The cost of hospitalisation for youth self-harm: differences across age groups, sex, Indigenous and non-Indigenous populations

  • Irina KinchinEmail author
  • Alex M. T. Russell
  • Joshua Byrnes
  • Janya McCalman
  • Christopher M. Doran
  • Ernest Hunter
Original Paper



To report the comparative rates, average length of stay and cost per episode of hospital management for self-harm in three age cohorts: 15–19 years, 20–24 years and 25–29 years; by sex and indigeneity.

Design, setting, participants

A secondary data analysis of the Australian Institute of Health and Welfare (AIHW) dataset between 1st January 2014 and 31st December 2014 inclusive.

Main outcome measures

Cost per episode of hospitalised self-harm and rates by age group, sex and Indigenous status.


The rate of hospitalised self-harm among Australian youth was 254.0 per 100,000 population. This rate resulted in an annual cost to the healthcare system of AU$55 million or an average cost per episode of $4649 (95% CI $4488:$4810). Hospitalised self-harm was 21 times higher than the rate of suicide (11,820 episodes of hospitalised self-harm/564 suicides). Indigenous youth had on average a 1.4 times higher rate of hospitalised self-harm and 2.2 times higher rate of suicide than non-Indigenous counterparts. When controlling for age and sex, the average cost per episode was significantly lower for Indigenous youth compared to non-Indigenous youth, estimated marginal means $4538 and $4954, respectively (p < 0.001).


Hospitalised self-harm among Australian youth resulted in a substantial cost to the healthcare system. This cost is only part of the overall burden associated with self-harm. The rate of hospitalised self-harm was significantly higher in Indigenous youth, but the associated cost per episode was significantly lower.


Hospital Cost Suicide Self-harm Adolescents Diagnostic related groups (DRGs) 



We wish to acknowledge the Department of Justice and Regulation for proving access to the Australian National Coronial Information System (NCIS), the Australian Institute of Health and Welfare (AIHW) for providing self-harm hospitalisation data and Central Queensland University for providing financial support to access the data.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centre for Health Economics Research and Evaluation (CHERE)University of Technology SydneySydneyAustralia
  2. 2.Centre for Indigenous Health Equity Research, School of Health, Medical and Applied SciencesCentral Queensland UniversityBrisbaneAustralia
  3. 3.School of Health, Medical and Applied SciencesCentral Queensland UniversitySydneyAustralia
  4. 4.Centre for Applied Health EconomicsGriffith UniversityBrisbaneAustralia
  5. 5.Cairns and Hinterland Hospital and Health ServiceCairnsAustralia

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