KPIs for Australian Public Mental Health Services: PI 14J – Outcomes readiness, 2015

Collection and usage attributes

Coverage/Scope:

State/territory specialised mental health care services. 

The following episodes of mental health care (and related outcomes measures) are excluded:

• Brief ambulatory episodes of mental health care
• Brief inpatient episodes of mental health care.

The following services are excluded:

• Australian Government funded aged residential services.

Methodology:

• Reference period for 2015 performance reporting: 2013–14.
• Only the Health of the Nation Outcome Scales (HoNOS) family of measures (including HoNOS, HoNOS65+ and HoNOSCA) is considered in the calculation of this indicator.
• Outcomes readiness is calculated for the following consumer groups:
• Group A: Consumers discharged from hospital. All people who were discharged from an acute admitted patient mental health care service unit within the reference period, with a completed clinical outcome measure collected at both admission (the ‘baseline’) and discharge (the ‘follow-up’). 
• Group B: Consumers discharged from ambulatory care. All people who were discharged from an ambulatory care episode, provided by an ambulatory mental health care service, within the reference period, with a completed clinical outcome measure collected at both admission (the ‘baseline’) and discharge (the ‘follow-up’). Ambulatory episodes that are completed because the consumer was admitted to hospital or residential mental health care are excluded from the analysis (that is, where the National Outcomes Casemix Collection (NOCC) ‘reason for collection’ equals change of setting). 
• Group C: Consumers in ongoing ambulatory care. All people who have an ‘open’ ambulatory episode of mental health care at the end of reference period, where there is a completed clinical outcome measure collected at both the first occasion rated within the reference period, which will be either an admission or review (the ‘baseline’), and the last occasion rated, which will be a review (the ‘follow-up’), in the same reference period.

(Numerator ÷ Denominator) x 100

Calculated separately for each group.

Number of in-scope episodes of mental health care with completed outcome measures at both baseline and follow-up within the reference period.

Number of in-scope episodes of mental health care within the reference period.

Service variables: Setting (Group A, B or C) 

Consumer variables: Age (0-17, 18-64, 65+)

Representational attributes

Indicator conceptual framework

Accountability attributes

State/territory level

Estimates of the total number of episodes requiring outcomes assessment is not provided directly to the National Outcomes and Classification Collection, however this can be approximated from the NMDSs (Community Mental Health Care, Admitted Patient Mental Health Care and Residential Mental Health Care).

A proxy solution is to use estimates from the NMDSs (Community Mental Health Care, Admitted Patient Mental Health Care and Residential Mental Health Care).

Longer term, a process is needed that allows data reported to the NOCC for consumers who begin an episode in a given year to be tracked when the episode continues into subsequent years. Work is underway to build in an episode identifier into the NOCC and Community Mental Health Care NMDS to enable this. Additionally, consistent, cross-year use of service identifiers and unique identifiers for consumers by states and territories is necessary to enable full capacity to construct this indicator using the NOCC.

Further definition of a ‘completed clinical outcome measure’ to resolve whether tolerance levels will be set to accept some degree of missing data also needs to be developed.

Source and reference attributes