In August 2012, the Independent Hospital Pricing Authority (IHPA) engaged the Australian Institute of Health and Welfare (AIHW) to develop nationally consistent definitions and guidelines for subacute and non-acute admitted patient care and care types for implementation from 1 July 2013 to support activity based funding.
In developing these definitions and guidelines, the AIHW consulted with jurisdictions and other stakeholders, through the IHPA's Subacute Care Working Group (SCWG) and the Australian Health Ministers' Advisory Council's (AHMAC) National Health Information Standards and Statistics Committee (NHISSC), between September and December 2012. The work was also informed by review of previous related work and key literature, and review of relevant national health data.
In line with the recommendations of the consultation process, the data element for 'care type' was revised to:
- include a definition of subacute care that provides a framework within which the subacute care type definitions sit
- ensure that care classified as subacute is care that:
- is delivered under the management of or informed by a clinician with specialised expertise in the care type
- is evidenced by an individualised multidisciplinary management plan that is documented in the patient's medical record
- reflects both the characteristics of the patient and the expertise of the treating clinician
- use consistent, contemporary language in line with the International Classification of Functioning, Disability and Health.
Guidelines have been included in the 'guide for use' for the data element to guide clinicians in the assignment of the care types. These include guidelines around:
- timing and responsibility for assignment of care type
- retrospective changes for care type assignment
- situations where the clinician responsible for care is not located at the same facility as the patient
- changes of care type for patients who receive acute same-day intervention(s) during the course of a subacute episode of care.
The revised data element has been agreed to by the SCWG, the IHPA and the NHISSC. It has been endorsed on behalf of AHMAC by the National Health Information and Performance Principal Committee for inclusion in the National Minimum Data Set (NMDS) for Admitted Patient Care from 1 July 2013.