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National Healthcare Agreement: P23-Selected potentially avoidable GP-type presentations to emergency departments, 2010

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termSelected potentially avoidable GP-type presentations to emergency departments, 2010
METeOR identifier:Help on this term394721
Registration status:Help on this termHealth, Superseded 08/06/2011
Description:Help on this termAttendances at public hospital emergency departments that could have potentially been avoided through the provision of appropriate non-hospital services in the community.
Indicator set:Help on this termNational Healthcare Agreement (2010) Health, Superseded 08/06/2011
Outcome area:Help on this termPrimary and Community Health Health, Standard 07/07/2010
Quality statement:Help on this termNational Healthcare Agreement: P23-Selected potentially avoidable GP-type presentations to emergency departments, 2010 QS Health, Superseded 08/06/2011

Collection and usage attributes

Computation description:Help on this term

Limited to public hospitals in Peer Groups A and B.

Potentially avoidable GP-type presentations are defined as presentations to public hospital emergency departments with a type of visit of emergency presentation (or not reported) that:

•   were allocated a Triage category of 4 or 5 AND

•   did not arrive by ambulance or police or correctional vehicle AND

•   were not admitted to the hospital, referred to another hospital, AND

•   and did not die

Computation:Help on this termNumerator only.
Numerator:Help on this termNumber of potentially avoidable GP-type presentations to emergency departments.
Numerator data elements:Help on this term
Data Element / Data SetNon-admitted patient emergency department service episode—type of visit to emergency department, code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetNon-admitted patient emergency department service episode—triage category, code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetNon-admitted patient emergency department service episode—transport mode (arrival), code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetNon-admitted patient emergency department service episode—episode end status, code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Hospital peer group
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Disaggregation data elements:Help on this term
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2008) NNNNN
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Used for disaggregation by remoteness area and SEIFA of residence.
Data Element / Data SetPerson—Indigenous status, code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—Australian state/territory identifier, code N
Data Source
National Non-admitted Patient Emergency Department Care Database
Guide for use
Data source type: Administrative by-product data
Comments:Help on this termSpecified disaggregation: Nationally and by state/territory: by Indigenous status, remoteness area and SEIFA of residence

Available disaggregation: Nationally and by state/territory: by Indigenous status, remoteness area and SEIFA of residence

Data for 2008-09 will be available by June 2010.

Most recent data available for 2010 CRC baseline report: 2007-08

Representational attributes

Representation class:Help on this termCount
Data type:Help on this termReal
Unit of measure:Help on this termEpisode
Format:Help on this termNN[NNNNN]

Indicator conceptual framework

Framework and dimensions:Help on this termAccessibility

Data source attributes

Data sources:Help on this term
Data SourceNational Non-admitted Patient Emergency Department Care Database
Frequency
Annual
Data custodian

Australian Institute of Health and Welfare


Accountability attributes

Reporting requirements:Help on this termNational Healthcare Agreement
Organisation responsible for providing data:Help on this termAustralian Institute of Health and Welfare
Benchmark:Help on this term

Related National Partnership Agreement benchmark/target:

National Healthcare Agreement performance benchmark and National Partnership on Taking Pressure of Public Hospitals performance benchmark:

By 2012–13, 80 percent of emergency department presentations are seen within clinically recommended triage times as recommended by the Australian College of Emergency Medicine

National Partnership on Taking Pressure of Public Hospitals performance benchmark:

By 2013–14, 95 per cent of hospitals with an ED report to the non-admitted emergency care national minimum data set collection.

National Partnership Agreement on Taking Pressure of Public Hospitals output measures.

Output A nationally accepted definition of what a non-emergency GP type presentation is based on emergency department DRGs by June 2012

Joint Roles: D10 Commonwealth and States to develop a nationally consistent DRG based definition of a non emergency primary care presentation 

Further data development / collection required:Help on this termSpecification: Interim

There has been an undertaking during development of the NPA on Hospital and Health Workforce Reform (Taking the pressure off public hospitals) that there are four streams of work to fully define this indicator:

1.        Explore and determine the intent of the indicator and agree on an appropriate term, i.e. ‘General Practitioner’ or ‘Primary Care’?

2.        Inclusion of clinical information in the ED NMDS

3.        Identifying a subset of diagnosis codes to be used as a factor for identifying the GP type/primary care presentations; and

4.        Defining an ED for the purposes of reporting in-scope ED attendances.

Following this data development, it is likely that the long-term measure for this indicator may differ substantially from the interim measure.

Data development work is planned to refine definitions and consider possible implementation of nationally consistent clinical information about diagnosis/presenting problem into the NAPED NMDS.

The COAG 19(2) initiative will provide exemptions under Section 19(2) of the Health Insurance Act 1973 to enable Medicare rebate to be claimed for state-remunerated primary health care services (for non-admitted and non-referred patients) in some rural and remote communities of less than 7,000 people. This active encouragement of GP services through EDs should be taken into consideration when collecting and reporting this data.

Work is required to improve the identification of Indigenous Australians within these data.
Other issues caveats:Help on this termDisaggregations within individual jurisdictions are subject to data quality considerations. Some disaggregations may result in numbers too small for publication.

Coverage of the data collection was about 78% of all ED presentations to public hospitals in 2007–08. These data are available for hospitals in Peer Group A and B. Coverage for other hospitals, particularly those in more remote areas, is incomplete. This means that data by Indigenous status and remoteness area should be interpreted with caution.

This definition of ‘potentially avoidable GP-type presentation’ was used in the Booz Allen study of emergency department care in NSW, and is considered to be a reasonable starting approximation of the population that should be receiving service in the primary care sector.

Relational attributes

Related metadata references:Help on this term

See also National Healthcare Agreement: P14-Waiting times for GP's, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P24-GP-type services, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P35-Waiting times for emergency department care, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P36-Waiting time for admission following emergency department care, 2010 Health, Superseded 08/06/2011

Has been superseded by National Healthcare Agreement: PI 23-Selected potentially avoidable GP-type presentations to emergency departments, 2011 Health, Superseded 31/10/2011

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