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Post-discharge community mental health care, 2018 (Service level)

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termPost-discharge community mental health care, 2018 (Service level)
METeOR identifier:Help on this term633048
Registration status:Help on this termHealth, Candidate 02/10/2018
Description:Help on this term

The percentage of separations from the mental health service organisation’s acute psychiatric inpatient unit(s) for which a community mental health service contact, in which the consumer participated, was recorded in the seven days following that separation.

NOTE: This indicator is related to Post-discharge community care (Jurisdictional level). There are no technical differences in the calculation methodologies between the Service level version and the Jurisdictional level version of this indicator.

Rationale:Help on this term
  • A responsive community support system for persons who have experienced an acute psychiatric episode requiring hospitalisation is essential to maintain clinical and functional stability and to minimise the need for hospital readmission.
  • Consumers leaving hospital after a psychiatric admission with a formal discharge plan, involving linkages with community services and supports, are less likely to need early readmission.
  • Research indicates that consumers have increased vulnerability immediately following discharge, including higher risk for suicide.
Indicator set:Help on this termKey Performance Indicators for Australian Public Mental Health Services (Service level version) (2018) Health, Candidate 09/08/2018

Collection and usage attributes

Computation description:Help on this term

Coverage/Scope:

All public mental health service organisations acute psychiatric inpatient units. The following separations are excluded:

  • same day separations;
  • statistical and change of care type separations;
  • separations that end by transfer to another acute or psychiatric hospital;
  • separations that end in death, or left against medical advice/discharge at own risk;
  • separations where length of stay is one night only and procedure code for Electroconvulsive therapy (ECT) is recorded;
  • separations that end by transfer to community residential mental health services.

The following community service contacts are excluded:

  • community service contacts on the day of separation;
  • contacts where a consumer does not participate.

Methodology:

  • Implementation of this indicator requires the capacity to track service use across inpatient and community boundaries and is dependent on the capacity to link patient identifiers.
  • For the purpose of this indicator, when a mental health service organisation has more than one unit of a particular admitted patient care program, those units should be combined.
  • All acute admitted mental health service units are in-scope for this indicator, including short-stay units and emergency acute mental health admitted units.
  • The categorisation of the admitted patient unit is based on the principal purpose(s) of the admitted patient care program rather than the classification of individual consumers.
  • One of the following ECT procedure codes are recorded:
    • ACHI 5th edition (2006–2008) uses ICD-10 procedure codes 93340-02 and 93340-03.
    • ACHI 6th to 9th editions (2008 to 2015) use ICD-10 procedure codes 93341-00 to 93341-99.
    • ACHI 10th (2015 to current) edition uses procedure codes 14224-0 to 14224-06.
    • ACHI 5th to 10th editions (2006 to current) ECT Block 1907 may be selected to capture all data regardless of code changes over time.
Computation:Help on this term

(Numerator ÷ Denominator) x 100

Numerator:Help on this term

Number of in-scope separations from the mental health service organisation’s acute psychiatric inpatient unit(s) for which a public sector community mental health service contact in which the consumer participated, was recorded in the seven days following that separation.

Denominator:Help on this term

Number of in-scope separations for the mental health service organisation’s acute psychiatric inpatient unit(s).

Disaggregation:Help on this term

Service variables: target population.

Consumer attributes: age, Socio-Economic Indexes for Areas (SEIFA), remoteness, Indigenous status.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN].N

Indicator conceptual framework

Framework and dimensions:Help on this termContinuous

Accessible

Safe

Accountability attributes

Benchmark:Help on this term

Levels at which indicator can be useful for benchmarking:

  • service unit
  • mental health service organisation
  • regional group of services
  • state/territory.
Further data development / collection required:Help on this term

This indicator cannot be accurately constructed using the Admitted Patient and Community Mental Health Care National Minimum Data Sets because they do not share a common unique identifier to allow persons admitted into hospital to be tracked in the community services data. Additionally, states and territories vary in the extent to which state-wide unique identifiers are in place to allow accurate tracking of persons who are seen by multiple organisations.

There is no proxy solution available. To construct this indicator at a national level requires separate indicator data to be provided individually by states and territories.

Development of a system of state-wide unique patient identifiers within all mental health NMDSs is needed to improve this capacity.

For this indicator, only direct contact with the consumer constitutes 'follow-up'. A growing body of evidence suggests that for some cohorts, follow-up with carers represents best practice (such as follow-up with parents for children and adolescents). Data development work to consistently capture information about carers in state/territory data systems is necessary to allow further development of this indicator.

Other issues caveats:Help on this term
  • The reliability of this indicator is dependent on the implementation of state-wide unique patient identifiers as the community services may not necessarily be delivered by the same mental health service organisation that discharges the consumer from hospital care. Access to state-wide data is required to construct this indicator accurately.
  • When reported at an individual service or catchment level, interpretation of this indicator needs to consider that catchment areas for inpatient and ambulatory services may differ. Ideally services should implement processes to ensure a shared responsibility for following up with consumers who reside out of area.
  • This measure does not consider variations in intensity or frequency of service contacts following separation from hospital.
  • This measure does not distinguish qualitative differences between phone and face-to-face community contacts.

Source and reference attributes

Submitting organisation:Help on this term

Australian Institute of Health and Welfare on behalf of the National Mental Health Performance Subcommittee

Reference documents:Help on this term

National Mental Health Performance Subcommittee (NMHPSC) 2013. Key Performance Indicators for Australian Public Mental Health Services, 3rd edn. Canberra: NMHPSC.

Relational attributes

Related metadata references:Help on this term

Supersedes KPIs for Australian Public Mental Health Services: PI 12 – Rate of post-discharge community care, 2015– Health, Standard 19/11/2015

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