Non-admitted patient service event

A non-admitted patient service event is defined as an interaction between one or more health-care provider(s) with one non-admitted patient, which must contain therapeutic/clinical content and result in a dated entry in the patient's medical record.

Counting rules:

1. All non-admitted services that meet the criteria of a non-admitted patient service event should be counted, and be counted only once regardless of the number of health-care providers present. The multiple health-care provider indicator can be used to identify service events with three or more health-care providers.

2. Patients can be counted as having multiple non-admitted patient service events in one day, provided that every visit meets each of the criteria in the definition of a non-admitted patient service event.

3. Patient education services can be counted as non-admitted patient service events, provided that they meet the criteria included in the definition of a non-admitted patient service event.

4. Each patient attending a group session is counted as a non-admitted patient service event, providing that the session included the provision of therapeutic/clinical advice for each patient and that this was recorded using a dated entry in each patient’s medical record. A data element identifying a group session is included to record this type of service event.

5. Consultations delivered by information and communication technology (ICT), including but not limited to telehealth and where the patient is participating via a video link consultation, can be counted as service events if they substitute for a face-to-face consultation, provided that they meet all the criteria included in the definition of a non-admitted patient service event. A telephone consultation is only counted as one non-admitted patient service event, irrespective of the number of health professionals or locations participating in the consultation. A telehealth consultation has service events counted at the location of the healthcare provider and the location of the patient.

6. Services provided to inpatients (including services provided by staff working in non-admitted services who visit admitted patients in wards, or other types of consultation and liaison services involving inpatients) are not counted as non-admitted patient service events.

7. Travel by a health professional is not counted as a non-admitted patient service event.

8. All non-admitted services that meet the criteria in the definition of non-admitted patient service events must be counted, irrespective of funding source (including Medicare Benefits Schedule) for the non-admitted service.

9. For activity based funding purposes, diagnostic services are not counted as non-admitted patient service events; these are an integral part of the requesting clinic's non-admitted patient service event.

10. Renal dialysis, total parenteral nutrition, home enteral nutrition and home ventilation performed by the patient in their own home without the presence of a health-care provider may be counted as a non-admitted patient service event, provided there is documentation of the procedures in the patient's medical record. For activity based funding purposes, all non-admitted patient sessions performed per month are to be bundled and counted as one non-admitted patient service event per patient per calendar month regardless of the number of sessions.

11. Multidisciplinary case conferences without the patient present whilst not meeting the definition of a non-admitted patient service event, are reported through this data set for activity based funding purposes, provided there is documentation of the conference and associated outcomes in the patient's medical record.

The NAP NBEDS is intended to capture instances of healthcare provision from the point of view of the patient. This may be for assessment, examination, consultation, treatment and/or education.

One service event is recorded for each interaction, regardless of the number of healthcare providers present.

Events broken in time:

The period of interaction can be broken but still regarded as one service event if it was intended to be unbroken in time. This covers those circumstances in which treatment during a service event is temporarily interrupted for unexpected reasons, for example, a healthcare provider is called to assess another patient who requires more urgent care. Where a healthcare provider is unable to complete the interaction, it is considered to be a service event only if the definition of service event (above) is met.

Setting:

Service events can occur in an outpatient clinic or other setting.

Mode:

Service events delivered via Information and Communication Technology (ICT) (including but not limited to telephone and where the patient is participating via a video link) are included if:

• they are a substitute for a face-to-face service event
• the definition of a service event (above) is met.

Accompanied patients:

If a patient is accompanied by a carer/relative, or the carer/relative acts on behalf of the patient with or without the patient present (e.g. the mother of a two-year-old patient, or the carer for an incapacitated patient), only the patient’s service event is recorded unless the carer/relative interaction meets the definition of a service event (above).

Note: carer refers to an informal carer only.

Service events delivered in groups:

Care provided to two or more patients by the same service provider(s) at the same time can also be referred to as a group session.

One service event is recorded for each patient who attends a group session regardless of the number of healthcare providers present, where the definition of a service event (above) is met.

Service requests:

A service event is the result of a service request (including formal referral and self-referral or attendance at a walk-in clinic).

Activities which do not meet the definition of a service event include:

• work-related services provided in clinics for staff
• non-attendances for a booked outpatient
• booked outpatient services that did not go ahead

Classification of care type depends on an assessment of the overall nature of care provided, based on other service event characteristics collected at the jurisdiction level such as clinic type, provider type and/or referral details. The method used to derive the care type should be submitted with the dataset.

Interaction with the Non-admitted patient (NAP) National Best Endeavours Data Set (NBEDS) and Non-admitted patient care (NAPC) aggregate NBEDS 2019–20.

The NAP NBEDS and NAPC aggregate NBEDS work together to collect data on non-admitted activity in the public hospital system. The principle should be applied that no service event is to be double-counted or included in both the NAP NBEDS or the NAPC aggregate NBEDS. Therefore activity that is reported through the NAP NBEDS should not be reported through the NAPC aggregate NBEDS.

It is intended that activity should be reported primarily at the patient level through the NAP NBEDS, and where activity is not able to be reported at a patient level through the NAP NBEDS, this activity should be reported through the NAPC aggregate NBEDS. If the following data elements in the NAP NBEDS cannot be reported as a minimum for a specific service event, then the service event should be reported through the NAPC aggregate NBEDS:

Person—person identifier, XXXXXX[X(14)]

Establishment—organisation identifier (Australian), NNX[X]NNNNN

Establishment—Local Hospital Network identifier, code NNN

Record—identifier, X[X(79)]

Non-admitted patient service event—non-admitted service type, code (Tier 2 v5.0) NN.NN

Non-admitted patient service event—service date, DDMMYYYY

Non-admitted patient service event—group session indicator, yes/no/not stated/inadequately described code N

Episode of care—source of funding, patient funding source code NN

Glossary items

Glossary terms that are relevant to this NBEDS are listed below.

Activity based funding

Local Hospital Network

Multidisciplinary case conference

Outpatient clinic service

IHPA (Independent Hospital Pricing Authority) 2018. Tier 2 Non-Admitted Services Compendium. Sydney: IHPA.

IHPA 2018. Tier 2 Non-Admitted Services Definitions Manual. Sydney: IHPA.