Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale 65+ score code N

Identifying and definitional attributes
Metadata item type:	Data Element
Short name:	Level of psychiatric symptom severity (HoNOS 65+ score)
METEOR identifier:	449363
Registration status:	Health, Superseded 28/02/2017 Independent Hospital Pricing Authority, Standard 12/11/2015 Tasmanian Health, Superseded 19/01/2018
Definition:	An assessment of the severity of a person's psychiatric symptoms, as represented by a HoNOS 65+ score-based code.
Context:	Psychiatric symptom severity, persons aged 65 years and over.
Data Element Concept:	Person—level of psychiatric symptom severity
Value Domain:	Health of the Nation Outcome Scale 65+ score code N

Value domain attributes
Representational attributes
Representation class:	Code
Data type:	Number
Format:	N
Maximum character length:	1
	Value	Meaning
Permissible values:	0	No problems within the period stated
	1	Minor problem requiring no action
	2	Mild problem but definitely present
	3	Moderately severe problem
	4	Severe to very severe problem

Collection and usage attributes
Guide for use:	The Health of the Nation Outcome Scale for elderly people (HoNOS65+) is used to rate adult mental health service users. Together, the scales rate various aspects of mental and social health. HoNOS65+ is answered on an item-specific anchored 4-point scale with higher scores indicating more problems. Each scale is assigned a value of between 0 and 4. The twelve scales are as follows: Behavioural disturbance Non-accidental self injury Problem drinking or drug use Cognitive problems Problems related to physical illness or disability Problems associated with hallucinations and delusions Problems associated with depressive symptoms Other mental and behavioural problems Problems with social or supportive relationships Problems with activities of daily living Overall problems with living conditions Problems with work and leisure activities and the quality of the daytime environment The sum of the individual scores of each of the scales represents the total HoNOS65+ score. The total HoNOS65+ score ranges from 0 to 48, and represents the overall severity of an individual's psychiatric symptoms.

Collection and usage attributes

Guide for use:

The Health of the Nation Outcome Scale for elderly people (HoNOS65+) is used to rate adult mental health service users. Together, the scales rate various aspects of mental and social health.

HoNOS65+ is answered on an item-specific anchored 4-point scale with higher scores indicating more problems. Each scale is assigned a value of between 0 and 4. The twelve scales are as follows:

Behavioural disturbance
Non-accidental self injury
Problem drinking or drug use
Cognitive problems
Problems related to physical illness or disability
Problems associated with hallucinations and delusions
Problems associated with depressive symptoms
Other mental and behavioural problems
Problems with social or supportive relationships
Problems with activities of daily living
Overall problems with living conditions
Problems with work and leisure activities and the quality of the daytime environment

The sum of the individual scores of each of the scales represents the total HoNOS65+ score. The total HoNOS65+ score ranges from 0 to 48, and represents the overall severity of an individual's psychiatric symptoms.

Source and reference attributes
Submitting organisation:	Independent Hospital Pricing Authority

Data element attributes
Source and reference attributes
Submitting organisation:	Independent Hospital Pricing Authority
Reference documents:	Health of the Nation Outcome Scales (HoNOS), Royal College of Psychiatrists 1996. Viewed 17 October 2013, http://www.rcpsych.ac.uk/training/honos/whatishonos.aspx
Relational attributes
Related metadata references:	Has been superseded by Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale 65+ score code N Health, Superseded 25/01/2018 Independent Hospital Pricing Authority, Recorded 04/08/2016 Tasmanian Health, Superseded 19/01/2018 See also Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale score code N Independent Hospital Pricing Authority, Standard 15/10/2014
Implementation in Data Set Specifications: All attributes +	Activity based funding: Mental health care DSS 2016-17 Independent Hospital Pricing Authority, Superseded 28/02/2017 DSS specific attributes + Implementation start date: 01/07/2016 Implementation end date: 30/06/2017 Conditional obligation: Reporting of the HoNOS 65+ at the start of the mental health phase of care is mandatory for patients in all settings. Reporting of the HoNOS 65+ is not mandatory if mental health phase of care is reported as Assessment Only. The HoNOS 65+ should only be reported for patients aged 65 years and over. Admitted patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: Reporting of the HoNOS65+ at admission and separation is mandatory for admitted patients in psychiatric hospitals or designated psychiatric units in acute hospitals. Reporting is optional for admitted patients in non-designated hospitals or units. The HoNOS65+ should only be reported for patients aged 65 years and over. The HoNOS65+ discharge rating is not required if the episode of admitted care had a length of stay of 3 days or less. Admitted subacute and non-acute hospital care DSS 2014-15 Health, Superseded 13/11/2014 DSS specific attributes + Implementation start date: 01/07/2014 Implementation end date: 30/06/2015 Conditional obligation: Only the HoNOS65+ scores at admission are required to be reported. Only required to be reported for episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 5, Psychogeriatric care. Only required to be reported when the Episode of admitted patient care—clinical assessment only indicator, yes/no code N value is recorded as Code 2, No. Admitted subacute and non-acute hospital care DSS 2015-16 Health, Superseded 19/11/2015 DSS specific attributes + Implementation start date: 01/07/2015 Implementation end date: 30/06/2016 Conditional obligation: Only the HoNOS65+ scores at admission are required to be reported. Only required to be reported for episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 5, Psychogeriatric care. Admitted subacute and non-acute hospital care NBEDS 2016-17 Health, Superseded 03/11/2016 DSS specific attributes + Implementation start date: 01/07/2016 Implementation end date: 30/06/2017 Conditional obligation: Only the HoNOS65+ scores at admission are required to be reported. Only required to be reported for episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 5, Psychogeriatric care. Ambulatory patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: For the purposes of this DSS, an ambulatory episode is defined as a period of continuous contact between a consumer and a mental health service within an ambulatory service setting. This is consistent with the definition in the National Outcomes and Casemix Collection. Reporting of the HoNOS65+ is mandatory for the first and last service contacts of an ambulatory mental health care episode provided by a specialised mental health service. Reporting is optional for service contacts provided by specialised mental health services from non-government organisations that receive state or territory government funding. Reporting is optional for service events provided by non-specialised mental health services. The HoNOS65+ should only be reported for patients aged 65 years and over. The HoNOS65+ discharge rating is not required if the episode of ambulatory care had a length of stay of 3 days or less. DSS specific information: The HoNOS65+ for the first service contact may be derived from the HoNOS65+ admission rating submitted for the patient's ambulatory care episode as part of the National Outcomes and Casemix Collection reporting requirements. The HoNOS65+ for the last service contact may be derived from the HoNOS65+ discharge rating submitted for the patient's ambulatory care episode as part of the National Outcomes and Casemix Collection reporting requirements. Residential patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: Reporting of HoNOS65+ at admission and separation is mandatory for residential mental health care services that are included in the General list of in-scope public hospital services, which have been developed under the National Health Reform Agreement (2011). Reporting is optional for episodes of residential mental health care provided by government-funded, non-government operated services. The HoNOS65+ should only be reported for patients aged 65 years and over. Tasmanian Subacute/Non-acute Data Set - 2016 Tasmanian Health, Superseded 18/01/2018 DSS specific attributes + Implementation start date: 01/07/2016 Implementation end date: 30/06/2017 Tasmanian Subacute/Non-acute Data Set - 2017 Tasmanian Health, Superseded 18/01/2018 DSS specific attributes + Implementation start date: 01/07/2017 Implementation end date: 30/06/2018 Tasmanian Subacute/Non-acute Data Set - 2018 Tasmanian Health, Superseded 06/05/2020 DSS specific attributes + Implementation start date: 01/07/2018 Implementation end date: 30/06/2019 Tasmanian Subacute/Non-acute Data Set - 2019 Tasmanian Health, Superseded 06/05/2020 DSS specific attributes + Implementation start date: 01/07/2019 Implementation end date: 30/06/2020
Implementation in Indicators:	Used as Numerator KPIs for Australian Public Mental Health Services: PI 01J – Change in consumer's clinical outcomes, 2015 Health, Superseded 11/05/2016 KPIs for Australian Public Mental Health Services: PI 01J – Change in consumer's clinical outcomes, 2016 Health, Superseded 14/06/2017

Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale 65+ score code N

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Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale 65+ score code N

Data Element Attributes

Identifying and definitional attributes

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Representational attributes

Collection and usage attributes

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Data element attributes

Source and reference attributes

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