Public Hospital Report Card 2022

South Australia

AMA SA President’s Introduction

Dr Michelle Atchison

AMA SA President

Within a nation of states plagued by public hospital crises and below-par performances, South Australia continues to stand out for all the wrong reasons. Our hospitals are not managing. Our emergency departments (EDs) are among the worst-performing in Australia. Our sick, injured and overwrought patients don’t know where to turn.

The AMA’s review of 2020-21 data shows the percentage of urgent ED presentations seen within 30 minutes in South Australia has dropped to 50 per cent – 25 per cent below the next-worst state – and only 61 per cent of ED presentations were completed within the benchmark four hours.

As I mentioned to South Australian Government committee looking into ramping and logjams in February, it’s not what I’d want or expect for my own care, let alone that of an ageing parent or young child. Our hospitals must be better, and they need the funds to be better.

Emergency department

South Australia - COVID-19 impact on public hospital emergency department patient volumes

Following the March 2020 pandemic declaration and the subsequent drop in emergency department presentations, South Australia saw the number of emergency presentations gradually increase to the end of the 2019-20 financial year which was 3.0 per cent above 2018-19 levels.

In 2020-21 South Australia recorded an 8.4 per cent increase in emergency presentations compared to 2019-20.1

Waiting times

Percentage of triage Category 3 (Urgent) emergency department patients seen within recommended time (less than 30 minutes) - South Australia

In 2020-21 the percentage of Category 3 Urgent emergency presentations seen on time in South Australia was 50 per cent, a 5.0 per cent drop compared to the year before and 25 per cent below the best performing state.

Source: The State of our Public Hospitals (DOHA 2004-2010). Australian Institute of Health and Welfare (AIHW). Emergency department care 2010-2020-21

Percentage of emergency department visits completed in four hours or less - South Australia

Source: Australian Institute of Health and Welfare (AIHW). Emergency department care (2011-12 to 2020-21): Australian hospital statistics.
Note: National emergency access targets were abolished with effect from 1 July 2015

Elective surgery

Waiting times

South Australia – COVID-19 impact on public hospital elective surgery volumes

South Australia introduced Category 2 and 3 elective surgery restrictions in March 2020, followed by full resumption in May 2020.2 This meant that between 2018-19 and 2019-20 the volume of Category 2 elective surgeries declined by just 4 per cent.3 In 2020-21 the volume Category 2 elective surgeries increased by 2.3 per cent.4

Median waiting time for elective surgery (days) - South Australia compared to best and worst performing State or Territory

Source: Australian Institute of Health and Welfare (AIHW). Elective surgery data cubes (2001-02 to 2006-07): Australian hospital statistics. Australian Institute of Health and Welfare (AIHW). Elective surgery waiting times (2007-08 to 2020-21): Australian hospital statistics

Category 2 patients

Percentage of Category 2 elective surgery patients admitted within the recommended time (90 days) South Australia

62 per cent of patients on the Category 2 elective surgery waiting list were seen within the recommended 90 days in South Australia. This is a 17 per cent drop compared to the previous year.

Source: The State of Our Public Hospitals (DoHA 2004-2010) FOI request reference 253-1001 lodged June 2011. 2011-12 estimate based on State and Territory Government published data; State and Territory data for 2012 calendar year published by Australian Institute of Health and Welfare (AIHW) National emergency access and elective surgery targets 2012: Australian hospital statistics. Australian Institute of Health and Welfare (AIHW) Elective surgery waiting times 2013-14 to 2020-21: Australian hospital statistics.
2010-12 data not available

Public hospital funding

The most recent public hospital funding data is for the year 2019-20, so it is partially affected by COVID-19.

Commonwealth and South Australian government per person funding for public hospitals (constant prices)

Source: Australian Institute of Health and Welfare (AIHW) 2022, Health Expenditure Australia: 2008-09 to 2019-20 viewed 10 February 2022 https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20/contents/main-visualisations/overview

Per person average annual per cent increase in public hospital funding by government source (constant prices)

2008-09 to 2013-14 2014-15 to 2019-20 2009-10 to 2019-20 
Commonwealth -2.18% 2.55% 1.03%
South Australia 6.87% 1.95% 2.97%

1 Australian Institute of Health and Welfare 2022. Australian Hospital Statistics: Emergency department care 2020-21 table 2.2 viewed 1 February 2022 https://www.aihw.gov.au/getmedia/0d0d6cbf-e764-4a89-a71a-b03c5156235d/Emergency-Department-Care-2020-21.xlsx.aspx

2 Steven Marshal Premier of South Australia 2020. Media Releases Operation Restore Elective Surgery https://www.premier.sa.gov.au/news/media-releases/news/operation-restore-elective-surgery

3 Australian Institute of Health and Welfare (2021). Australian Hospital Statistics: Elective surgery waiting times 2019-20 Table 4.14 viewed 5 August 2021 https://www.aihw.gov.au/getmedia/5042f8a8-4711-455a-9c6d-60650f954fbe/Elective-surgery-waiting-times-2018-19.xlsx.aspx

4 Australian Institute of Health and Welfare (2022). Australian Hospital Statistics: Elective surgery waiting times 2020-21 Table 4.15 viewed 2 Feb 2022 https://www.aihw.gov.au/getmedia/9d847d52-b1d3-4366-9900-1a0d4db1055d/Elective-surgery-waiting-times-2020-21.xlsx.aspx