Identifying and definitional attributes
|Metadata item type:||Quality Statement|
|Registration status:||AIHW Data Quality Statements, Archived 15/12/2017|
|Quality statement summary:|
Summary of key issues
The NSABDC includes counts of healthcare associated cases of Staphylococcus aureus bacteraemia (SAB) for each public hospital covered by SAB surveillance arrangements, and for private hospitals that choose to provide data. The data for public hospitals are collected under hospital infection control arrangements by state and territory health authorities. The data include the counts of patient days under surveillance.
Data on the numbers of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) cases for public hospitals are reported separately at a state or territory level.
A case (patient episode) of SAB is defined as a positive blood culture for Staphylococcus aureus. For surveillance purposes, only the first isolate per patient is counted, unless at least 14 days has passed without a positive blood culture, after which an additional episode is recorded.
A case of SAB will be considered to be healthcare-associated if: the first positive blood culture is collected more than 48 hours after hospital admission or less than 48 hours after discharge, or, if the first positive blood culture is collected 48 hours or less after admission and one or more of the following key clinical criteria was met for the patient episode of SAB:
1. SAB is a complication of the presence of an indwelling medical device (for example, intravascular line, haemodialysis vascular access, cerebrospinal fluid shunt, urinary catheter).
2. SAB occurs within 30 days of a surgical procedure where the SAB is related to the surgical site.
3. An invasive instrumentation or incision related to the SAB was performed within 48 hours.
4. SAB is associated with neutropenia contributed to by cytotoxic therapy. Neutropenia is defined as at least two separate calendar days with values of absolute neutrophil count <500 cells/mm3 (<0.5 x 109/ L) on or within a seven-day time period which includes the date the positive blood specimen was collected (Day 1), the 3 calendar days before and the 3 calendar days after.
This definition of a case of SAB was used by all states and territories for reporting for the 2015–16 year.
The AIHW is a major national agency set up by the Australian Government under the Australian Institute of Health and Welfare Act 1987 to provide reliable, regular and relevant information and statistics on Australia’s health and welfare. It is an independent corporate Commonwealth entity established in 1987, governed by a management board, and accountable to the Australian Parliament through the Health portfolio.
The AIHW aims to improve the health and wellbeing of Australians through better health and welfare information and statistics. It collects and reports information on a wide range of topics and issues, ranging from health and welfare expenditure, hospitals, disease and injury, and mental health, to ageing, homelessness, disability and child protection.
The Institute also plays a role in developing and maintaining national metadata standards. This work contributes to improving the quality and consistency of national health and welfare statistics. The Institute works closely with governments and non-government organisations to achieve greater adherence to these standards in administrative data collections to promote national consistency and comparability of data and reporting.
One of the AIHW’s main functions is to work with the states and territories to improve the quality of administrative data and, where possible, to compile national data sets based on data from each jurisdiction, analyse these data sets, and disseminate information and statistics.
The Australian Institute of Health and Welfare Act 1987, in conjunction with compliance to the Privacy Act 1988, (Cwlth), ensures that the data collections managed by the AIHW are kept securely and under the strictest conditions with respect to privacy and confidentiality.
For further information, see the AIHW website http://www.aihw.gov.au/.
Data for the NSABDC were supplied to the AIHW by state and territory health authorities for the purpose of reporting against the NHA performance benchmark and performance indicator ‘Healthcare-associated infections: Staphylococcus aureus bacteraemia’ and for reporting under the Performance and Accountability Framework on the AIHW's MyHospitals website http://www.myhospitals.gov.au/.
The Performance and Accountability Framework can be accessed at http://www.aihw.gov.au/health-performance/performance-and-accountability-framework/.
Data are provided annually by state and territory health authorities. The reference period for this data set is 2015–16, with revised data provided for 2010–11 to 2014–15.
States and territories provided the data to the AIHW by December 2016. The data were published in January 2017.
The AIHW publishes data from the NSABDC annually in the 'Staphylococcus aureus bacteraemia in Australian public hospitals: Australian hospital statistics' series. These reports may be accessed on the AIHW website: http://www.aihw.gov.au/hospitals/.
Information on the definitions used for the NSABDC, including patient days, admitted patient, non-admitted patient and care type, are available on the AIHW’s online metadata repository (METeOR). METeOR can be accessed on the AIHW website:
The NHA performance indicator specification can be accessed on the METeOR website:
Data from the NSABDC are used for the NHA performance benchmark and performance indicator about safety and quality in hospital and related care.
Only cases associated with hospital care in each jurisdiction are reported. If a case is associated with care provided in another jurisdiction, then it is reported (where known) by the jurisdiction where the care associated with the SAB occurred.
There may be patient episodes of SAB identified by a hospital which did not originate in the identifying hospital (as determined by the definition of a patient episode of SAB), but in another hospital. If the originating hospital is under SAB surveillance, then the patient episode of SAB is reported against the originating hospital.
Almost all cases of SAB will be diagnosed when the patient is an admitted patient. However, the intention is that cases are reported whether they were determined to be associated with admitted patient care or non-admitted patient care in public hospitals. There may be imprecise exclusion of some SAB cases due to the inherent difficulties in determining the origins of SAB episodes, such as those originating from non-hospital settings. However, it is likely that the number of cases incorrectly included or excluded would be small.
The count of patient days (used in the denominator for performance indicator calculation) reflects the amount of admitted patient activity, but does not reflect the amount of non-admitted patient activity. The amount of hospital activity that patient days reflect varies among jurisdictions and over time because of variation in admission practices.
The data have not been adjusted for differences in casemix among the states and territories or among hospital peer groups. ('Casemix' is a term that refers to the range and types of patients treated by a hospital or other health service.) For SAB, relevant aspects of casemix that could affect the risk of SAB for patients include patient comorbidities and procedures performed.
States and territories are primarily responsible for the quality of the data they provide. However, the AIHW undertakes validations on receipt of data. Data are checked for valid values, logical consistency and historical consistency. Potential errors are queried with jurisdictions, and corrections and resubmissions may be made in response to these edit queries. The AIHW does not adjust data to account for possible data errors or missing or incorrect values, except as stated.
Processes and capacity to validate a patient episode of SAB may vary between states and territories, and arrangements for the collection of data by hospitals and the reporting to state and territory health authorities may also vary. Jurisdictional manuals should be referred to for full details of definitions used in their infection surveillance arrangements.
For some states and territories there is less than 100 per cent coverage of public hospitals as surveillance arrangements may not be in place in all wards or all hospitals.
For 2015–16, Western Australia reported one case where both MRSA and MSSA were identified. This case has been reported in the MRSA count, not reported in the MSSA count, and reported as one case in the total for Western Australia.
The patient day data for 2015–16 may be preliminary for some hospitals or jurisdictions.
New South Wales reports occupied bed days, rather than patient days, for calculation of the performance indicator denominator. The comparability of New South Wales performance indicator data to that for other jurisdictions is therefore limited (but only by the small extent that counts of occupied bed days would be expected to differ from counts of patient days). New South Wales performance indicator data are included in the Australian performance indicator data because it is expected that at the national level the use of occupied bed days, rather than patient days, for New South Wales is unlikely to create a marked difference in the Australian performance indicator data.
The NSABDC data were first reported in the 2010 COAG Reform Council National Agreement performance information 2008-09 (SCRGSP 2009). Since that report further work has been undertaken on data development for the NHA performance indicator, including the definition of an episode of SAB and the definition of the number of patient days under SAB surveillance, as used for the denominator of the NHA performance indicator.
The most recent work in 2016 was to revise the definition of patient days under SAB surveillance to exclude unqualified newborns, and to update the neutropenia criterion, as advised by the Australian Commission on Safety and Quality in Health Care. All jurisdictions re-provided data for the reporting years of 2010–11 to 2014–15 according to the revised specification.
For 2010–11 to 2014–15, all states and territories used the definition of SAB patient episodes as defined above in the 'Quality statement summary — description', but with the following neutropenia criterion:
SAB is associated with neutropenia (<1 x 109) contributed to by cytotoxic therapy.
For 2015–16, all states and territories used the definition of SAB patient episodes as defined above with the updated neutropenia criterion as described above in the 'Quality statement summary — description'.
The change to the neutropenia criterion is not considered to have resulted in counts of SAB cases for 2015–16 that are not comparable with previous years.
Data for 2010–11 and 2011–12 are comparable, except for Queensland, where the 2010–11 data only include patients aged 14 years and over, whereas the 2011–12 data include patients of all ages.
Due to the changes in the denominator of the performance indicator specification, data published in 2017 for the reporting years 2010–11 to 2015–16 are not comparable with data previously published in COAG Reform Council publications, the AIHW series 'Staphylococcus aureus bacteraemia in Australian public hospitals: Australian hospital statistics' nor the Report on Government Services.
Source and reference attributes
Australian Institute of Health and Welfare
|Steward:||Australian Institute of Health and Welfare|
|Related metadata references:|
Supersedes National Staphylococcus aureus Bacteraemia Data Collection (NSABDC) Data Quality Statement: 2011-12 AIHW Data Quality Statements, Archived 03/02/2017
Has been superseded by National Staphylococcus aureus Bacteraemia Data Collection, 2016–17: Quality Statement AIHW Data Quality Statements, Archived 21/01/2019
See also National Staphylococcus aureus Bacteraemia Data Collection, 2018–19: Quality Statement Health, Proposed 01/11/2019, AIHW Data Quality Statements, Archived 01/03/2021
See also National Staphylococcus aureus Bacteraemia Data Collection, 2019–20: Quality Statement AIHW Data Quality Statements, Endorsed 23/02/2021