National Healthcare Agreement: P42-Intentional self-harm in hospitals, 2010

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:Intentional self-harm in hospitals, 2010
METeOR identifier:395079
Registration status:Health, Superseded 08/06/2011
Description:Separations in which a patient self-harmed during an admission.
Indicator set:National Healthcare Agreement (2010) Health, Superseded 08/06/2011
Outcome area:Hospital and Related Care Health, Standard 07/07/2010
National Health Performance Authority (retired), Retired 01/07/2016
Quality statement:National Healthcare Agreement: P42-Intentional self-harm in hospitals, 2010 QS Health, Superseded 08/06/2011

Collection and usage attributes

Computation description:

Excludes separations with a principal diagnosis of an injury or poisoning (ICD-10-AM codes beginning with S and T).

Intentional self-harm is identified by ICD-10-AM external cause codes X60–X84. Self-harm is defined in ICD-10-AM as ‘Intentional self-harm: includes purposefully-inflicted poisoning or injury, suicide and attempted suicide.’

Place of occurrence of 'Health service area' is identified by ICD-10 code Y92.22.

Presented as number only, and per 1,000 separations.
Computation:

Numerator only; and

1,000 x (Numerator ÷ Denominator)
Numerator:Number of hospital separations with an external cause code for intentional self-harm and a place of occurrence of 'Health service area'
Numerator data elements:
Data Element / Data SetPerson—person identifier, XXXXXX[X(14)]
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—condition onset flag, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetInjury event—external cause, code (ICD-10-AM 5th edn) ANN{.N[N]}
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetInjury event—place of occurrence, code (ICD-10-AM 5th edn) ANN{.N[N]}
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 5th edn) ANN{.N[N]}
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of care—additional diagnosis, code (ICD-10-AM 5th edn) ANN{.N[N]}
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Denominator:Total number of separations
Denominator data elements:
Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Disaggregation data elements:
Data Element / Data SetEstablishment—Australian state/territory identifier, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Used for disaggregation by state/territory (public and private hospitals).
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2006) NNNNN
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
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
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEstablishment—sector, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Comments:

Specified disaggregation: Nationally and by state/territory: by Indigenous status, remoteness area and SEIFA of residence, and private/public hospital type.

Available disaggregation: Nationally and by state/territory: by Indigenous status, remoteness area and SEIFA of residence, and private/public hospital type.

Data for 2008-09 wil be available in June 2010.

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

Representational attributes

Representation class:Rate
Data type:Real
Unit of measure:Episode
Format:N.N

Indicator conceptual framework

Framework and dimensions:Safety

Effectiveness

Data source attributes

Data sources:
Data SourceAdmitted Patient Care National Minimum Data Set (APC NMDS)
Frequency
Annual
Data custodian
Australian Institute of Health and Welfare

Accountability attributes

Reporting requirements:National Healthcare Agreement
Organisation responsible for providing data:Australian Institute of Health and Welfare
Further data development / collection required:

Specification: Interim

Introduction of the condition onset flag from 2008–09 should assist in refinement of this specification to limit the numerator to incidents of self-harm occurring in hospital, and exclude self-harm in health services areas occurring prior to admission.

The long-term specifications should exclude patients who self-harmed while on leave from hospital. The extent to which the place of occurrence data and the self-harm data are reported accurately is unknown and may be worth investigating. Better linkage of external cause codes and place of occurrence codes could also be useful.

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

Disaggregations within individual jurisdictions will be limited by data quality considerations. Some disaggregations may result in numbers too small for publication.

Excludes private hospitals in Tasmania, the ACT and NT. 

Note that the interim specifications for this indicator include separations that involved a self-harm incident which occurred in any health service area, not just hospitals. This may mean that the data will be an over-count. However, the quality of the place of occurrence data is unknown.

The interim specifications for this indicator also include separations that involved leave days. The place of occurrence data (for ‘health service area’) should exclude instances of self-harm that occurred while a patient was on leave (because they would probably not be in a ‘health service area’ while on leave). However, it is not known whether the quality of the place of occurrence data allows such a conclusion to be drawn.

If there is more than one external cause reported, there will be some uncertainty about whether the place of occurrence ‘health service area’ relates to the self-harm external cause or to the other external cause(s) that could result in an over-count or an under-count.

The quality of data on Indigenous status is not considered to be adequate for analysis purposes for the ACT and Tasmania.

Relational attributes

Related metadata references:

See also National Healthcare Agreement: P38-Adverse drug events in hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P39-Healthcare-associated Staphylococcus aureus (including MRSA) bacteraemia in acute care hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P40-Pressure ulcers in hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P41-Falls resulting in patient harm in hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2010 Health, Superseded 08/06/2011

Has been superseded by National Healthcare Agreement: PI 42-Intentional self-harm in hospitals, 2011 Health, Superseded 31/10/2011