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KPIs for Australian Public Mental Health Services: PI 04J – Average length of acute inpatient stay, 2017

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termMHS PI 04J: Average length of acute inpatient stay, 2017
METeOR identifier:Help on this term663813
Registration status:Help on this termHealth, Standard 14/06/2017
Description:Help on this term

Average length of stay of in-scope overnight separations from state/territory acute admitted patient mental health care service units.

NOTE: This specification has been adapted from the indicator MHS PI 04: Average length of acute inpatient stay, 2015 (Service level version) using terminology consistent with the National Health Data Dictionary. There are technical differences in the calculation methodologies between the Service level version and the Jurisdictional level version of this indicator due to different available data sources to construct this indicator. Caution should be taken to ensure the correct methodology is followed.

Rationale:Help on this term

Length of stay is a key driver of variation in admitted patient day costs and reflects differences between mental health service organisations in practice and casemix, or both. The aim of this indicator is to better understand the factors underlying variation (such as costs) as well as providing a basis for utilisation review. For example, it allows for the assessment of services provided to particular consumer groups against clinical protocols developed for those groups.

Indicator set:Help on this termKey Performance Indicators for Australian Public Mental Health Services (Jurisdictional level version) (2017) Health, Standard 14/06/2017

Collection and usage attributes

Computation description:Help on this term

Coverage/Scope:

State/territory acute admitted patient mental health care service units in scope for reporting defined by the Mental Health Establishments National Minimum Data Set (NMDS).

For jurisdictional level reporting the following separation and associated patient days are excluded:

  • Forensic services.

Methodology:

  • Reference period for 2017 performance reporting: 2015–16
  • NOTE: Same-day separations are not excluded from the accrued mental health care days definition (see links below).
Computation:Help on this term

Numerator ÷ Denominator

Numerator:Help on this term

Number of mental health care days for state/territory acute admitted patient mental health care service unit(s) within the reference period.

Numerator data elements:Help on this term
Data Element / Data SetEstablishment—accrued mental health care days, total N[N(7)]
NMDS / DSS
Mental health establishments NMDS 2015-16
Data Element / Data SetSpecialised mental health service—admitted patient care program type, code N
NMDS / DSS
Mental health establishments NMDS 2015-16
Denominator:Help on this term

Number of separations from state/territory acute admitted patient mental health care service unit(s) occurring within the reference period.

Denominator data elements:Help on this term
Data Element / Data SetEstablishment—number of separations (financial year), total N[NNNNN]
NMDS / DSS
Mental health establishments NMDS 2015-16
Disaggregation:Help on this term

Service variables: Target population.

Consumer attributes: not available.

Disaggregation data elements:Help on this term
Data Element / Data SetSpecialised mental health service—target population group, code N
NMDS / DSS
Mental health establishments NMDS 2015-16

Representational attributes

Representation class:Help on this termMean (average)
Data type:Help on this termReal
Unit of measure:Help on this termTime (e.g. days, hours)
Format:Help on this term

N[NN].N

Indicator conceptual framework

Framework and dimensions:Help on this termEfficient

Appropriate

Accountability attributes

Benchmark:Help on this term

State/territory level

Further data development / collection required:Help on this term

The Admitted Patient Care NMDS allows length of stay to be calculated for individual hospitals but it does not allow sub-units of individual hospitals (e.g. specialised psychiatric units) to be identified separately. The implication is that average length of stay for specific specialised psychiatric units, acute or otherwise, cannot be directly constructed at a national level from the current NMDS.

There are two main approaches that enable construction of the indicator from national data:

  • The use of the ‘psychiatric care days’ flag in the Admitted Patient Mental Health Care NMDS enables identification of the subset of separations from hospitals that received treatment and care in a specialised psychiatric unit. While the flag does not distinguish acute and non-acute units, the vast majority of separations are attributable to acute units. A trimming process to isolate separations with extreme length of stay (e.g. > 365 days) can be used to approximate acute units.  However, the data source cannot disaggregate acute psychiatric units by target population.

  • Existing national reporting mechanisms, e.g. Mental health services in Australia and the Report on Government Services uses the Mental Health Establishments NMDS as an alternative data source for reporting average length of stay. Subsequently all patient days in the reference period are included which may not be directly related to the separations in the same reference period, particularly around the borders of the reference period. Consequently, the results of the two approaches are not strictly comparable.

Data regarding the type of admitted patient unit would need to be added to the Admitted Patient Care NMDS. Alternatively, admitted patient unit identifiers that could be linked to data captured in the Mental Health Establishments NMDS would provide the necessary information.

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 2013. Key Performance Indicators for Australian Public Mental Health Services, 3rd edn. Canberra: NMHPC.

Relational attributes

Related metadata references:Help on this term

Has been superseded by Average length of acute mental health inpatient stay, 2018 Health, Candidate 09/08/2018

Supersedes KPIs for Australian Public Mental Health Services: PI 04J – Average length of acute inpatient stay, 2016 Health, Superseded 14/06/2017

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