Episode of admitted patient care—admission urgency status, code N

Identifying and definitional attributes

• Health, Standard 25/01/2018

Data element concept attributes

Identifying and definitional attributes

• ACT Health (retired), Candidate 09/08/2018
• Health, Standard 01/03/2005
• Tasmanian Health, Standard 05/09/2016

Value domain attributes

Identifying and definitional attributes

• ACT Health (retired), Candidate 09/08/2018
• Commonwealth Department of Health, Candidate 16/07/2015
• Health, Standard 01/03/2005

Representational attributes

Data element attributes

Collection and usage attributes

CODE 1    Urgency status assigned - emergency

Emergency admission:

The following guidelines may be used by health professionals, hospitals and health insurers in determining whether an emergency admission has occurred. These guidelines should not be considered definitive.

An emergency admission occurs if one or more of the following clinical conditions are applicable such that the patient required admission within 24 hours.

Such a patient would be:

• at risk of serious morbidity or mortality and requiring urgent assessment and/or resuscitation; or
• suffering from suspected acute organ or system failure; or
• suffering from an illness or injury where the viability or function of a body part or organ is acutely threatened; or
• suffering from a drug overdose, toxic substance or toxin effect; or
• experiencing severe psychiatric disturbance whereby the health of the patient or other people is at immediate risk; or
• suffering severe pain where the viability or function of a body part or organ is suspected to be acutely threatened; or
• suffering acute significant haemorrhage and requiring urgent assessment and treatment; or
• suffering gynaecological or obstetric complications; or
• suffering an acute condition which represents a significant threat to the patient's physical or psychological wellbeing; or
• suffering a condition which represents a significant threat to public health.

If an admission meets the definition of emergency, it is categorised as emergency, regardless of whether the admission occurred within 24 hours of such a categorisation being made, or after 24 hours or more.

CODE 2     Urgency status assigned - elective

Elective admissions:

If an admission meets the definition of elective, it is categorised as elective, regardless of whether the admission actually occurred after 24 hours or more, or it occurred within 24 hours. The distinguishing characteristic is that the admission could be delayed by at least 24 hours.

Scheduled admissions:

A patient who expects to have an elective admission will often have that admission scheduled in advance. Whether or not the admission has been scheduled does not affect the categorisation of the admission as emergency or elective, which depends only on whether it meets the definitions above. That is, patients both with and without a scheduled admission can be admitted on either an emergency or elective basis.

Admissions from elective surgery waiting lists:

Patients on waiting lists for elective surgery are assigned a Clinical urgency status which indicates the clinical assessment of the urgency with which a patient requires elective hospital care. On admission, they will also be assigned an urgency of admission category, which may or may not be elective:

• Patients who are removed from elective surgery waiting lists on admission as an elective patient for the procedure for which they were waiting (see code 1 in metadata item Reason for removal from an elective surgery waiting list code N) will be assigned an Admission urgency status code N code of 2. In that case, their clinical urgency category could be regarded as further detail on how urgent their admission was.
• Patients who are removed from elective surgery waiting lists on admission as an emergency patient for the procedure for which they were waiting (see code 2 in metadata item Reason for removal from an elective surgery waiting list code N), will be assigned an Admission urgency status code N code of 1.

CODE 3     Urgency status not assigned

Admissions for which an urgency status is usually not assigned are:

• admissions for normal delivery (obstetric)
• admissions which begin with the birth of the patient, or when it was intended that the birth occur in the hospital, commence shortly after the birth of the patient
• statistical admissions
• planned readmissions for the patient to receive limited care or treatment for a current condition, for example dialysis or chemotherapy.

An urgency status can be assigned for admissions of the types listed above for which an urgency status is not usually assigned. For example, a patient who is to have an obstetric admission may have one or more of the clinical conditions listed above and be admitted on an emergency basis.

CODE 9     Not known/not reported

This code is used when it is not known whether or not an urgency status has been assigned, or when an urgency status has been assigned but is not known.

Source and reference attributes

Emergency definition working party

National Health Data Committee

Relational attributes