NSW, Aust Public Hospital Births - beware the "Rebound"

A small "rebound" in births in NSW Public Hospitals may not be the reprieve that people could seek to present it as...

My first piece on the NSW BHI data for births in NSW can be found here.

The NSW Bureau of Health Information has just released the official figures for Births in NSW Public Hospitals for Q3, 2023 (July to September).

The red circle is my own and is what I will be looking at in this Stack.

To set the filter on the BHI Data Portal, follow this:

Now, some notes in the circled area:

• Yes, there has been a “rebound”;

• But that “rebound” sits below any pre-COVID number;

• That “rebound” appears to be tapering off and may not have much additional “growth” left in it.

It’s also important to note that:

• These are Public Hospital Births only;

• Private Hospital and Births at Home are not included;

• Public Hospital Births are free in NSW;

• Private Hospital Births incur additional costs;

• Australia is currently going through (as you well know) a serious Cost of Living crisis;

• Hardest hit are those with new mortgages and renters - the very cohort that is also having babies;

• There would, therefore, be an undeniable switch of Private Hospital Births ($$$) to Public Hospital Births (Free) to alleviate this pressure;

• This would artificially inflate the Public Hospital numbers and, in doing so, create the mirage of a “rebound”.

Taking a look at the NSW Government’s “Mother and Babies Reports” for previous years we can check official year-end total births in NSW up until 2021.

And adding up the totals from the BHI’s Quarterly reports we can find the Public Hospital births for those same years and check how consistent the % of total births in Public Hospitals was.

And we get these figures:

And from this we can see:

• Consistent slight increase 2015-2020 with an average of 75%-ish;

• 2021 dips a bit, which we can attribute to the “COVID scare” as some people would not have wanted to be in Public Hospitals, and the Cost of Living was not biting, yet (first rate rise was May, 2022), so Private still an attractive option.

So, with the COVID scare campaign over in 2022, assuming a 75% base rate for Public Hospitals is not unreasonable for 2022.

But…by 2023, we’re stuck in the middle of a Cost of Living crisis with the birthing cohort bearing the brunt of it and, so, the most likely to look for pressure relief.

Enter the switch to Public Hospitals.

How big is this switch? We don’t know. The 2023 Mothers and Babies Report will not be available until mid-2025 (because…you know…efficient governments and all that…) so a finalised, official total births in NSW in 18+ months away…

But we can plot it out ourselves, for now…

A couple more things before we do:

• The pre-COVID 2015-2019 average for Q3 was 18,111 Public Hospital Births. That sits the Q3, 2023 value of 16,818 at 92.86% = a 7.14% decline;

• I see no reason to think the 75% average doesn’t hold across all quarters of the year. More Private in Summer and more Public in Winter (or whatever) makes no sense, so we’ll assume the 75% holds across the year;

• 18,111 Q3 average at 75% = 24,148 total births in NSW on average in Q3, 2015-2019.

So, let’s look at what happens if we plot out an increase in Public Hospital Births as a % of Overall Births in NSW:

So, in summary:

• The (in my opinion, very unlikely) absence of a Private-to-Public shift would see us sitting with a 7.14% / 3.7-sigma decline;

• The more of a switch that there is, however…the more of a decline / sigma deviation we have;

• A rise from 75% Public to 80% Public would require 1-in-5 “normally” Private Hospital women to switch to Public - how likely that is…?

• But, if it’s reasonable…the likelihood of this being a natural event is less than 1-in-390 billion.

So…now we just have to wait 18 months for the government to actually release the official 2023 total figures…

I mean, unless they come clean and tell us early 2024…right…?