: Hospital discharges involving injury and poisoning by DHB region, 2009/10 97
Figure 55: Hospital discharges involving injury and poisoning by DHB region, 2009/10 98
Figure 56: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10 100
Figure 57: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10 101
Figure 58: Average length of stay by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10 106
Figure 59: Total bed days by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10 107
Figure 60: Age-specific rates for hospital discharges involving injury and poisoning by patient type, 2009/10 111
Figure 61: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10 112
Figure 62: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10 113
Figure 63: Hospital discharges involving injury and poisoning by deprivation quintile and patient type, 2009/10 114
Key points
Overview
Hospital discharges
• There were more than 1.1 million discharges from New Zealand hospitals in 2009/10. This equates to 21,794.8 publicly funded hospitalisations per 100,000 people and 1407.7 privately funded hospitalisations per 100,000 people (age-standardised).
• There were 310 more publicly funded hospitalisations and 147 fewer privately funded hospitalisations per 100,000 people in 2009/10 compared with 2008/09.
Hospital procedures
• More than 1.5 million procedures were performed in New Zealand hospitals in 2009/10. Relative to the population, there were 28,617.5 publicly funded procedures and 2926.8 privately funded procedures per 100,000 people (age-standardised).
• There were 1449 more publicly funded procedures and 336 fewer privately funded procedures per 100,000 people in 2009/10 compared with 2008/09.
Hospital discharges involving injury and poisoning
• There were 180,042 discharges involving injury and poisoning from New Zealand hospitals in 2009/10. This equates to 3595.1 hospitalisations per 100,000 people (age-standardised).
• There were 87 more hospitalisations involving injury and poisoning per 100,000 people in 2009/10 compared with 2008/09.
Sex
• In 2009/10 there were:
– 79 male hospitalisations for every 100 female hospitalisations
– 80 male procedures for every 100 female procedures
– 112 male hospitalisations involving injury and poisoning for every 100 female hospitalisations.
• In 2009/10, females had higher age-standardised rates of hospital discharges and hospital procedures compared with males, while males had a higher rate of hospitalisations involving injury and poisoning compared with females.
Age
• Generally, older patients (aged 65 years and over) had higher rates of hospital discharges, procedures and hospitalisations involving injury and poisoning compared with other age groups in 2009/10.
• Young patients aged 0–4 years and females aged 15–49 years also had higher hospitalisation and procedure rates compared with other age groups in 2009/10.
Ethnicity
• In 2009/10 Māori accounted for:
– 16 out of every 100 publicly funded hospital discharges
– 15 out of every 100 publicly funded hospital procedures
– 15 out of every 100 hospitalisations involving injury and poisoning.
• Māori had higher rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning compared with non-Māori in each year from 1995/96 to 2009/10.
Deprivation
• As deprivation increased, rates of publicly funded hospital discharges, procedures and hospitalisations involving injury and poisoning increased in 2009/10.
• As deprivation increased, rates of privately funded hospital discharges and procedures decreased in 2009/10.
• At all levels of deprivation Māori had higher rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning compared with non-Māori in 2009/10.
District health board region
• Over half of North Island DHB regions and one South Island DHB region had significantly higher hospitalisation rates compared to the New Zealand rate in 2009/10.
• The majority of North Island DHB regions and half of South Island DHB regions had significantly higher procedure rates compared to the national rate in 2009/10.
• Nearly two-thirds of North Island DHB regions had significantly higher rates for hospitalisations involving injury and poisoning compared to the New Zealand rate in 2009/10.
Selected diagnoses and procedures
• For most selected diagnoses (including those for hospitalisations involving injury and poisoning), male hospitalisation rates were higher than female rates in 2009/10.
• For the majority of selected procedures and selected diagnoses (including those for hospitalisations involving injury and poisoning), Māori had higher rates compared with non-Māori in 2009/10.
Length of stay and bed days
• The average length of stay increased for hospital discharges and decreased for both procedures and hospitalisations involving injury and poisoning from 1995/96 to 2009/10.
• On average, non-Māori hospitalisations (including those involving injury and poisoning) were longer than those of Māori in 2009/10. However, for hospital procedures, Māori spent slightly longer (on average) in hospital compared with non-Māori.
• Compared with publicly funded patients, the average length of stay was:
– longer for privately funded hospitalisations in 2009/10
– shorter for privately funded procedures in 2009/10.
• From 1995/96 to 2009/10 the total number of bed days increased by:
– nearly 2 million (or 56.9%) for publicly funded hospital discharges
– almost 400,000 (or 57.5%) for hospitalisations involving injury and poisoning.
• The total number of bed days increased by over 80,000 (or 20.9%) for privately funded hospitalisations from 2004/05 to 2009/10.
Inpatients and day cases
• In 2009/10, day cases accounted for:
– one out of every three publicly funded hospital discharges
– one out of every three publicly funded procedures
– one out of every four hospitalisations involving injury and poisoning.
• Day cases accounted for more than half of all:
– privately funded hospital discharges (56.0%)
– privately funded hospital procedures (54.7%) in 2009/10.
Introduction
Purpose
The purpose of this Hospital Events publication series is to inform discussion and assist in future policy development. Readership of this publication is wide ranging, and its contents reflect this, aiming to meet the needs of all interested parties.
This publication contains statistical information about events[1] in New Zealand hospitals, including:
• discharges (hospitalisations) from publicly and privately funded facilities
• procedures performed in publicly and privately funded facilities
• discharges involving injury and poisoning.
While this publication focuses on hospital events that occurred in the 2008/09 and 2009/10 years, it also contains time trends from 1995/96 onwards.
Data sources, data quality and timing issues
The National Minimum Dataset
The data in this publication is from the National Minimum Dataset (NMDS), a national collection of public and private hospital discharge information (including clinical information) for inpatients and day patients. The NMDS collects and stores unit record data. It is important to note that hospital events recorded in the NMDS represent individual events rather than individual people. The number of events will be higher than the number of people, because one person can contribute numerous unique hospital events to the dataset.
The information presented in this publication is reported by financial year ended 30 June. For example, the 2009/10 financial year relates to the period from 1 July 2009 to 30 June 2010.
The publication covers both publicly and privately funded hospital events. Publicly funded events[2] can occur in public or private hospitals, just as privately funded events can occur in private or public hospitals. Figure 1 and Table 1 illustrate this point.
Figure 1: Number of hospital discharges by hospital type and funding type, 2009/10
|Public hospitals |Private hospitals |
|[pic] |[pic] |
Source: National Minimum Dataset
Table 1 shows that for the six years to 30 June 2010, the majority of discharges from public hospitals were publicly funded. Over half of reported discharges from private hospitals[3] were privately funded.
Table 1: Hospital discharges by hospital type and funding type, 2004/05–2009/10
|Year |Hospital type |Number of discharges |Percent of total discharges |
| | |Funding type |Funding type |
| | |Public |Private |Public |Private |
| |Private |57,786 |83,903 |6.0 |8.8 |
|2005/06 |Public |837,983 |2743 |85.8 |0.3 |
| |Private |55,254 |80,868 |5.7 |8.3 |
|2006/07 |Public |864,405 |3082 |85.8 |0.3 |
| |Private |61,388 |78,721 |6.1 |7.8 |
|2007/08 |Public |867,932 |3550 |86.3 |0.4 |
| |Private |65,211 |68,612 |6.5 |6.8 |
|2008/09 |Public |935,305 |3101 |86.9 |0.3 |
| |Private |64,277 |73,682 |6.0 |6.8 |
|2009/10 |Public |972,224 |3679 |87.8 |0.3 |
| |Private |63,730 |67,557 |5.8 |6.1 |
Source: National Minimum Dataset
It is important to note that the private hospital data in this publication is not complete, as not all private hospitals report their data to the Ministry of Health. The following section provides information on the quality of hospital data.
Quality of publicly funded hospital data
This publication contains publicly funded hospital data for the financial years from 1995/96 to 2009/10 (1 July 1995 to 30 June 2010). Improvements in the recording and reporting of data from July 1995 have enabled meaningful analysis from that point onward.
Quality of privately funded hospital data
This publication contains privately funded hospital data for the financial years from 2004/05 to 2009/10 (1 July 2004 to 30 June 2010). Data has been used from 2004/05 onwards because the completeness of privately funded and privately provided hospital data improved from that point.
The privately funded hospital data included in this publication are not complete, as not all private hospitals report their data to the Ministry of Health. In 2010, for example, 10 hospitals reported no data, and two hospitals sent data to the Ministry of Health with some months missing. In 2009, four hospitals reported no data and nine hospitals reported incomplete data. The Ministry of Health has no means of accurately assessing the number and nature of discharge data that are not reported. For these reasons, regional comparisons of privately funded hospital data are not included in this publication.
Other aspects affecting the quality of privately funded data are ethnicity and diagnosis information. Ethnicity data for private hospitals have not been included in this publication due to the high number of events that have no ethnicity information recorded. Diagnosis information is more complete for medical discharges than for surgical data due to more complete reporting.
The strengths of the privately funded hospital data include procedure information, length of stay and patient details.
In summary, care should be taken when analysing the privately funded hospital data in this publication, because they do not present a complete dataset.
Timing of data
The timeliness of all hospital discharge information is improving and will continue to do so. The Ministry of Health conducts data quality work after public and private hospital data are coded. Once this process is complete, provisional hospital data is made available via the Ministry of Health’s website. More detail can be found in the ‘Further hospital-related information’ section towards the end of this publication.
Hospital discharges
This chapter presents statistics on discharges from publicly and privately funded New Zealand hospitals. Note that information is presented according to the number of hospital discharges, rather than the number of patients. The number of discharges will be higher than the number of patients, because one person can be hospitalised more than once in a given year.
Overview
There were 1,107,190 reported discharges[4] from New Zealand hospitals in 2009/10. Publicly funded hospitalisations made up the majority of total hospital discharges in 2009/10 – 93.6% of hospital discharges were publicly funded.
Over the past six years, the number of publicly funded hospital discharges increased by 19.0%, while the number of reported privately funded hospital discharges decreased by 18.0%.
The number of publicly funded hospitalisations relative to the population[5] was 21,794.8 per 100,000 in 2009/10. In the same year, there were 1407.7 privately funded hospitalisations per 100,000 people (Table 2).
Compared with 2008/09, there were 310 more publicly funded hospitalisations and 147 fewer privately funded hospitalisations per 100,000 people in 2009/10.
Compared with privately funded patients, it is more common for publicly funded patients to be hospitalised more than once in any given year. In 2009/10, 59.1% (611,937) of publicly funded hospitalisations were for patients who were treated more than once (in either a public or private hospital). In the same year, 18.2% (12,949) of privately funded hospitalisations were for patients who were treated more than once (in either a private or public hospital).
In 2009/10, 680,787 people were discharged 1,107,190 times from New Zealand hospitals. Figure 2 shows that almost 11,379 patients received both publicly funded and privately funded treatment during this year. It is important to note that a single person can contribute many unique hospital events in any particular year.
Figure 2: Number of patients discharged from hospital by funding type, 2009/10
[pic]
Source: National Minimum Dataset
Sex
Each year more females than males are discharged from New Zealand hospitals. There were 79 male hospitalisations for every 100 female hospitalisations in 2009/10. In this year, females accounted for 55.8% of all publicly funded and privately funded hospitalisations. Maternity-related events accounted for almost one in five of these female hospitalisations. Please refer to the ‘Selected diagnoses’ section in this chapter for further information.
Table 2 shows the number of hospital discharges and age-standardised rates by sex for the period from 1 July 1995 to 30 June 2010. In 2009/10, 617,337 females and 489,853 males were discharged from public and private hospitals. Accounting for changes in the New Zealand population, the rate of publicly funded hospitalisations increased by 30.7% from 1995/96 to 2009/10. The rate of reported privately funded hospitalisations fell by 25.0% from 2004/05 to 2009/10.
Table 2: Hospital discharges and age-standardised rates by sex, 1995/96–2009/10
|Publicly funded hospital discharges |
|Year |Male |Female |Total |
| |Number |Rate |Number |Rate |Number |Rate |
|1996/97 |279,101 |14,546.9 |372,830 |18,480.7 |651,931 |16,493.8 |
|1997/98 |294,257 |15,180.3 |386,765 |19,003.6 |681,022 |17,072.0 |
|1998/99 |306,649 |15,682.0 |397,546 |19,351.1 |704,195 |17,507.5 |
|1999/00 |323,471 |16,371.8 |420,951 |20,334.4 |744,422 |18,357.6 |
|2000/01 |349,893 |17,566.3 |450,080 |21,628.4 |799,973 |19,608.8 |
|2001/02 |364,087 |17,963.1 |458,298 |21,642.0 |822,386 |19,806.9 |
|2002/03 |366,426 |17,709.2 |461,769 |21,387.1 |828,195 |19,559.0 |
|2003/04 |373,481 |17,724.0 |472,579 |21,546.8 |846,060 |19,651.1 |
|2004/05 |387,223 |18,036.3 |483,129 |21,704.0 |870,352 |19,891.5 |
|2005/06 |398,381 |18,281.1 |494,856 |21,951.5 |893,237 |20,148.6 |
|2006/07 |411,247 |18,429.4 |514,546 |22,545.9 |925,793 |20,512.6 |
|2007/08 |412,668 |18,151.8 |520,475 |22,590.3 |933,143 |20,395.6 |
|2008/09 |442,269 |19,111.1 |557,313 |23,816.2 |999,582 |21,484.7 |
|2009/10 |457,160 |19,295.6 |578,794 |24,259.3 |1,035,954 |21,794.8 |
|Privately funded hospital discharges |
|Year |Male |Female |Total |
| |Number |Rate |Number |Rate |Number |Rate |
|2005/06 |37,649 |1639.7 |45,962 |1894.6 |83,611 |1769.5 |
|2006/07 |37,019 |1579.0 |44,784 |1822.5 |81,803 |1702.6 |
|2007/08 |32,206 |1351.6 |39,956 |1615.6 |72,162 |1485.9 |
|2008/09 |35,982 |1489.1 |40,801 |1618.9 |76,783 |1554.8 |
|2009/10 |32,693 |1318.9 |38,543 |1493.1 |71,236 |1407.7 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Figure 3 shows that females had a consistently higher rate of publicly funded and privately funded hospitalisations than males from 1999/00 to 2009/10. Over this time period, the rate of publicly funded hospitalisations increased by 19.3% for females and 17.9% for males.
For privately funded facilities, the hospitalisation rate for females and males decreased by 25.4% and 24.6% respectively, from 2004/05 to 2009/10. Some of this decrease is due to the number of privately funded hospitals that report their data to the Ministry of Health (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).
Figure 3: Age-standardised hospital discharge rates by sex, 1999/00–2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Age
In 2009/10, the number of publicly funded hospitalisations was highest in the 0–4 year age group,[6] with 143,281 or 13.8% of total discharges (Table 3).
However, those aged 85 years and over had the highest rate[7] of publicly funded hospitalisations in 2009/10. In this age group, there were around 97,000 hospitalisations per 100,000 males and around 82,500 hospitalisations per 100,000 females.
Table 3: Publicly funded hospital discharges by five-year age group and sex, 2009/10
|Age group (years) |Male |Female |Total |
| |Number |Rate |Number |
| |Number |Rate |Number |Rate |Number |Rate |
|5–9 |1096 |746.1 |778 |556.0 |1874 |653.4 |
|10–14 |555 |366.1 |565 |391.8 |1120 |378.7 |
|15–19 |1103 |666.4 |1325 |844.6 |2428 |753.1 |
|20–24 |1186 |734.9 |1644 |1068.6 |2830 |897.8 |
|25–29 |897 |626.5 |1385 |953.7 |2282 |791.2 |
|30–34 |976 |754.7 |1789 |1277.9 |2765 |1026.6 |
|35–39 |1368 |956.6 |2579 |1629.3 |3947 |1310.0 |
|40–44 |1756 |1175.9 |3044 |1874.4 |4800 |1539.8 |
|45–49 |2304 |1475.6 |3570 |2143.8 |5874 |1820.4 |
|50–54 |2762 |1936.3 |3596 |2415.9 |6358 |2181.3 |
|55–59 |3220 |2608.8 |3533 |2762.1 |6753 |2686.8 |
|60–64 |3878 |3429.1 |3645 |3109.5 |7523 |3266.5 |
|65–69 |3202 |3723.7 |2870 |3180.8 |6072 |3445.7 |
|70–74 |2235 |3412.7 |2095 |2931.7 |4330 |3161.7 |
|75–79 |1810 |3702.9 |1747 |3103.0 |3557 |3381.8 |
|80–84 |1334 |3833.3 |1460 |3180.1 |2794 |3461.8 |
|85+ |1033 |4320.4 |1491 |3228.7 |2524 |3601.1 |
|All ages |32,693 |1524.4 |38,543 |1733.7 |71,236 |1630.9 |
Source: National Minimum Dataset
Note: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.
Figure 4 shows publicly funded hospital discharge rates by five-year age group and sex for 2009/10.
Females had higher hospitalisation rates than males over the child-bearing years
(15–49 years).[8] For males, the rate of publicly funded hospitalisations generally increased with age from 15 years.
For both males and females, hospitalisation rates peaked in the 85 years and over age group: 97,055.4 per 100,000 males and 82,529.2 per 100,000 females.
Figure 4: Age-specific publicly funded hospital discharge rates by sex, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 5 shows privately funded hospitalisation rates by five-year age group and sex for 2009/10. The trends are similar to those seen for publicly funded hospitalisations in Figure 2, although females did not have such a pronounced increase in rates over the child-bearing years.
The highest rates of hospitalisations for both males and females were in the 85 years and over age group: 4320.4 privately funded hospitalisations per 100,000 males and 3228.7 per 100,000 females.
Figure 5: Age-specific privately funded hospital discharge rates by sex, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Ethnicity
This section presents ethnicity data for publicly funded hospital discharges only. Ethnicity data for private hospitals cannot be included in this publication due to the high number of discharges that have no ethnicity information recorded (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).
Māori accounted for 16.8% (174,427) of publicly funded hospitalisations in 2009/10. According to Statistics New Zealand, Māori made up 15.2% of the New Zealand population at 30 June 2010.[9]
Table 5 shows that Māori had higher hospitalisation rates compared with non-Māori for each year from 1995/96 to 2009/10. Furthermore, the rate for Māori showed a larger increase compared with non-Māori over the 15 years to 30 June 2010 (48.3% and 27.2% respectively).
Table 5: Publicly funded hospital discharges and age-standardised rates by ethnicity, 1995/96–2009/10
|Year |Māori discharges |Non-Māori discharges |
| |Number |Rate |Number |Rate |
|1995/96 |91,678 |18,924.0 |557,813 |16,549.9 |
|1996/97 |93,997 |19,092.2 |557,934 |16,288.2 |
|1997/98 |99,811 |20,115.2 |581,211 |16,833.5 |
|1998/99 |104,661 |20,840.6 |599,534 |17,229.7 |
|1999/00 |112,007 |22,025.6 |632,415 |18,056.0 |
|2000/01 |123,037 |23,514.5 |676,936 |19,245.6 |
|2001/02 |127,671 |24,127.4 |694,715 |19,396.7 |
|2002/03 |132,726 |24,859.1 |695,469 |18,998.9 |
|2003/04 |138,571 |25,683.8 |707,489 |18,999.6 |
|2004/05 |143,919 |26,396.4 |726,433 |19,161.8 |
|2005/06 |150,085 |26,989.3 |743,152 |19,348.7 |
|2006/07 |154,931 |27,103.6 |770,862 |19,731.0 |
|2007/08 |153,523 |25,900.8 |779,620 |19,739.5 |
|2008/09 |167,941 |27,612.6 |831,641 |20,731.4 |
|2009/10 |174,427 |28,072.1 |861,527 |21,043.4 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Figure 6 shows that the greatest disparity between Māori and non-Māori hospitalisation rates occurred in 2005/06. In this year, the rate for Māori was 39.5% higher than the rate for non-Māori. In 2009/10, the hospitalisation rate for Māori was 33.4% higher than the rate for non-Māori.
Hospitalisation rates for Māori were significantly[10] higher than rates for non-Māori for each year from 1995/96 to 2009/10.
Compared with 2008/09, there were 459 more Māori hospitalisations (per 100,000 Māori) in 2009/10. Non-Māori had 312 more hospitalisations (per 100,000 non-Māori) in 2009/10 compared with the previous year.
Figure 6: Age-standardised publicly funded hospital discharge rates by ethnicity,
1999/00–2009/10
[pic]
Source: National Minimum Dataset
Note 1: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Note 2: The drop in the hospitalisation rate in 2007/08 may be due to administrative reasons such as the under-reporting of short stay emergency department events in some district health boards.
Table 6 shows that for both Māori and non-Māori, more females were discharged from hospital than males for each year from 1995/96 to 2009/10. Māori males experienced the greatest increase in rates of hospitalisation (56.7%) over the same time period.
Table 6: Publicly funded hospital discharges and age-standardised rates by ethnicity and sex, 1995/96–2009/10
|Year |Māori male |Māori female |Non-Māori male |Non-Māori female |
| |Number |Rate |Number |
| |Male |Female |Total |
| |Male |Female |Total |Male |
| | |Male |
| | |Male |Female |Total |
|C00–C96, D45–D47 |Total cancer |53.5 |26.4 |39.4 |
|C16 |Stomach cancer |0.3 |0.2 |0.2 |
|C18–C21 |Colorectal cancer* |2.3 |2.0 |2.1 |
|C33–C34 |Lung cancer† |1.0 |0.5 |0.7 |
|C43 |Melanoma of the skin |1.2 |0.6 |0.9 |
|C50 |Breast cancer |0.0 |13.8 |7.1 |
|C53 |Cervical cancer |… |0.2 |0.1 |
|C61 |Prostate cancer |37.4 |… |18.1 |
|E10–E14 |Diabetes mellitus |2.8 |3.5 |3.2 |
|F00–F09 |Organic, including symptomatic, mental disorders |2.1 |2.2 |2.2 |
|I05–I09 |Chronic rheumatic heart disease |0.7 |0.6 |0.7 |
|I10–I15 |Hypertensive diseases |0.3 |0.7 |0.5 |
|I20–I25 |Ischaemic heart diseases |14.3 |5.3 |9.5 |
|I30–I52 |Other forms of heart disease‡ |9.3 |4.4 |6.7 |
|I60–I69 |Cerebrovascular diseases |3.6 |2.2 |2.8 |
|J09–J18 |Pneumonia and influenza |3.9 |2.5 |3.2 |
|J40–J47 |Chronic lower respiratory diseases |2.3 |2.1 |2.2 |
|J40–J44 |COPD§ |1.1 |1.2 |1.1 |
|K80 |Cholelithiasis (gallstones) |1.6 |4.7 |3.2 |
|N17–N19 |Renal failure |0.3 |0.3 |0.3 |
|O00–O99 |Pregnancy, childbirth and the puerperium |… |45.5 |23.0 |
|Q00–Q99 |Congenital anomalies |10.3 |12.2 |11.3 |
| |All fracturesф |3.0 |1.9 |2.5 |
| |All diagnoses |1318.9 |1493.1 |1407.7 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
* Includes cancer of the colon, rectosigmoid junction, rectum, anus and anal canal.
† Includes cancer of the trachea, bronchus and lung.
‡ Includes pericardial diseases, valve disorders, myocarditis, cardiomyopathy, conduction disorders, cardiac arrest and heart failure, but excludes chronic rheumatic heart disease.
§ Chronic obstructive pulmonary disease.
ф Includes ICD codes S02 (fracture of skull and facial bones), S12 (fracture of neck), S22 (fracture of rib(s), sternum and thoracic spine), S32 (fracture of lumbar spine and pelvis), S42 (fracture of shoulder and upper arm), S52 (fracture of forearm), S62 (fracture at wrist and hand level), S72 (fracture of femur), S82 (fracture of lower leg, including ankle), S92 (fracture of foot, except ankle), T02 (fractures involving multiple body regions), T08 (fracture of spine, level unspecified) and T12 (fracture of lower limb, level unspecified).
... = not applicable.
Sex-based differences in privately funded hospitalisations
Overall, females had a higher privately funded hospitalisation rate compared with males (age-standardised rate that was 1493.1 for females and 1318.9 for males).
Table 10 shows that in 2009/10 females had:
• almost three times the male hospitalisation rate for gallstones
• more than twice the male hospitalisation rate for hypertensive diseases
• a higher hospitalisation rate for diabetes and congenital anomalies.
In 2009/10, males had:
• over 2.5 times the female hospitalisation rate for ischaemic heart diseases
• over twice the female hospitalisation rate for other forms of heart disease, total cancer and lung cancer
• almost twice the female hospitalisation rate for melanoma of the skin
• over 1.5 times the female hospitalisation rate for stomach cancer, fractures, cerebrovascular disease, and pneumonia and influenza
• higher hospitalisation rates for colorectal cancer and chronic lower respiratory diseases.
Length of stay and bed days
This section focuses on the average number of days (length of stay) and the total number of days (bed days) spent in public and private hospitals. It presents data for inpatients, and excludes day cases (patients hospitalised for zero days and discharged routinely). See the ‘Definitions’ section for a more detailed explanation of length of stay. It should be noted that average length of stay data is skewed by long-stay geriatric events. For example, one patient had been in hospital for almost 19 years in 2009/10.
For publicly funded hospitalisations, the average length of stay increased by 1.4 days and the total number of bed days increased by nearly 2 million (or 58.3%) from 1995/96 to 2009/10 (Table 11).
Non-Māori spent longer, on average, in publicly funded hospitals compared with Māori. In 1995/96 non-Māori spent 2.1 days longer in hospital compared with Māori. In 2009/10 this disparity increased to 3.8 days and was greatest between females. Non-Māori females spent 4.9 days longer in hospital, on average, than Māori females in this year.
While the number of bed days for Māori increased over time, the proportion of bed days for Māori fell slightly (from 10.3% of total bed days in 1995/96 to 10.0% in 2009/10).
Table 11: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital discharges, 1995/96 and 2009/10
|Population |1995/96 |2009/10 |
| |Average length of stay |Average length of stay |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |6.9 |6.8 |6.8 |8.0 |9.0 |8.5 |
|Total |6.7 |6.4 |6.5 |7.6 |8.2 |7.9 |
| |Bed days |Bed days |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |1,276,056 |1,690,242 |2,966,298 |1,914,325 |2,797,458 |4,711,783 |
|Total |1,433,159 |1,873,826 |3,306,985 |2,175,343 |3,059,934 |5,235,277 |
| |Percent of total bed days |Percent of total bed days |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |89.0 |90.2 |89.7 |88.0 |91.4 |90.0 |
|Total |100.0 |100.0 |100.0 |100.0 |100.0 |100.0 |
Source: National Minimum Dataset
Table 12 shows that for privately funded hospitalisations, the average length of stay increased by 4.2 days from 2004/05 to 2009/10. The total number of bed days increased by over 80,000 (or 20.9%) over the same time period. Females spent longer, on average, in privately funded hospitals compared with males. In 2004/05 females spent almost six days longer in hospital compared with males. In 2009/10 this disparity decreased to just under five days.
Table 12: Average length of stay and total bed days by sex, privately funded hospital discharges, 2004/05 and 2009/10
| |2004/05 |2009/10 |
| |Average length of stay |Average length of stay |
| |Male |Female |Total |Male |Female |Total |
| |Bed days |Bed days |
| |Male |Female |Total |Male |Female |Total |
Source: National Minimum Dataset
Note: Ethnicity data for privately funded hospital discharges are not included due to the high number of hospitalisations that have no ethnicity information recorded.
Table 13 shows the average length of stay and the total number of bed days for publicly funded hospitalisations by DHB region of residence in 2009/10. Of all DHB regions:
• South Canterbury had the longest average length of stay (11.8 days)
• Tairawhiti had the shortest average length of stay (4.9 days)
• Canterbury had the highest number of bed days (733,254)
• Tairawhiti had the lowest number of bed days (40,946).
Compared to New Zealand as a whole:
• all DHB regions in the South Island had a longer average length of stay
• the majority of DHB regions in the North Island had a shorter average length of stay (Wairarapa, Waikato, Lakes, MidCentral, Waitemata, Whanganui, Hawke’s Bay, Taranaki, Northland, Counties Manukau, and Tairawhiti).
Table 13: Average length of stay and total bed days by DHB region, total population, publicly funded hospital discharges, 2009/10
|DHB region |Average length of stay |Total bed days |
| |Male |Female |
| |Male |Female |Total |Male |Female |Total |
|Waitemata |5.2 |3.7 |4.3 |19,149 |17,869 |37,018 |
|Auckland |8.7 |5.0 |6.6 |22,683 |17,894 |40,577 |
|Counties Manukau |5.2 |3.5 |4.2 |31,130 |31,406 |62,536 |
|Waikato |5.9 |4.2 |4.9 |30,697 |31,785 |62,482 |
|Lakes |5.1 |4.5 |4.7 |14,310 |16,288 |30,598 |
|Bay of Plenty |5.8 |4.8 |5.3 |23,085 |24,771 |47,856 |
|Tairawhiti |4.4 |3.9 |4.1 |8140 |9911 |18,051 |
|Hawke’s Bay |4.6 |3.7 |4.1 |13,858 |15,304 |29,162 |
|Taranaki |5.2 |3.8 |4.3 |7020 |7524 |14,544 |
|MidCentral |4.5 |4.0 |4.2 |7404 |8759 |16,163 |
|Whanganui |5.2 |3.8 |4.3 |5780 |7283 |13,063 |
|Capital & Coast |7.9 |5.4 |6.4 |13,558 |14,210 |27,768 |
|Hutt Valley |7.9 |3.9 |5.6 |11,308 |7323 |18,631 |
|Wairarapa |3.8 |3.8 |3.8 |1747 |2274 |4021 |
|Nelson Marlborough |4.5 |4.1 |4.2 |2265 |3275 |5540 |
|West Coast |4.6 |3.3 |3.8 |806 |928 |1734 |
|Canterbury |7.7 |4.1 |5.6 |15,932 |11,790 |27,722 |
|South Canterbury |4.8 |5.8 |5.4 |833 |1800 |2633 |
|Otago |7.7 |5.8 |6.7 |5162 |4326 |9488 |
|Southland |5.1 |3.2 |4.1 |4046 |2798 |6844 |
|Overseas and undefined |6.8 |6.7 |6.8 |658 |742 |1400 |
|Total New Zealand |5.7 |4.1 |4.8 |261,018 |262,476 |523,494 |
Source: National Minimum Dataset
Compared to New Zealand as a whole:
• three DHB regions in the South Island had a longer average length of stay for Māori (Otago, Canterbury and South Canterbury)
• five DHB regions in the North Island had a longer average length of stay for Māori (Auckland, Capital & Coast, Hutt Valley, Bay of Plenty and Waikato).
Inpatients and day cases
This section presents hospital discharges by patient type: inpatients and day cases.
For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient who does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.
In 2009/10, day cases made up 36.2% (375,276) of publicly funded hospitalisations, with the remaining 63.8% being inpatients (Table 15). The proportion of day cases was higher for privately funded hospitalisations. Day cases made up over half of all privately funded hospitalisations in each year from 2004/05 to 2009/10.
The number of publicly funded day case hospitalisations in 2009/10 was more than 2.5 times that in 1995/96. Furthermore, the proportion of day cases increased from one in five publicly funded hospitalisations (21.9%) in 1995/96 to over one-third (36.2%) in 2009/10. Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events. The proportion of privately funded day case discharges remained relatively stable from 2004/05 to 2009/10.
Table 15: Hospital discharges by patient type, 1995/96–2009/10
|Year |Publicly funded hospital discharges |Privately funded hospital discharges |
| |Inpatient |Day case |% day case |Inpatient |Day case |% day case |
|1996/97 |499,595 |152,336 |23.4 | | | |
|1997/98 |507,812 |173,210 |25.4 | | | |
|1998/99 |514,760 |189,435 |26.9 | | | |
|1999/00 |536,778 |207,644 |27.9 | | | |
|2000/01 |563,894 |236,079 |29.5 | | | |
|2001/02 |572,232 |250,154 |30.4 | | | |
|2002/03 |570,965 |257,230 |31.1 | | | |
|2003/04 |580,742 |265,318 |31.4 | | | |
|2004/05 |583,786 |286,566 |32.9 |36,267 |50,580 |58.2 |
|2005/06 |592,473 |300,764 |33.7 |34,258 |49,353 |59.0 |
|2006/07 |607,082 |318,711 |34.4 |33,555 |48,248 |59.0 |
|2007/08 |618,570 |314,573 |33.7 |30,453 |41,709 |57.8 |
|2008/09 |644,826 |354,756 |35.5 |34,066 |42,717 |55.6 |
|2009/10 |660,678 |375,276 |36.2 |31,357 |39,879 |56.0 |
Source: National Minimum Dataset
Figure 18 shows age-specific rates for publicly funded inpatient and day case hospitalisations in 2009/10. Those aged 85 years and over had the highest inpatient rate (68,256.5 per 100,000 people) while those aged 80–84 had the highest day case rate (22,651.5 per 100,000).
The rate of inpatient hospitalisations was greater than day case hospitalisations for all age groups except for those aged 5–9 years. As would be expected, the inpatient rate was:
• more than 3.5 times the day case rate for those aged 85 and over
• almost three times the day case rate for those aged 0–4 years
• more than twice the day case rate for those aged 80–84 years
• approximately twice the day case rate for those aged 30–34 years.
Figure 18: Age-specific publicly funded hospital discharge rates by patient type, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 19 shows privately funded hospitalisation rates by five-year age group and patient type for 2009/10. Those aged 85 years and over had the highest inpatient rate (1987.4 per 100,000 people) while those aged 80–84 and 75–79 had the highest day case rates (2061.7 and 2047.0 respectively).
The rate of day case hospitalisations was greater than inpatient hospitalisations for all age groups except those aged 30–34 and 85 years and over. Furthermore, the day case rate was:
• over four times the inpatient rate for those aged 5–9 years
• more than three times the inpatient rate for those aged 0–4 years
• more than twice the inpatient rate for those aged 10–14 years
• 1.5 times the inpatient rate for those aged 75–79 and 80–84 years.
Figure 19: Age-specific privately funded hospital discharge rates by patient type, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 20 shows publicly funded inpatient hospitalisation rates by five-year age group and ethnicity for 2009/10. The highest inpatient rates occurred in Māori aged 80–84 and in non-Māori aged 85 years and over. Overall, Māori had higher inpatient rates compared with non-Māori. The inpatient rate was greater for Māori for most age groups except those aged 0–4 and 85 years and over. In particular, the Māori inpatient rate was:
• almost twice the non-Māori rate for those aged 20–24 and 45–69 years
• around 1.5 times the non-Māori rate for those aged 15–19, 25–29, 40–44 and 70–74 years.
Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care.
Figure 20: Age-specific publicly funded hospital discharge rates by ethnicity, inpatients, 2007/08
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 21 shows publicly funded day case hospitalisation rates by five-year age group and ethnicity for 2009/10. Those aged 75–79 years had the highest day case rate for both Māori and non-Māori. Overall, Māori had higher day case rates compared with non-Māori. The day case rate was greater for Māori for most age groups except those aged 0–4, 10–14 and 80 years and over.
The greatest disparities between day case rates occurred in those aged 55–69 years, where Māori rates were approximately double the non-Māori rates for each five year age group.
Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care.
Figure 21: Age-specific publicly funded hospital discharge rates by ethnicity, day cases, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 22 shows publicly funded hospitalisation rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, hospitalisation rates for inpatients and day cases increased as deprivation increased.
For the most deprived areas (quintile 5), both inpatient and day case rates were more than twice the rates for the least deprived areas (quintile 1). For each deprivation quintile, inpatient rates were approximately 75% higher than day case rates.
Figure 22: Publicly funded hospital discharges by deprivation quintile and patient type, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population; 95% confidence intervals.
Figure 23 shows privately funded hospitalisation rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, hospitalisation rates for inpatients and day cases decreased as deprivation increased (the opposite trend to that shown in Figure 22 for publicly funded hospitalisations).
At all levels of deprivation, day case rates were higher than inpatient rates. The greatest disparity between privately funded inpatient and day case hospitalisations occurred in the least deprived areas of New Zealand (where the rate for day cases was more than 1.5 times the rate for inpatients).
Figure 23: Privately funded hospital discharges by deprivation quintile and patient type, 2009/10
[pic]
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population; 95% confidence intervals.
Hospital procedures
This chapter presents statistics on hospital procedures performed in publicly and privately funded New Zealand hospitals. Note that information is presented according to the number of procedures performed, rather than the number of patients. Some patients will experience more than one procedure during their hospitalisation. Also, patients may be hospitalised more than once in a given year.
Overview
More than 1.5 million procedures were performed in New Zealand hospitals in 2009/10. Publicly funded procedures made up the majority of all hospital procedures. In 2009/10, 90.3% of hospital procedures were publicly funded.
Over the past six years, the number of publicly funded hospital procedures increased by 21.6%, while the number of reported privately funded procedures decreased by 9.6%.
The number of publicly funded hospital procedures relative to the population was 28,617.5 per 100,000 in 2009/10. In the same year, there were 2926.8 privately funded procedures per 100,000 people (Table 16).
Compared with 2008/09, there were 1449 more publicly funded procedures and 336 fewer privately funded procedures per 100,000 people in 2009/10.
Sex
Each year more procedures are performed on females than males. There were 80 male procedures for every 100 female procedures in 2009/10. In this year, females accounted for 55.6% of all publicly funded and privately funded hospital procedures. Almost one in five procedures performed on females in 2009/10 was an obstetric (or maternity-related) procedure. Refer to the ‘Selected procedures’ section of this publication for further information.
Table 16 presents the number of hospital procedures and age-standardised rates by sex from 1 July 1995 to 30 June 2010. In 2009/10, a total of 844,585 publicly and privately funded procedures were performed on females and 675,381 were performed on males. Accounting for changes in the New Zealand population, the rate of publicly funded procedures increased by 92.4% from 1995/96 to 2009/10. The rate of reported privately funded procedures fell by 17.7% from 2004/05 to 2009/10.
Table 16: Hospital procedures and age-standardised rates by sex, 1995/96–2009/10
|Publicly funded hospital procedures |
|Year |Male |Female |Total |
| |Number |Rate |Number |Rate |Number |Rate |
|1996/97 |274,405 |13,978.0 |405,129 |19,827.5 |679,534 |16,888.6 |
|1997/98 |313,918 |15,783.1 |451,563 |21,831.1 |765,481 |18,792.1 |
|1998/99 |327,363 |16,311.2 |454,408 |21,811.7 |781,771 |19,062.4 |
|1999/00 |307,313 |15,195.8 |436,745 |21,077.3 |744,058 |18,159.1 |
|2000/01 |324,973 |15,886.6 |451,912 |21,659.6 |776,885 |18,801.8 |
|2001/02 |434,540 |20,930.3 |572,269 |26,826.5 |1,006,809 |23,905.3 |
|2002/03 |452,637 |21,295.8 |592,314 |27,165.3 |1,044,951 |24,260.7 |
|2003/04 |468,088 |21,634.8 |609,969 |27,533.2 |1,078,057 |24,622.3 |
|2004/05 |500,009 |22,850.0 |629,480 |28,259.3 |1,129,489 |25,602.4 |
|2005/06 |526,669 |23,743.7 |652,768 |28,991.3 |1,179,437 |26,424.9 |
|2006/07 |545,952 |24,151.6 |680,770 |30,006.5 |1,226,722 |27,133.9 |
|2007/08 |553,532 |24,059.1 |695,723 |30,394.9 |1,249,255 |27,276.2 |
|2008/09 |563,583 |23,868.8 |710,178 |30,383.4 |1,273,761 |27,168.5 |
|2009/10 |609,712 |25,218.2 |763,560 |31,937.8 |1,373,272 |28,617.5 |
|Privately funded hospital procedures |
|Year |Male |Female |Total |
| |Number |Rate |Number |Rate |Number |Rate |
|2005/06 |77,517 |3401.7 |98,278 |4117.2 |175,795 |3766.2 |
|2006/07 |75,510 |3246.7 |94,918 |3923.6 |170,428 |3592.0 |
|2007/08 |64,868 |2745.2 |83,569 |3436.4 |148,437 |3097.6 |
|2008/09 |73,284 |3055.5 |85,989 |3462.1 |159,273 |3263.4 |
|2009/10 |65,669 |2664.0 |81,025 |3176.7 |146,694 |2926.8 |
Source: National Minimum Dataset
Note 1: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Note 2: The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
Figure 24 shows females had a consistently higher rate of publicly funded and privately funded procedures than males. From 1999/00 to 2009/10, the rate of publicly funded procedures increased by 51.5% for females and 66.0% for males. The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
For privately funded procedures, the rate for females and males decreased by 17.7% and 17.9% respectively, from 2004/05 to 2009/10.
Figure 24: Age-standardised hospital procedure rates by sex, 1999/00–2009/10
[pic]
Source: National Minimum Dataset
Note 1: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Note 2: The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
Age
Table 17 shows that the age group with the highest number of publicly funded hospital procedures in 2009/10 was 0–4 year olds (94,160 or 6.9% of total procedures), followed by 65–69 year-olds (91,817 or 6.7% of total procedures).
Those aged 80–84 years had the highest rate of publicly funded procedures in 2009/10. Within this age group, more than 107,000 procedures were performed per 100,000 males and more than 80,000 procedures were performed per 100,000 females.
Note that these rates were calculated according to the number of procedures performed, rather than the number of patients. Multiple procedures can be reported for a single theatre visit. Also, some patients may be hospitalised more than once in a given year.
Table 17: Publicly funded hospital procedures by five-year age group and sex, 2009/10
|Age group |Male |Female |Total |
|(years) | | | |
| |Number |Rate |Number |Rate |Number |Rate |
|5–9 |32,412 |22,064.0 |25,477 |18,208.3 |57,889 |20,183.0 |
|10–14 |20,014 |13,203.6 |13,560 |9403.0 |33,574 |11,351.0 |
|15–19 |24,285 |14,672.8 |34,257 |21,836.4 |58,542 |18,158.8 |
|20–24 |23,421 |14,513.0 |54,906 |35,690.3 |78,327 |24,848.4 |
|25–29 |18,719 |13,073.8 |64,330 |44,295.3 |83,049 |28,795.5 |
|30–34 |17,539 |13,561.4 |73,929 |52,810.2 |91,468 |33,961.3 |
|35–39 |23,212 |16,232.2 |62,810 |39,680.3 |86,022 |28,551.2 |
|40–44 |27,705 |18,552.9 |40,840 |25,147.8 |68,545 |21,988.6 |
|45–49 |33,982 |21,763.8 |38,775 |23,284.1 |72,757 |22,548.4 |
|50–54 |37,711 |26,437.9 |37,311 |25,066.2 |75,022 |25,738.3 |
|55–59 |40,885 |33,124.0 |37,161 |29,052.5 |78,046 |31,052.0 |
|60–64 |48,678 |43,043.6 |42,845 |36,550.9 |91,523 |39,739.0 |
|65–69 |49,511 |57,577.6 |42,306 |46,886.8 |91,817 |52,103.6 |
|70–74 |48,205 |73,606.7 |42,371 |59,293.3 |90,576 |66,138.0 |
|75–79 |46,782 |95,707.9 |40,234 |71,463.6 |87,016 |82,730.6 |
|80–84 |37,321 |107,244.3 |36,741 |80,028.3 |74,062 |91,763.1 |
|85+ |24,654 |103,111.7 |36,223 |78,438.7 |60,877 |86,855.5 |
|All ages |609,712 |28,430.1 |763,560 |34,345.1 |1,373,272 |31,440.8 |
Source: National Minimum Dataset
Note 1: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.
Note 2: The rate shown is based on number of procedures. Some patients may experience more than one procedure during their hospitalisation. Patients may also be hospitalised more than once in a given year.
Table 18 shows that over half of all privately funded procedures (55.0%) were performed on those aged 40–69 years in 2009/10. This age-related trend has occurred each year since 2004/05.
Those aged 65–69 years had the highest rate of privately funded procedures in 2009/10. Within this age group, more than 7600 procedures were performed per 100,000 males and over 6700 procedures were performed per 100,000 females.
Table 18: Privately funded hospital procedures by five-year age group and sex, 2009/10
|Age group |Male |Female |Total |
|(years) | | | |
| |Number |Rate |Number |Rate |Number |Rate |
|5–9 |2348 |1598.4 |1650 |1179.2 |3998 |1393.9 |
|10–14 |1202 |793.0 |1139 |789.8 |2341 |791.5 |
|15–19 |2089 |1262.2 |2670 |1701.9 |4759 |1476.2 |
|20–24 |2248 |1393.0 |3199 |2079.4 |5447 |1728.0 |
|25–29 |1745 |1218.7 |2833 |1950.7 |4578 |1587.3 |
|30–34 |1983 |1533.3 |3914 |2795.9 |5897 |2189.5 |
|35–39 |2798 |1956.6 |5871 |3709.0 |8669 |2877.3 |
|40–44 |3656 |2448.3 |6961 |4286.3 |10,617 |3405.8 |
|45–49 |4835 |3096.6 |8245 |4951.1 |13,080 |4053.7 |
|50–54 |5847 |4099.1 |8129 |5461.2 |13,976 |4794.8 |
|55–59 |6703 |5430.6 |7856 |6141.8 |14,559 |5792.6 |
|60–64 |8026 |7097.0 |7864 |6708.8 |15,890 |6899.4 |
|65–69 |6555 |7623.0 |6054 |6709.5 |12,609 |7155.3 |
|70–74 |4401 |6720.1 |4304 |6022.9 |8705 |6356.3 |
|75–79 |3494 |7148.1 |3270 |5808.2 |6764 |6430.9 |
|80–84 |2295 |6594.8 |2548 |5550.0 |4843 |6000.5 |
|85+ |1412 |5905.5 |1754 |3798.2 |3166 |4517.0 |
|All ages |65,669 |3062.1 |81,025 |3644.5 |146,694 |3358.5 |
Source: National Minimum Dataset
Note: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.
Figure 25 shows publicly funded hospital procedure rates by five-year age group and sex for 2009/10. The trend is similar to that for publicly funded hospitalisation rates (refer to Figure 4).
Females had higher procedure rates than males over the child-bearing years (between 15 and 49 years). For males, the rate of procedures generally increased with age, from 10 years.
For both males and females, the rate of hospitalisations peaked in the 80–84 year age group. For females aged 25–34 years, the procedure rate was approximately 3.5 times the rate for males. Obstetric procedures made up more than half (53.5%) of all publicly funded procedures for females in this age range.
Figure 25: Age-specific publicly funded hospital procedure rates by sex, 2009/10
[pic]
Source: National Minimum Dataset
Note 1: Rates shown are age-specific rates per 100,000 people in each age group.
Note 2: Rates shown are based on number of procedures. Some patients may experience more than one procedure during their hospitalisation. Patients may also be hospitalised more than once in a given year.
Figure 26 shows privately funded procedure rates by five-year age group and sex for 2009/10. The trend is similar to that for privately funded hospitalisation rates (refer to Figure 5).
Privately funded procedure rates for males and females peaked in the 65–69 year age group. In 2009/10, older males (60 years and over) and younger males (0–9 years) had higher procedure rates compared with females. The procedure rate for females aged 15–59 years was higher than that for males, largely due to gynaecological procedures (7518) and more anaesthesia procedures compared with males.[14] Obstetric procedures (673) made up only a small proportion of procedures for females in this age range.
Figure 26: Age-specific privately funded hospital procedure rates by sex, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Ethnicity
This section presents ethnicity data for publicly funded hospital procedures only. Ethnicity data for private hospitals cannot be included in this publication due to the high number of procedures that have no ethnicity information recorded (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).
Publicly funded hospital procedures for Māori accounted for 15.6% (214,395) of all publicly funded procedures in 2009/10.
Table 19 shows that Māori had higher procedure rates compared with non-Māori for each year from 1995/96 to 2009/10. It also shows that the procedure rate for Māori showed a larger increase compared with the rate for non-Māori over the 15 years to 30 June 2010 (116.8% and 87.8% respectively).
Table 19: Publicly funded hospital procedures and age-standardised rates by ethnicity, 1995/96–2009/10
|Year |Māori |Non-Māori |
| |Number |Rate |Number |Rate |
|1995/96 |75,290 |16,221.8 |512,851 |14,707.3 |
|1996/97 |88,785 |18,893.3 |590,749 |16,645.7 |
|1997/98 |99,380 |21,027.3 |666,101 |18,551.7 |
|1998/99 |103,148 |21,388.5 |678,623 |18,816.8 |
|1999/00 |104,129 |20,952.2 |639,929 |17,840.9 |
|2000/01 |111,491 |21,773.9 |665,394 |18,426.0 |
|2001/02 |145,799 |27,965.9 |861,010 |23,371.4 |
|2002/03 |153,941 |29,343.5 |891,010 |23,607.0 |
|2003/04 |163,290 |30,644.0 |914,767 |23,830.7 |
|2004/05 |174,926 |31,911.2 |954,563 |24,721.0 |
|2005/06 |187,709 |33,614.4 |991,728 |25,414.0 |
|2006/07 |197,424 |34,221.2 |1,029,298 |26,037.6 |
|2007/08 |198,316 |33,424.4 |1,050,939 |26,278.9 |
|2008/09 |202,343 |33,782.5 |1,071,418 |26,138.6 |
|2009/10 |214,395 |35,172.9 |1,158,877 |27,618.9 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Figure 27 shows that the disparity between Māori and non-Māori procedure rates has generally increased over time. The greatest disparity occurred in 2005/06, when the procedure rate for Māori was 32.3% higher than the rate for non-Māori. In 2009/10, the procedure rate for Māori was 27.4% higher than the rate for non-Māori. As explained previously, the increase in the rate of procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
Compared with 2008/09, Māori received approximately 1400 more procedures (per 100,000 Māori) in 2009/10. Non-Māori received approximately 1500 more procedures (per 100,000 non-Māori) in 2009/10 compared with the previous year.
Figure 27: Age-standardised hospital procedure rates by ethnicity,
1999/00–2009/10
[pic]
Source: National Minimum Dataset
Note 1: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Note 2: The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
Table 20 presents numbers and age-standardised rates of hospital procedures by ethnicity and sex. For both Māori and non-Māori, females had a higher number of procedures than males for each year from 1995/96 to 2009/10. As evident in the case of hospital discharges, Māori males experienced the greatest increase in procedure rates (147.3%) over the same time period.
Compared to 2008/09, non-Māori females had the greatest increase in procedure rates: they received 1593 more procedures (per 100,000 non-Māori females) in 2009/10.
Table 20: Publicly funded hospital procedures and age-standardised rates by ethnicity and sex, 1995/96–2009/10
|Year |Māori |Non-Māori |
| |Male |Female |Male |Female |
| |Number |Rate |Number |
| |Male |Female |Total |
| |Male |Female |Total |
| |Male |
| |Male |Female |Total |
|Carpal and tarsal tunnel procedures |20.4 |25.3 |22.9 |
|Cataracts |64.0 |79.2 |71.7 |
|Cholecystectomies |12.4 |33.3 |23.2 |
|Coronary angioplasties |4.6 |1.4 |2.9 |
|Coronary artery bypass grafts |4.9 |0.6 |2.7 |
|Grommets and myringotomies |87.5 |62.8 |75.5 |
|Hernia |90.3 |17.9 |53.0 |
|Hip replacements |30.8 |25.7 |28.2 |
|Hysterectomies |0.0 |51.2 |26.5 |
|Knee replacements |21.3 |18.5 |19.8 |
|Prostatectomies |30.7 |0.0 |14.7 |
|Tonsils and adenoids |79.7 |89.1 |84.4 |
|Varicose veins |25.0 |38.0 |31.7 |
|All procedures |2664.0 |3176.7 |2926.8 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Sex-based differences in privately funded hospital procedures
Overall, females had a higher age-standardised rate for privately funded hospital procedures compared with males. However, for over half of the selected procedures included (Table 24), rates for males were higher than female rates. For example, in 2009/10 males had:
• over eight times the female rate for coronary artery bypass grafts
• over five times the female rate for hernia procedures
• over three times the female rate for coronary angioplasties
• higher rates for grommets and myringotomies, hip replacements and knee replacements compared with females.
In 2009/10 females had:
• over 2.5 times the male procedure rate for cholecystectomies
• over 1.5 times the male rate for varicose veins
• higher rates for carpal and tarsal tunnel procedures, cataracts and tonsil and adenoid procedures compared with males.
Length of stay
This section focuses on the average length of stay (number of days) in hospital for publicly funded and privately funded hospital procedures. It presents data for inpatients, and excludes day cases (patients hospitalised for zero days and discharged routinely). See the ‘Definitions’ section for a detailed explanation of length of stay.
Table 25 shows that for publicly funded procedures, non-Māori spent slightly longer in hospital compared with Māori in 2009/10 (7.5 days compared with 7.3 days on average). In this year, non-Māori females spent longer in hospital compared with Māori females, while Māori males spent longer than non-Māori males.
The average length of stay in hospital for publicly funded procedures fell from 8.0 days to 7.4 days from 1995/96 to 2009/10. Over the same time period, the average length of stay decreased for non-Māori and increased for Māori.
Table 25: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital procedures, 1995/96 and 2009/10
| |1995/96 |2009/10 |
| |Average length of stay |Average length of stay |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |9.7 |7.1 |8.2 |8.5 |6.7 |7.5 |
|Total |9.7 |6.9 |8.0 |8.5 |6.6 |7.4 |
Source: National Minimum Dataset
For privately funded hospital procedures, the average length of stay fell slightly from 2.9 days in 2004/05 to 2.6 days in 2009/10 (Table 26). Females spent less time in hospital than males for privately funded procedures in 2009/10.
The average length of stay for privately funded procedures was 4.8 days less than for publicly funded procedures in 2009/10.
Table 26: Average length of stay and total bed days by sex and ethnicity, privately funded hospital procedures, 2004/05 and 2009/10
| |2004/05 |2009/10 |
| |Average length of stay |Average length of stay |
| |Male |Female |Total |Male |Female |Total |
Source: National Minimum Dataset
Note: Ethnicity data for privately funded hospital discharges is not included due to the high number of discharges that have no ethnicity information recorded.
Figure 39 shows the average length of stay for hospital procedures by deprivation quintile. The average length of stay in hospital for publicly funded procedures was longer for all deprivation quintiles compared with privately funded procedures in 2009/10.
For publicly funded procedures, the least deprived areas had a shorter length of stay in hospital compared with the rest of the New Zealand in 2009/10 (7.1 days on average). For the remaining deprivation quintiles, the average length of stay was comparable at around 7.5 days.
For privately funded procedures, the average length of stay was lowest in the second least deprived areas (quintile 2) and highest in the most deprived areas (quintile 5).
Figure 39: Average length of stay, hospital procedures, 2009/10
[pic]
Source: National Minimum Dataset
Table 27 shows the average length of stay for publicly funded hospital procedures by DHB region in 2009/10. For the total population, Waikato had the longest average length of stay of all DHB regions (8.6 days), while Nelson Marlborough had the shortest (5.9 days). Compared to New Zealand as a whole:
• four DHB regions in the North Island had a longer average length of stay (Waikato, Auckland, Bay of Plenty and Hawke’s Bay)
• half of South Island DHB regions had a longer average length of stay (Otago, South Canterbury and Canterbury).
For Māori, Otago had the longest average length of stay for all DHB regions (11.6 days), while Nelson Marlborough had the shortest (5.9 days). Compared to New Zealand as a whole:
• two DHB regions in the South Island had a longer average length of stay (Otago and Southland)
• three DHB regions in the North Island had a longer average length of stay (Auckland, Waikato and Northland).
Table 27: Average length of stay by ethnicity and DHB region, publicly funded hospital procedures, 2009/10
|DHB region |Total population |Māori population |
| |Male |Female |Total |Male |Female |Total |
|Waitemata |8.1 |6.1 |6.9 |8.4 |5.5 |6.7 |
|Auckland |10.3 |6.5 |8.1 |12.1 |6.4 |8.9 |
|Counties Manukau |8.2 |6.2 |7.0 |9.2 |5.3 |6.9 |
|Waikato |9.5 |7.8 |8.6 |9.6 |7.5 |8.4 |
|Lakes |7.2 |5.9 |6.5 |7.4 |6.5 |6.9 |
|Bay of Plenty |9.1 |6.9 |7.9 |9.4 |5.4 |7.2 |
|Tairawhiti |8.2 |6.1 |7.0 |8.5 |5.9 |7.0 |
|Hawke’s Bay |8.6 |6.7 |7.6 |8.7 |5.8 |7.0 |
|Taranaki |8.0 |6.1 |7.0 |8.9 |5.1 |6.7 |
|MidCentral |8.0 |6.8 |7.3 |7.4 |5.3 |6.1 |
|Whanganui |6.0 |6.2 |6.1 |6.9 |6.1 |6.4 |
|Capital & Coast |9.1 |6.3 |7.4 |8.8 |6.1 |7.1 |
|Hutt Valley |7.8 |6.5 |7.0 |7.9 |5.4 |6.5 |
|Wairarapa |6.7 |5.4 |6.0 |6.2 |6.1 |6.1 |
|Nelson Marlborough |6.2 |5.6 |5.9 |4.2 |6.7 |5.9 |
|West Coast |7.3 |6.1 |6.7 |8.5 |4.3 |6.0 |
|Canterbury |8.7 |6.6 |7.5 |8.6 |5.6 |6.9 |
|South Canterbury |8.2 |7.0 |7.6 |3.4 |8.0 |6.4 |
|Otago |8.7 |7.9 |8.3 |9.9 |12.9 |11.6 |
|Southland |8.5 |6.5 |7.4 |10.9 |4.0 |7.4 |
|Overseas and undefined |9.0 |9.4 |9.2 |7.7 |6.8 |7.3 |
|Total New Zealand |8.5 |6.6 |7.4 |9.0 |6.1 |7.3 |
Source: National Minimum Dataset
Inpatients and day cases
This section presents hospital procedures by patient type: inpatients and day cases.
For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient that does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.
In 2009/10, day cases made up one-third (33.9%) of publicly funded hospital procedures; the remaining 66.1% were inpatients (Table 28). The proportion of day cases was higher for privately funded procedures. Day cases made up over half of all privately funded hospital procedures from 2004/05 to 2009/10.
The number of publicly funded day case procedures in 2009/10 was more than three times that in 1995/96. Furthermore, the proportion of day cases increased from one-quarter of procedures in 1995/96 to one-third in 2009/10. Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events. As explained previously, the increase in procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.
Table 28: Hospital procedures by patient type, 1995/96–2009/10
|Year |Publicly funded hospital procedures |Privately funded hospital procedures |
| |Inpatient |Day case |% day case |
| |Number |Rate |Number |Rate |Number |Rate |
|1996/97 |54,102 |2865.1 |43,949 |1979.3 |98,051 |2427.3 |
|1997/98 |57,488 |3007.3 |47,651 |2113.9 |105,139 |2562.4 |
|1998/99 |58,976 |3058.0 |50,214 |2187.5 |109,190 |2624.3 |
|1999/00 |63,608 |3258.3 |54,052 |2314.3 |117,660 |2786.0 |
|2000/01 |70,277 |3581.4 |60,610 |2594.7 |130,887 |3087.3 |
|2001/02 |72,408 |3614.1 |61,625 |2567.9 |134,033 |3090.3 |
|2002/03 |72,286 |3509.5 |63,413 |2573.4 |135,699 |3042.0 |
|2003/04 |73,261 |3491.3 |64,608 |2569.6 |137,869 |3030.4 |
|2004/05 |76,406 |3580.2 |66,414 |2588.7 |142,820 |3083.5 |
|2005/06 |81,763 |3777.7 |70,394 |2710.2 |152,157 |3243.1 |
|2006/07 |83,781 |3800.9 |72,662 |2772.1 |156,443 |3284.5 |
|2007/08 |85,406 |3806.5 |73,506 |2766.3 |158,912 |3284.7 |
|2008/09 |92,524 |4054.2 |79,474 |2961.6 |171,998 |3507.3 |
|2009/10 |95,460 |4093.7 |84,582 |3093.2 |180,042 |3595.1 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Figure 46 shows that males had a consistently higher rate of hospitalisations involving injury and poisoning than females from 1999/00 to 2009/10. Over this time period, the rate increased by 33.7% for females and 25.6% for males.
There were 131 more female hospitalisations involving injury and poisoning (per 100,000 females) and 39 more male hospitalisations (per 100,000 males) in 2009/10 compared with 2008/09.
Figure 46: Age-standardised hospital discharge rates involving injury and poisoning by sex, 1995/96–2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Age
Table 30 shows that the number of hospitalisations involving injury and poisoning peaked in those aged 75 years and over. This age group made up 23.3% (41,995) of hospitalisations, followed by those aged 15–24 years (12.9% or 23,204) in 2009/10.
Those aged 85 years and over had the highest rate of hospitalisations involving injury and poisoning in 2009/10. Within this age group, there were more than 25,000 hospitalisations per 100,000 females and over 22,000 hospitalisations per 100,000 males.
Table 30: Hospital discharges involving injury and poisoning by five-year age group and sex, 2009/10
|Age group (years) |Male |Female |Total |
| |Number |Rate |Number |Rate |Number |Rate |
|5–9 |3,705 |2522.1 |2,731 |1951.8 |6,436 |2243.9 |
|10–14 |4,660 |3074.3 |2,450 |1698.9 |7,110 |2403.8 |
|15–19 |7,397 |4469.2 |4,467 |2847.4 |11,864 |3680.0 |
|20–24 |7,236 |4483.8 |4,104 |2667.7 |11,340 |3597.5 |
|25–29 |4,988 |3483.7 |3,324 |2288.8 |8,312 |2882.0 |
|30–34 |4,222 |3264.5 |3,264 |2331.6 |7,486 |2779.5 |
|35–39 |4,811 |3364.3 |3,993 |2522.6 |8,804 |2922.1 |
|40–44 |5,131 |3436.0 |4,030 |2481.5 |9,161 |2938.8 |
|45–49 |5,312 |3402.1 |4,401 |2642.8 |9,713 |3010.2 |
|50–54 |5,155 |3614.0 |4,233 |2843.8 |9,388 |3220.8 |
|55–59 |5,002 |4052.5 |4,103 |3207.7 |9,105 |3622.6 |
|60–64 |5,505 |4867.8 |4,632 |3951.5 |10,137 |4401.5 |
|65–69 |5,168 |6010.0 |4,607 |5105.8 |9,775 |5547.0 |
|70–74 |5,316 |8117.3 |5,170 |7234.8 |10,486 |7656.8 |
|75–79 |5,811 |11,888.3 |6,156 |10,934.3 |11,967 |11,377.6 |
|80–84 |5,640 |16,206.9 |7,492 |16,318.9 |13,132 |16,270.6 |
|85+ |5,331 |22,296.1 |11,565 |25,043.3 |16,896 |24,106.1 |
|All ages |95,460 |4451.2 |84,582 |3804.5 |180,042 |4122.0 |
Source: National Minimum Dataset
Note: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.
Figure 47 shows rates for hospitalisations involving injury and poisoning by five-year age group and sex for 2009/10. Males had higher hospitalisation rates than females for all age groups except those aged 80 years and over. The greatest disparity between male and female rates of hospitalisations was for those aged 10–14 years, where the male rate was almost twice the female rate. From the 50–54 year age group, rates for males and females steadily increased to peak in the 85 years and over age group.
Figure 47: Age-specific rates for hospital discharges involving injury and poisoning by sex, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Ethnicity
Hospitalisations for Māori accounted for 15.1% (27,199) of all publicly funded hospitalisations involving injury and poisoning in 2009/10.
Table 31 shows that Māori had higher rates for hospitalisations involving injury and poisoning compared with non-Māori for each year from 1995/96 to 2009/10. The hospitalisation rate for Māori also showed a larger increase compared with non-Māori over this time period (82.2% compared with 47.9%).
Table 31: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity, 1995/96–2009/10
|Year |Māori |Non-Māori |
| |Number |Rate |Number |Rate |
|1995/96 |12,020 |2460.9 |80,326 |2332.5 |
|1996/97 |12,900 |2624.8 |85,151 |2396.9 |
|1997/98 |13,763 |2786.2 |91,376 |2529.3 |
|1998/99 |14,725 |2930.1 |94,465 |2572.9 |
|1999/00 |16,229 |3223.0 |101,431 |2718.2 |
|2000/01 |18,321 |3487.7 |112,566 |3018.0 |
|2001/02 |18,715 |3490.2 |115,318 |3015.2 |
|2002/03 |19,284 |3572.3 |116,415 |2944.8 |
|2003/04 |19,552 |3606.2 |118,317 |2933.8 |
|2004/05 |20,295 |3701.2 |122,525 |2982.2 |
|2005/06 |22,040 |3920.6 |130,117 |3127.1 |
|2006/07 |23,278 |4051.2 |133,165 |3152.4 |
|2007/08 |23,162 |3961.6 |135,750 |3168.8 |
|2008/09 |26,129 |4379.2 |145,869 |3360.0 |
|2009/10 |27,199 |4483.1 |152,843 |3449.8 |
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Figure 48 shows that the disparity between Māori and non-Māori rates for hospitalisations involving injury and poisoning generally increased over the 11 years to 2009/10. The greatest disparity between rates occurred in 2008/09, when the rate for Māori was 30.3% higher than the rate for non-Māori.
There were 103 more Māori hospitalisations (per 100,000 Māori) and 89 more non-Māori hospitalisations (per 100,000 non-Māori) in 2009/10 compared to 2008/09.
Figure 48: Age-standardised rates for hospital discharges involving injury and poisoning by ethnicity, 1999/00–2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.
Māori males and non-Māori males had higher numbers and rates of hospitalisations than females for each year from 1995/96 to 2009/10 (Table 32). Hospitalisation rates for Māori males and Māori females increased more (74.5% and 93.4%) than their non-Māori counterparts (39.7% and 61.0%) over the same time period.
In 2009/10, Māori males accounted for 57.4% of hospitalisations for Māori, while non-Māori males made up 52.2% of hospitalisations for non-Māori. Compared with 2008/09, Māori females showed the greatest increase in rates: there were 170 more hospitalisations for Māori females (per 100,000 Māori females) in 2009/10.
Table 32: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity and sex, 1995/96–2009/10
|Year |Māori male |Māori female |Non-Māori male |Non-Māori female |
| |Number |Rate |Number |
| |Male |Female |Total |
| |Male |Female |Total |Male |
| | |Male |
| |Average length of stay |Average length of stay |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |7.2 |10.1 |8.5 |7.4 |9.0 |8.2 |
|Total |7.0 |9.5 |8.1 |7.2 |8.6 |7.9 |
| |Bed days |Bed days |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |280,369 |321,149 |601,518 |427,072 |497,936 |925,008 |
|Total |319,163 |343,136 |662,299 |493,597 |549,533 |1,043,130 |
| |Percent of total bed days |Percent of total bed days |
| |Male |Female |Total |Male |Female |Total |
|Non-Māori |87.8 |93.6 |90.8 |86.5 |90.6 |88.7 |
|Total |100.0 |100.0 |100.0 |100.0 |100.0 |100.0 |
Source: National Minimum Dataset
The following figures show the average length of stay (Figure 58) and the total number of bed days (Figure 59) for hospitalisations involving injury and poisoning by deprivation quintile. In 2009/10, the average length of stay was:
• longest for patients in the second most deprived (fourth) quintile (8.5 days)
• shortest for patients in the most deprived quintile (7.3 days).
Figure 58: Average length of stay by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10
[pic]
Source: National Minimum Dataset
In 2009/10, the total number of days spent in publicly owned facilities for hospitalisations involving injury and poisoning was:
• highest in the second most deprived (fourth) quintile (267,679 bed days)
• lowest in the least deprived quintile (139,166 bed days).
Figure 59: Total bed days by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10
[pic]
Source: National Minimum Dataset
Table 37 shows the average length of stay and total number of bed days for hospitalisations involving injury and poisoning by DHB region of residence. Of all DHB regions, South Canterbury had the longest average length of stay (11.9 days) in 2009/10, while Whanganui had the shortest (5.7 days). Auckland had the highest number of bed days (132,237), while Wairarapa had the lowest (8480).
Compared to New Zealand as a whole:
• all six South Island DHB regions had a longer average length of stay
• five North Island DHB regions had a longer average length of stay (Capital & Coast, Auckland, Bay of Plenty, Waikato and MidCentral).
Table 37: Average length of stay and total bed days by DHB region, total population, hospital discharges involving injury and poisoning, 2009/10
|DHB region |Average length of stay |Total bed days |
| |Male |Female |Total |Male |Female |Total |
|Waitemata |6.0 |7.9 |6.9 |52,512 |64,078 |116,590 |
|Auckland |8.8 |10.4 |9.5 |62,510 |69,727 |132,237 |
|Counties Manukau |6.0 |7.5 |6.7 |45,289 |49,083 |94,372 |
|Waikato |7.7 |8.5 |8.0 |42,579 |42,754 |85,333 |
|Lakes |5.4 |6.2 |5.8 |11,521 |10,738 |22,259 |
|Bay of Plenty |7.4 |8.9 |8.1 |27,779 |28,993 |56,772 |
|Tairawhiti |6.0 |6.5 |6.2 |5888 |5397 |11,285 |
|Hawke’s Bay |6.8 |7.9 |7.3 |16,172 |15,419 |31,591 |
|Taranaki |6.3 |7.6 |6.9 |11,079 |11,477 |22,556 |
|MidCentral |7.1 |8.7 |7.9 |15,507 |19,871 |35,378 |
|Whanganui |5.2 |6.3 |5.7 |6018 |6150 |12,168 |
|Capital & Coast |10.4 |10.2 |10.3 |34,731 |39,485 |74,216 |
|Hutt Valley |7.3 |8.2 |7.7 |12,670 |14,098 |26,768 |
|Wairarapa |5.1 |7.4 |6.1 |3823 |4657 |8480 |
|Nelson Marlborough |7.6 |8.7 |8.1 |15,591 |15,981 |31,572 |
|West Coast |6.3 |10.9 |8.4 |3594 |5041 |8635 |
|Canterbury |6.9 |9.8 |8.3 |49,866 |73,096 |122,962 |
|South Canterbury |13.8 |10.2 |11.9 |10,585 |8505 |19,090 |
|Otago |8.1 |9.5 |8.8 |26,838 |30,931 |57,769 |
|Southland |9.1 |10.6 |9.8 |16,808 |15,850 |32,658 |
|Overseas and undefined |5.2 |5.6 |5.4 |3237 |2917 |6154 |
|Total New Zealand |7.2 |8.6 |7.9 |493,597 |549,533 |1,043,130 |
Source: National Minimum Dataset
Table 38 shows that Māori patients residing in the Capital & Coast DHB region stayed longer in hospital (10.7 days on average) than other DHB regions for hospitalisations involving injury and poisoning in 2009/10. Māori patients residing in the Wairarapa DHB region had the shortest average length of stay (4.3 days). Of all DHB regions, Waikato had the highest number of bed days for hospitalisations involving injury and poisoning for Māori (14,775), while South Canterbury had the lowest (319).
Compared to New Zealand as a whole:
• three South Island DHB regions had a longer average length of stay (Otago, Southland and Canterbury)
• four North Island DHB regions had a longer average length of stay (Capital & Coast, Auckland, Waikato and Taranaki).
Table 38: Average length of stay and total bed days by DHB region, Māori population, hospital discharges involving injury and poisoning, 2009/10
|DHB region |Average length of stay |Total bed days |
| |Male |Female |Total |Male |Female |Total |
|Waitemata |5.9 |4.4 |5.2 |5841 |3167 |9008 |
|Auckland |8.4 |8.3 |8.4 |6191 |5047 |11,238 |
|Counties Manukau |5.7 |4.9 |5.3 |8281 |5753 |14,034 |
|Waikato |7.0 |6.8 |6.9 |8410 |6365 |14,775 |
|Lakes |5.1 |6.3 |5.6 |3572 |3270 |6842 |
|Bay of Plenty |5.7 |6.0 |5.8 |5301 |3868 |9169 |
|Tairawhiti |5.6 |6.1 |5.8 |2666 |2235 |4901 |
|Hawke’s Bay |5.5 |5.0 |5.3 |3577 |2035 |5612 |
|Taranaki |6.3 |6.9 |6.5 |1712 |1159 |2871 |
|MidCentral |5.7 |5.1 |5.5 |1895 |1224 |3119 |
|Whanganui |4.9 |5.9 |5.4 |1186 |1229 |2415 |
|Capital & Coast |9.8 |11.7 |10.7 |3541 |4432 |7973 |
|Hutt Valley |6.0 |6.3 |6.1 |2008 |1427 |3435 |
|Wairarapa |3.5 |5.6 |4.3 |384 |381 |765 |
|Nelson Marlborough |3.7 |5.9 |4.8 |422 |679 |1101 |
|West Coast |5.6 |4.1 |5.0 |261 |114 |375 |
|Canterbury |6.2 |6.5 |6.4 |2799 |2246 |5045 |
|South Canterbury |3.6 |8.0 |5.1 |143 |176 |319 |
|Otago |5.1 |10.8 |7.5 |879 |1353 |2232 |
|Southland |8.4 |5.5 |7.4 |1596 |493 |2089 |
|Overseas and undefined |4.6 |6.3 |5.3 |142 |133 |275 |
|Total New Zealand |6.1 |6.3 |6.2 |66,525 |51,597 |118,122 |
Source: National Minimum Dataset
Inpatients and day cases
This section presents hospitalisations involving injury and poisoning by patient type: inpatients and day cases. For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient that does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.
In 2009/10, day cases made up 26.5% (47,678) of hospitalisations involving injury and poisoning: the remaining three-quarters were inpatients (Table 39). The number of day case hospitalisations in 2009/10 was more than four times higher than in 1995/96 (11,044 compared with 47,678). Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events.
As a proportion of all hospitalisations involving injury and poisoning, day cases more than doubled from 1995/96 to 2009/10: from 12.0% to 26.5%.
Table 39: Hospital discharges involving injury and poisoning by patient type,
1995/96–2009/10
|Year |Inpatient |Day case |Percent day cases |
|1995/96 |81,302 |11,044 |12.0 |
|1996/97 |86,417 |11,634 |11.9 |
|1997/98 |91,946 |13,193 |12.5 |
|1998/99 |93,753 |15,437 |14.1 |
|1999/00 |99,038 |18,622 |15.8 |
|2000/01 |106,505 |24,382 |18.6 |
|2001/02 |106,767 |27,266 |20.3 |
|2002/03 |109,620 |26,079 |19.2 |
|2003/04 |111,146 |26,723 |19.4 |
|2004/05 |112,817 |30,003 |21.0 |
|2005/06 |118,531 |33,626 |22.1 |
|2006/07 |120,924 |35,519 |22.7 |
|2007/08 |122,577 |36,335 |22.9 |
|2008/09 |126,723 |45,275 |26.3 |
|2009/10 |132,364 |47,678 |26.5 |
Source: National Minimum Dataset
Figure 60 shows age-specific rates for inpatient and day case hospitalisations involving injury and poisoning in 2009/10. For all age groups the inpatient rate was higher than the corresponding day case rate. Those aged 85 years and over had both the highest inpatient rate (21,573.7 per 100,000 people) and the highest day case rate (2532.5 per 100,000) in 2009/10.
The difference between inpatient and day case rates increased with age; specifically the inpatient rate was:
• approximately 1.5 times the day case rate for those aged 0–24 years
• 8.5 times the day case rate for those aged 85 years and over.
Figure 60: Age-specific rates for hospital discharges involving injury and poisoning by patient type, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 61 shows inpatient rates for hospitalisations involving injury and poisoning by five-year age group and ethnicity for 2009/10. The rate of inpatient hospitalisations was greater for Māori than non-Māori for all age groups except for those aged 80 years and over. In particular, the inpatient rate for Māori was over 1.5 times the rate for non-Māori for those aged 25–69 years.
Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care.
Figure 61: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 62 shows day case rates for hospitalisations involving injury and poisoning by five-year age group and ethnicity for 2009/10. The day case rate was greater for Māori aged 15–74 years compared with non-Māori. The highest rate for Māori was for those aged 20–24 years (1828.5 per 100,000 Māori), while for non-Māori the highest rate was for those aged 85 years and over (2547.7 per 100,000 non-Māori).
Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care.
Figure 62: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-specific rates per 100,000 people in each age group.
Figure 63 shows rates for publicly funded hospitalisations involving injury and poisoning by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, inpatient and day case rates increased as deprivation increased. At all levels of deprivation, the rate for inpatient hospitalisations was greater than the rate for day cases. This disparity was greatest in the most deprived areas of New Zealand, where the rate for inpatients was almost 2.5 times the rate for day cases.
Figure 63: Hospital discharges involving injury and poisoning by deprivation quintile and patient type, 2009/10
[pic]
Source: National Minimum Dataset
Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population; 95% confidence intervals.
Further hospital-related information
Electronic version of this Hospital Events publication
Electronic copies of this publication series (in PDF and Word format) are available at: t.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-event-data-and-stats
Statistical hospital data tables are available online in Excel format alongside the Hospital Events publication.
These tables contain hospital event data by deprivation quintile, average length of stay, bed days, inpatients and day cases. Population denominators are also provided at national, regional, ethnic and deprivation quintile levels.
Other hospital-related Ministry of Health publications
• Further detailed information on numbers of hospital discharges, hospital procedures and hospital discharges involving injury and poisoning are released in the annual online hospital data sets Publicly funded hospital discharges and Privately funded hospital discharges (t.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-event-data-and-stats).
• Information on hospital surgical activity data can be found in the quarterly Hospital Surgical Activity series (t.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-surgical-activity-data-and-stats).
Other publications containing data from the National Minimum Dataset
Other Ministry of Health publications that report data from the NMDS are:
• New Zealand Maternity Clinical Indicators, Maternity Factsheet and Maternity Snapshot, Report on Maternity series
t.nz/nz-health-statistics/health-statistics-and-data-sets/maternity-and-newborn-data-and-stats
• Suicide Facts: Deaths and Intentional Self-harm Hospitalisations series
t.nz/nz-health-statistics/health-statistics-and-data-sets/suicide-data-and-stats
• Mortality and Demographic Data series
t.nz/nz-health-statistics/health-statistics-and-data-sets/mortality-data-and-stats
These publications, and others produced by the Ministry of Health, can all be found through t.nz/nz-health-statistics/health-statistics-and-data-sets
Other hospital-related publications
Serious injury outcome indicator reports
Statistics New Zealand produces the annual Serious Injury Outcome Indicator reports. These indicators cover only a subset of the hospitalisation data held within this publication and cannot be directly compared.
For more information and access to the indicator technical report, please see this web page: t.nz/browse_for_stats/health/injuries/serious-injury-outcome-indicators-reports.aspx
If you require further information relating to the methodology, classifications and processes used, and how they differ between publications, please contact data-enquiries@t.nz
Population and demographic data
For population and other demographic data contact the Ministry of Health
(email: data-enquiries@t.nz) or Statistics New Zealand (t.nz).
Hospital data available from the Ministry of Health
Email: data-enquiries@t.nz
|Item |Notes |
|National Health Index (NHI) |A unique patient identifier. Restricted access. |
|number | |
|Admission source |A code used to describe the nature of admission (routine or transfer) for a hospital |
| |inpatient health event. |
|Admission type |A code used to describe the type of admission for a hospital health care event, for example |
| |arranged admission, acute admission, elective admission of a privately funded patient. |
|NZ resident status |A code identifying resident status at the time of the event. Used to identify overseas |
| |residents treated in New Zealand. Tied to public funding of events. |
|Date of birth |Day, month, year. |
|Age |Age in years. |
|Sex |Male, female, indeterminate, unknown. |
|Ethnicity |Based on Statistics New Zealand Standard Classification 1996 (Level 2), for example NZ |
| |Māori, NZ European or Pakeha, Other European, Samoan, Chinese and so on. Up to three |
| |ethnicities are recorded and prioritised. |
|Domicile code |Based on Statistics New Zealand Standard Area Unit code. Represents a person’s usual |
| |residential address. |
|Event type |A code identifying the type of health event, for example birth event, day patient, death |
| |event, psychiatric inpatient event, outpatient event. |
|Event end type |A code identifying how a health care event ended. For example, discharge to an acute |
| |facility, ended routinely, routine discharges from an emergency department acute facility. |
|Event start date |The admission date on which a health care event began. |
|Event end date |The date on which a health care user is discharged from a facility (ie, the date the health |
| |care event ended) or the date on which a sectioned mental health patient is discharged to |
| |leave. |
|Event local identifier |Local system-generated number to distinguish two or more events of the same type occurring |
| |on the same day at the same facility. |
|Event ID |An internal reference number that uniquely identifies a health event. |
|Event leave days |The number of days an inpatient on leave is absent from the hospital at midnight, up to a |
| |maximum of three days (midnights) for non-psychiatric hospital inpatients for any one leave |
| |episode. |
|Diagnosis code(s) |A code used to classify the clinical description of a diagnosis. Codes are from the World |
| |Health Organization International Classification of Diseases and Related Health Problems, |
| |Tenth Revision, Australian Modification (ICD-10-AM). Up to 99 codes may be recorded. |
|Accident/ecode(s) |A code used to classify the clinical description of a cause of an accident (involving injury|
| |and poisoning. Codes are from the World Health Organization International Classification of |
| |Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). |
|Accident date |The date when the accident/injury occurred. |
|Procedure code(s) |A code used to classify the clinical description of a procedure. Codes are from the World |
| |Health Organization International Classification of Diseases and Related Health Problems, |
| |Tenth Revision, Australian Modification (ICD-10-AM). Up to 99 codes may be recorded. |
|Procedure date(s) |The date the procedure was performed. |
|Agency code |A code that uniquely identifies an agency. An agency is an organisation, institution or |
| |group of institutions that contracts directly with the principal health service purchaser to|
| |deliver health care services to the community. |
|Facility code |A code that uniquely identifies a health care facility. |
|Facility type |A code that categorises facilities into particular types, for example public hospital, |
| |private hospital, psychiatric hospital, GP practice, health centre, drug and alcohol |
| |treatment facility. |
|Specialty code |The speciality from which the patient was discharged. |
|Purchaser code |A code for the organisation or body that purchased the health care service provided. |
|DRG code |A diagnosis-related group (DRG) code produced by the DRG grouper program. Provides another |
| |way of analysing event information based on classifying episodes of inpatient care into |
| |clinically meaningful groups with similar resource consumption. |
Additional information available from the Ministry of Health
You may require information not included in this report or in the online statistical tables. The Ministry of Health is able to produce customised data extracts tailored to your needs. These may incur a charge (at Official Information Act rates). If you require additional data or analysis, please contact:
Analytical Services
Ministry of Health
PO Box 5013
Wellington
New Zealand
Ph: (04) 496 2000
Fax: (04) 816 2898
Email: data-enquiries@t.nz
or visit: t.nz
The Ministry of Health welcomes comments and suggestions about this publication.
Definitions
|Age-specific rates |Refer to the ‘Technical notes’ section. |
|Age-standardised rates |Refer to the ‘Technical notes’ section. |
|Day case (day patient) |A person who is admitted to hospital and discharged routinely on the same day. Day cases |
| |do not include those patients who died in hospital or transferred to another hospital; |
| |these are considered inpatients. |
|District health board (DHB) region of |District health boards are body corporates owned by the Crown. They are responsible for |
|residence |providing or buying government-funded health care services for the population of a |
| |specific geographical area. This publication presents hospital data by DHB region of |
| |residence. Note that not all residents in a particular DHB will be treated in that DHB |
| |region. |
|Ethnicity |Two ethnic groupings are used in this publication: Māori and non-Māori. The Māori |
| |population includes everyone who identified as Māori, and the non-Māori population |
| |includes everyone else. |
| |This publication uses ‘prioritised ethnicity’, where each person is allocated to one |
| |ethnic group using the priority system Māori > non-Māori (Ministry of Health 2004). The |
| |aim of prioritisation is to ensure that when it is necessary to assign people to a single |
| |ethnic group, ethnic groups that are small or important in terms of policy are not swamped|
| |by the European ethnic group (Ministry of Health 2004). This method is also a more robust |
| |method of dealing with the low rate of multiple ethnicities in health sector data. |
| |The system recognises certain key characteristics of ethnicity: |
| |ethnicity is self-perceived, so people should identify their ethnic affiliation themselves|
| |wherever feasible |
| |a person can belong to more than one ethnic group |
| |the ethnicities with which a person identifies can change over time. |
|Event |An admission and discharge from a hospital. |
|Hospital discharge |Discharge occurs when a patient leaves hospital to return home, transfers to another |
| |hospital or residential institution, or dies in hospital after formal admission. In this |
| |publication, discharges are equivalent to the number of patients discharged, transferred |
| |from or dying in publicly or privately funded hospitals. |
|Inpatient |A person who is admitted to hospital for medical, surgical, psychiatric or obstetric |
| |treatment, observation or care and who stays at least one night. ‘Inpatient’ also includes|
| |healthy persons if formally admitted by the hospital as ‘boarders’, and patients who die |
| |in hospital or who are transferred to another hospital on the day of admission. |
|Intentional self-harm |Rates for intentional self-harm in this publication are defined using intentional |
| |self-harm external cause codes (X60–X84) from the ICD-10-AM. It is important to note that |
| |reported rates for intentional self-harm in this publication are not directly comparable |
| |with those reported in the Ministry of Health’s recent Suicide Facts: Deaths and |
| |intentional self-harm hospitalisations publications. The underlying data have been |
| |selected and filtered in different ways, and are reported for different time periods |
| |(calendar years versus financial years). For example, the rates reported in the Suicide |
| |Facts publication exclude short-stay emergency department admissions. Refer to the Suicide|
| |Facts: Deaths and intentional self-harm hospitalisations series for further detail. |
|International Statistical |The ICD-10-AM is used to classify causes of morbidity throughout this publication |
|Classification of Diseases and Related |(National Centre for Classification in Health 2008). |
|Health Problems, 10th Revision, |ICD-10-AM codes are based on the official version of the WHO’s International |
|Australian Modification, 6th Edition |Classification of Diseases and Related Health Problems. Codes are designed for |
|(ICD-10-AM) |classification of morbidity and mortality information for statistical purposes. ICD codes |
| |are also used for indexing hospital records by disease and operations, for data storage |
| |and retrieval. The clinical codes are used to classify the clinical description of a |
| |condition, cause of intentional and unintentional injury, underlying cause of death, |
| |operation or procedure performed or pathological nature of a tumour. |
|Length of stay |Equates to midnights spent in hospital. It is reported in days and calculated from the |
| |start date to the end date (less any leave days) of a hospital event. |
|National Minimum Dataset (NMDS) |A national collection of public and private hospital discharge information, including |
| |clinical information for inpatients and day patients (National Health Board Business Unit |
| |2010). |
|New Zealand Index of Deprivation 2006 |The New Zealand Deprivation Index is a measure of socioeconomic status calculated for |
|(NZDep2006) |small geographic areas. The calculation combines nine variables that reflect aspects of |
| |social and material deprivation from the 2006 Census of Population and Dwellings. The |
| |Deprivation Index is calculated at the level of meshblocks (geographical units containing |
| |a median of 90 people), and the Ministry of Health maps these to domicile codes, which are|
| |built up to the relevant geographic scale using weighted average, usually resident |
| |population counts from the Census. The nine variables in the index, by decreasing weight, |
| |are: |
| |1 income: people aged 18–64[21] receiving a means-tested benefit |
| |2 income: people living in an equivalised[22] household with income below an income |
| |threshold |
| |3 home ownership: people not living in their own home |
| |4 support: people aged under 65 living in a single-parent family |
| |5 employment: people aged 18–64 who are unemployed |
| |6 qualifications: people aged 18–64 with no qualifications |
| |7 living space: people living in an equivalised22 household below a bedroom occupancy |
| |threshold |
| |8 communication: people with no access to a telephone |
| |9 transport: people with no access to a car. |
| |The index scores are grouped into 10 deciles, with each decile representing an equal or |
| |similar size of the New Zealand population. |
| |For the purposes of this publication the 10 deciles have been combined into five |
| |quintiles. Quintile 1 (deciles 1 and 2) represents the least deprived areas and quintile 5|
| |(deciles 9 and 10) the most deprived areas. |
| |Further information is available from t.nz; search for ‘NZDep 2006 Index of |
| |Deprivation’. |
|Procedure |Procedures can be surgical or non-surgical, and can treat or diagnose a condition or |
| |provide patient support, such as anaesthesia. |
|Publicly funded hospital events |Health care events that are publicly funded; this includes Ministry of Health, DHB and ACC|
| |funded events. Also included are publicly funded hospital services provided in private |
| |hospitals. |
|Privately funded hospital events |Health care events that are privately funded; this includes insurance-funded and |
| |self-funded events. Also included are privately funded hospital services provided in |
| |public hospitals; the majority of these involve overseas residents whose country does not |
| |have a reciprocal health agreement with New Zealand (‘overseas chargeable’). |
Technical notes
In this publication, numbers are generally rounded to one decimal place. However, calculations are made from the full string (that is, all the numbers after the decimal place), thereby providing more precise reporting.
Rate calculations
Age-specific rates show the number of events (for example, hospitalisations or procedures) per 100,000 people in each age group for each year. In this publication age-specific rates are given in five-year age groups. Table N-1 presents the estimated resident population of New Zealand by age, sex and ethnicity as at 30 June 2010. This population was used to calculate the rates shown in this publication.
Table N-1: Population data, 2009/10
|Age group |Total population |Māori population |
|(years) | | |
| |Male |Female |Total |Male |Female |Total |
|5–9 |146,900 |139,920 |286,820 |35,750 |33,920 |69,680 |
|10–14 |151,580 |144,210 |295,780 |35,340 |33,480 |68,820 |
|15–19 |165,510 |156,880 |322,390 |34,940 |33,040 |67,980 |
|20–24 |161,380 |153,840 |315,220 |27,870 |28,680 |56,550 |
|25–29 |143,180 |145,230 |288,410 |20,230 |22,300 |42,540 |
|30–34 |129,330 |139,990 |269,330 |19,500 |22,160 |41,660 |
|35–39 |143,000 |158,290 |301,290 |19,970 |23,070 |43,040 |
|40–44 |149,330 |162,400 |311,730 |18,840 |21,380 |40,220 |
|45–49 |156,140 |166,530 |322,670 |18,360 |20,700 |39,060 |
|50–54 |142,640 |148,850 |291,480 |15,220 |16,900 |32,120 |
|55–59 |123,430 |127,910 |251,340 |11,440 |12,550 |23,990 |
|60–64 |113,090 |117,220 |230,310 |8,650 |9,460 |18,110 |
|65–69 |85,990 |90,230 |176,220 |5,810 |6,550 |12,350 |
|70–74 |65,490 |71,460 |136,950 |4,220 |4,840 |9,060 |
|75–79 |48,880 |56,300 |105,180 |2,380 |2,910 |5,300 |
|80–84 |34,800 |45,910 |80,710 |1,130 |1,630 |2,760 |
|85+ |23,910 |46,180 |70,090 |540 |930 |1,480 |
|All ages |2,144,600 |2,223,200 |4,367,800 |326,200 |337,700 |663,900 |
Source: Statistics New Zealand
Note: Because of rounding, individual figures in this table do not always sum to give the stated totals.
Age-standardised rates adjust for differences in age distribution of the populations being compared. Age-standardised rates are calculated by multiplying age-specific rates by a standard population (the direct standardisation method). They are artificially created figures that allow comparisons to be made with differing groups; they should only be compared with other adjusted rates that have been calculated using the same standard population.
The standard population used in these calculations is the WHO world standard population (Table N-2), a widely used New Zealand and international standard.
Table N-2: World Health Organization world standard population
|Age group |Population |
|0–4 |8860 |
|5–9 |8690 |
|10–14 |8600 |
|15–19 |8470 |
|20–24 |8220 |
|25–29 |7930 |
|30–34 |7610 |
|35–39 |7150 |
|40–44 |6590 |
|45–49 |6040 |
|50–54 |5370 |
|55–59 |4550 |
|60–64 |3720 |
|65–69 |2960 |
|70–74 |2210 |
|75–79 |1520 |
|80–84 |910 |
|85+ |635 |
|Total |100,035 |
Source: Ahmad et al 2001
Confidence intervals
The confidence intervals in this publication have been calculated using the methods presented in Keyfitz (1966). A confidence interval is a range of values used to describe the uncertainty around a single value (such as an age-standardised rate). Confidence intervals describe how different the estimate could have been if chance had led to a different set of data. Confidence intervals are calculated with a stated probability. For this publication, confidence intervals are calculated to a 95% probability, which indicates that there is a 95% chance that the true value lies within the confidence interval.
Confidence intervals may assist in comparing hospitalisation and procedure rates over time. If two confidence intervals do not overlap, then it is reasonable to assume that the difference is not due to chance. If they do overlap, it is not possible to draw any conclusion about the significance of any difference between them.
Procedure codes
Table N-3 presents the ICD-10-AM procedures codes used to define selected procedures in the publication.
Table N-3: ICD-10-AM 6th Edition procedure codes for selected procedures
|Procedure |Block |Procedure codes |
|Cataracts |195 |4269800, 4270200, 4270201 |
| |196 |4269801, 4270202, 4270203 |
| |197 |4269802, 4270204, 4270205 |
| |198 |4269803, 4270206, 4270207 |
| |199 |4269804, 4270208, 4270209 |
| |200 |4273101, 4269805, 4270210, 4270211 |
|Varicose veins |727 |3250800, 3250801, 3251100 |
| |728 |3250401, 3250700 |
|Grommets and myringotomies |309 |4162600, 4162601, 4163200, 4163201 |
|Hysterectomies/removal of womb |1268 |9044800, 3565300, 9044801, 3565301, 9044802, 3565304, 3566100, 3567000,|
| | |3566700, 3566400 |
| |1269 |3575000, 3575302, 3575600, 3575603, 3565700, 3567302, 3566701, 3566401 |
|Hernia |990 |3060902, 3060903, 3061402, 3061403 |
| |991 |3060900, 3060901, 3061400, 3061401 |
| |992 |3061700, 3061701, 3061702 |
| |993 |3040300, 3040500, 3040501, 3040502 |
| |994 |3056302, 3056303 |
| |996 |3040301, 3040503, 3040504, 3040505 |
| |997 |3061500 |
| |998 |3060100, 3060101, 3060000, 4383702 |
|Coronary angioplasties |670 |3830000, 3830300, 3830001, 3830301 |
| |671 |3830600, 3830601, 3830602, 3830603, 3830604, 3830605 |
|Hip replacement* |1489 |4752200, 4931200, 4931500, 4931800, 4931900, 9060700, 9060701 |
|Knee replacement* |1518 |4951700, 4951800, 4951900, 4953401 |
| |1519 |4952100, 4952101, 4952102, 4952103, 4952400, 4952401 |
|Coronary artery bypass grafts |672 |3849700, 3849701, 3849702, 3849703 |
| |673 |3849704, 3849705, 3849706, 3849707 |
| |674 |3850000, 3850300 |
| |675 |3850001, 3850301 |
| |676 |3850002, 3850302 |
| |677 |3850003, 3850303 |
| |678 |3850004, 3850304 |
| |679 |9020100, 9020101, 9020102, 9020103 |
|Prostatectomies |1165 |3720300, 3720100, 3720302 |
| |1166 |3720700, 3720701, 3720303, 3720304, 3720305, 3720306, 3720901, 3721001,|
| | |3721101 |
| |1167 |3720003, 3720004, 3720900, 3721000, 3721100, 3720005 |
|Tonsillectomies and adenoidectomies |412 |4178900, 4180100, 4178901, 4180400 |
|Carpal and tarsal tunnel procedures |76 |3933001, 3933100, 3933101 |
|Cholecystectomy |965 |3044300, 3044500, 3044600, 3044800, 3044900, 3045401, 3045500 |
* Procedure codes include total and partial replacements but exclude revisions.
References
Ahmad O, Boschi-Pinto C, Lopez AD, et al. 2001. Age Standardization of Rates: A new WHO standard. Geneva: World Health Organization GPE Discussion Paper Series: No. 31. URL: who.int/healthinfo/paper31.pdf (accessed 29 March 2011).
Benzeval M, Judge K, Shouls S. 2001. Understanding the relationship between income and health: How much can be gleaned from cross-sectional data? Social Policy and Administration 35: 376–96.
Keyfitz N. 1966. Sampling variance of standardized mortality rates. Human Biology 38: 309–17.
Ministry of Health. 2004. Ethnicity Data Protocols for the Health and Disability Sector. Wellington: Ministry of Health.
Ministry of Health. 2010. Suicide Facts: Deaths and intentional self-harm hospitalisations 2008. Wellington: Ministry of Health.
National Centre for Classification in Health. 2008. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification, 6th Edition (ICD-10-AM). Sydney: National Centre for Classification in Health.
National Health Board Business Unit. 2010. National Minimum Dataset (Hospital Events) Data Dictionary. Wellington: Ministry of Health.
Salmond C, Crampton P, Atkinson J. 2007. NZDep2006 Index of Deprivation User’s Manual. Wellington: Department of Public Health, University of Otago.
Statistics New Zealand. 2011a. Māori population estimates. Wellington: Statistics New Zealand. URL: estimates_and_projections/maori-population-estimates.aspx (accessed 17 August 2012).
Statistics New Zealand. 2011b. National population estimates. Wellington: Statistics New Zealand. URL: estimates_and_projections/NationalPopulationEstimates_HOTPJun11qtr.aspx (accessed 17 August 2012).
Statistics New Zealand. 2011c. Serious Injury Outcome Indicators: 1994–2010. Wellington: Statistics New Zealand. URL: t.nz/browse_for_stats/health/injuries/ serious-injury-outcome-indicators-94-10.aspx (accessed 17 September 2012).
Statistics New Zealand. 2011d. Serious Injury Outcome Indicators – Technical Report. Wellington: Statistics New Zealand. URL: t.nz/browse_for_stats/ health/injuries/serious-injury-outcome-tech-report.aspx (accessed 17 September 2012).
White P, Gunston J, Salmond C, et al. 2008. Atlas of Socioeconomic Deprivation in New Zealand NZDep2006. Wellington: Ministry of Health.
-----------------------
[1] Hospital events include those involving New Zealand and overseas residents treated in New Zealand.
[2] Publicly funded events include Accident Compensation Corporation (ACC), DHB and Ministry of Health funded events.
[3] In this publication, ‘private hospitals’ include private surgical hospitals and private aged care facilities.
[4] Hospital discharges (hospitalisations) include day patients, transfers and readmissions.
[5] An age-standardised rate is a rate that has been adjusted to take account of differences in the age distribution of the population over time or between different groups (for example, different ethnic groups). This publication has used the WHO world standard population in determining age-standardised rates. For more information on rates refer to the ‘Definitions’ section of this publication.
[6] Hospital discharges for children aged 0–4 years include birth events: 30.6% of publicly funded hospital discharges for this age group were for live births in 2009/10.
[7] An age-specific rate refers to the frequency with which an event occurs relative to the number of people in a defined age group. In this publication age-specific rates are given in five-year age groups.
[8] For females aged 15–49 years, hospitalisations relating to pregnancy and childbirth made up 40.3% of total publicly funded hospital discharges in 2009/10.
[9] See and estimates_and_projections/NationalPopulationEstimates_HOTPJun11qtr.aspx
[10] Rates were found to be statistically significant using 95% confidence intervals.
[11] Rates were found to be statistically significant using 95% confidence intervals.
[12] Categories Z00–Z99 (factors influencing health status and contact with health services) are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00–Y89 are recorded as ‘diagnoses’ or ‘problems’. As such, they have been excluded from analyses of selected diagnoses in this section of the publication. For example, categories Z40–Z54 are intended to indicate a reason for care. They are used for patients who have already been treated for a disease or injury, but who are receiving follow-up care or care to consolidate the treatment, to ensure that the condition has not recurred or to prevent recurrence. Infants are also included (Z38: Liveborn infants according to place of birth).
[13] Ethnicity data for privately funded hospitalisations are not shown due to the high number of privately funded hospital discharges that have no ethnicity information recorded.
[14] In 2009/10, females aged 15–59 received 20,063 anaesthesia procedures while males received 13,617.
[15] Rates were found to be statistically significant using 95% confidence intervals.
[16] ‘Non-invasive, cognitive and other interventions, not elsewhere classified’ (ICD chapter XIX) includes therapeutic and diagnostic interventions (such as exercise therapy, consultation and evaluation), interventions that require cognitive skills (such as counselling) and other interventions, such as anaesthesia.
[17] ‘Non-invasive, cognitive and other interventions, not elsewhere classified’ (ICD chapter XIX) includes therapeutic and diagnostic interventions (such as exercise therapy, consultation and evaluation), interventions that require cognitive skills (such as counselling) and other interventions such as anaesthesia.
[18] Ethnicity data for privately funded hospitalisations are not shown due to the high number of privately funded hospital discharges that have no ethnicity information recorded.
[19] Rates were found to be statistically significant using 95% confidence intervals.
[20] Note that reported rates for intentional self-harm in this publication are not directly comparable with those reported in the Ministry of Health’s Suicide Facts: Deaths and intentional self-harm hospitalisations publications. For more information please refer to the ‘Definitions’ section.
[21] The upper age boundary of 64 has been increased from the NZDep2001 value of 60 to better reflect societal norms.
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