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KPIs for Australian Public Mental Health Services: PI 09J – New client index, 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 09J: New client index, 2017
METeOR identifier:Help on this term663834
Registration status:Help on this termHealth, Standard 14/06/2017
Description:Help on this term

Percentage of new consumers under the care of state/territory specialised mental health services.

NOTE: This specification has been adapted from the indicator MHS PI 09: New client index, 2015  (Service level version) using terminology consistent with the National Health Data Dictionary. 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

Access to services by persons requiring care is a key issue and there is concern that the public mental health service system is inadequately responding to new people requiring care.

Existing population treatment rates are relatively low.

There is concern that public sector mental health services invest a disproportionate level of resources in dealing with existing clients and too little in responding to the needs of new consumers as they present.

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 public specialised mental health services.

The following exclusions apply:

  • Mental health clients for which a unique person identifier was not recorded, that is non-uniquely identifiable consumers, are to be excluded.

Methodology:

Reference period for 2017 performance reporting: 2015–16

  • Tracking the consumer's service use back from the date of first contact in the reference period should be calculated as the five years preceding the date of first contact rather than on a calendar or financial year basis.
  • Consumer counts should be unique at the state/territory level.

Requires a count of individuals receiving services provided by state/territory mental health services in the reference period. The preferred standard for reporting this data is for person counts to be based on unique enumeration of individuals receiving care within the year. That is, consumers who received services in the reference period in more than one service setting, or by more than one specialised mental health service organisation, should only be counted once.  However, in developing specifications for this indicator, it has been recognised that states and territories vary significantly in the extent to which persons can be counted uniquely at the jurisdiction level, the details of which are explored in the data quality statement for this indicator.

No additional service utilisation thresholds have been set for this indicator.  This approach has been taken to allow:

  • ‘assessment only’ cases to be included (i.e. individuals receiving only one service contact) because these are a regarded as a significant and valid service provided by specialist mental health services; and
  • all service contacts to be included in defining whether a person receives a service, including those delivered ‘on behalf’ of the consumer i.e. where the consumer does not directly participate.  This approach has been taken to ensure that the role of state and territory mental health services in providing back up as tertiary specialist services to other health providers is recognised.
Computation:Help on this term

(Numerator ÷ Denominator) x 100

Numerator:Help on this term

Number of new consumers who received services from state/territory public specialised mental health services within the reference period.

Numerator data elements:Help on this term
Data Element / Data SetData Element

Specialised mental health service—number of new consumers receiving services from specialised public mental health care services

Data Sources

State/territory community mental health care data

State/territory admitted patient data


Guide for use

A new consumer is defined as a person who has not been seen in the five years preceding the first contact with a state/territory public specialised mental health service in the reference period.


Denominator:Help on this term

Number of individuals recorded on jurisdictional mental health information systems as receiving one or more service events from state/territory public mental health services (including admitted patient, ambulatory and residential services) within the reference period.

Denominator data elements:Help on this term
Data Element / Data SetData Element

Specialised mental health service—number of consumers receiving services from specialised public mental health care services

Data Sources

State/territory community mental health care data

State/territory admitted patient data


Guide for use

Data source type: Administrative by-product


Disaggregation:Help on this term

Service variables: Nil

Consumer attributes: Age, sex, Socio-Economic Indexes for Areas (SEIFA) decile, remoteness area, Indigenous status.

Disaggregated data excludes missing or not reported data.

All disaggregated data are to be calculated as at the first service event for the reporting period, that is, any in-scope admission, residential episode or service contact, even if an ongoing event is underway at the start of the reporting period. In cases where a null value is returned, the first valid result is to be used.

Disaggregation data elements:Help on this term
Data Element / Data SetData Element

Person—age

Data Sources

State/territory community mental health care data

State/territory admitted patient data


Data Element / Data SetData Element

Person—sex

Data Sources

State/territory community mental health care data

State/territory admitted patient data


Data Element / Data SetData Element

Person—area of usual residence, statistical area level 2 (SA2) code

Data Sources

State/territory community mental health care data

State/territory admitted patient data

 


Guide for use

Used for disaggregation by remoteness and SEIFA


Data Element / Data SetData Element

Person—Indigenous status

Data Sources

State/territory community mental health care data

State/territory admitted patient data


Representational attributes

Representation class:Help on this termProportion
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN].N

Indicator conceptual framework

Framework and dimensions:Help on this termAccessible

Accountability attributes

Benchmark:Help on this term

State/territory level

Further data development / collection required:Help on this term

This indicator cannot be accurately constructed using the mental health National Minimum Data Sets (NMDSs) because they do not include unique patient identifiers that allow links across data sets and financial reporting years.

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

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

Other issues caveats:Help on this term
  • This indicator presents complexities at the analysis stage. For example, there are several approaches to defining ‘new client’ that depend on how the following issues are resolved:
    • Level of the mental health system at which ‘newness’ is defined: Consumers new to a particular organisation may be existing consumers of other organisations. Counts of new consumers at the state/territory level would certainly yield lower estimates than those derived from organisation-level counts.
    • Diagnosis criteria for defining ‘newness’: A consumer may present with a new condition, although they have received previous treatment for a different condition.
  • To date, the approach has been to specify an initial measure for implementation with a view to further refinement following detailed work to address the complexities associated with the definition of a new consumer and the possible implementation of unique state-wide patient identifiers within all jurisdictions.
  • This work does not take into account the activities of private mental health services, primary mental health care or the specialist private mental health sector.

When data for this indicator are requested, jurisdictions are required to answer whether a state-wide unique client identifier system is in place, or some comparable approach has been used in the data analysis to allow tracking of service utilisation by an individual consumer across all public specialised mental health services in the jurisdiction. Collection of this information is aimed at assessing the degree of consistency between jurisdictions in data reported the result of which are explored in the data quality statement for this indicator.

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

Supersedes KPIs for Australian Public Mental Health Services: PI 09J – New client index, 2016 Health, Superseded 14/06/2017

Has been superseded by Mental health new client index, 2018 Health, Candidate 09/08/2018

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