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National Healthcare Agreement: PI 27-Number of hospital patient days used by those eligible and waiting for residential aged care, 2018 QS

Identifying and definitional attributes

Metadata item type:Help on this termQuality Statement
METeOR identifier:Help on this term681605
Registration status:Help on this termHealth, Standard 30/01/2018

Relational attributes

Indicators linked to this Quality statement:Help on this term

National Healthcare Agreement: PI 27–Number of hospital patient days used by those eligible and waiting for residential aged care, 2018 Health, Standard 30/01/2018

Data quality

Quality statement summary:Help on this term
  • The National Hospital Morbidity Database (NHMD) is a comprehensive data set that has records for all separations of admitted patients from essentially all public and private hospitals in Australia.
  • The indicator as presented is a proxy measure based on available data items in the NHMD. The indicator is not a count of patient days used by those eligible (as assessed and approved by an Aged Care Assessment Team (ACAT)) and waiting for residential aged care. The indicator as presented is the number of patient days (and proportion of all patient days) used by patients where the care type is 'Maintenance', a diagnosis was reported as 'Person awaiting admission to residential aged care service' or 'Unavailability and inaccessibility of residential aged care service' and the separation mode was not 'Other (includes discharge to place of usual residence)'.
  • There is some variation among jurisdictions in the assignment of care-type categories. This may in part reflect measurement and definitional differences across jurisdictions.
  • Numerators for remoteness and socioeconomic status are based on the reported area of usual residence of the patient, regardless of the jurisdiction of hospital. This is relevant if significant numbers of one jurisdiction’s residents are treated in another jurisdiction.
  • Interpretation of rates for jurisdictions should take into consideration cross-border flows, particularly in the Australian Capital Territory.
  • Remoteness data for 2011–12 and previous years are not directly comparable to remoteness data for 2012–13 and subsequent years.
  • Socio-economic Indexes for Areas (SEIFA) data for 2010–11 and previous years are not directly comparable with SEIFA data for 2011–12, and SEIFA data for 2011–12 and previous years are not directly comparable with SEIFA data for 2012–13 and subsequent years.
Institutional environment:Help on this term

The Australian Institute of Health and Welfare (AIHW) has calculated this indicator.

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 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 main functions of the AIHW is to work with the states and territories to improve the quality of administrative data and, where possible, to compile national datasets based on data from each jurisdiction, to analyse these datasets and disseminate information and statistics.

The Australian Institute of Health and Welfare Act 1987, in conjunction with compliance to the Privacy Act 1988 (Commonwealth), 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 www.aihw.gov.au.

Data for the NHMD were supplied to the AIHW by state and territory health authorities under the terms of the National Health Information Agreement (see the following links):
http://meteor.aihw.gov.au/content/index.phtml/itemId/182135

The state and territory health authorities received these data from public hospitals. States and territories use these data for service planning, monitoring and internal and public reporting. Hospitals may be required to provide data to states and territories through a variety of administrative arrangements, contractual requirements or legislation.

Timeliness:Help on this term

The reference period for these data is 2015–16.

Accessibility:Help on this term

The AIHW provides a variety of products that draw upon the NHMD. Published products available on the AIHW website are:

  • Admitted patient care: Australian hospital statistics with associated Excel tables
  • interactive data cubes for Admitted patient care (for principal diagnoses, procedures and diagnosis related groups).

These products may be accessed on the AIHW website at: http://www.aihw.gov.au/hospitals/.

Interpretability:Help on this term

Supporting information on the quality and use of the NHMD are published annually in Admitted patient care: Australian hospital statistics series of reports (technical appendixes), available in hard copy or on the AIHW website. Readers are advised to note caveat information to ensure appropriate interpretation of the performance indicator. Supporting information includes discussion of coverage, completeness of coding, the quality of Indigenous data, and changes in service delivery that might affect interpretation of the published data. Metadata information for the NMDS for Admitted patient care is published in the AIHW’s online metadata repository, METeOR, and the National health data dictionary.

The data quality statement for the 2014–15 NHMD can be accessed on the AIHW website at: http://meteor.aihw.gov.au/content/index.phtml/itemId/638202

Relevance:Help on this term

The purpose of the national minimum data set (NMDS) for Admitted patient care is to collect information about care provided to admitted patients in Australian hospitals. The scope of the NMDS is episodes of care for admitted patients in essentially all hospitals in Australia, including public and private acute and psychiatric hospitals, free-standing day hospital facilities, alcohol and drug treatment hospitals and dental hospitals. Hospitals operated by the Australian Defence Force, corrections authorities and in Australia's off-shore territories are not included. Hospitals specialising in dental, ophthalmic aids and other specialised acute medical or surgical care are included.

The hospital separations data do not include episodes of non-admitted patient care provided in outpatient clinics or emergency departments.

This indicator is a proxy indicator.

Analyses by remoteness and socioeconomic status are based on the Statistical Area Level 2 (SA2) of usual residence of the patient. The SEIFA categories for socioeconomic status represent approximately the same proportion of the national population, but do not necessarily represent that proportion of the population in each state or territory (each SEIFA decile or quintile represents 10% and 20% respectively of the national population).

The SEIFA scores for each SA2 are derived from 2011 Census data and represent the attributes of the population in that SA2 in 2011.

In 2011, the ABS updated the SEIFA, based on the 2011 Australian Bureau of Statistics (ABS) Census of Population and Housing.  The new SEIFA will be referred to as SEIFA 2011, and the previous SEIFA as SEIFA 2006. Data for 2007–08 through to 2010–11 reported for SEIFA quintiles and deciles are reported using SEIFA 2006 at the Statistical Local Area (SLA) level.  Data for 2011–12 are reported using SEIFA 2011 at the SLA level. Data for 2012–13 are reported using SEIFA 2011 at the SA2 level.  The AIHW considers the change from SEIFA 2006 to SEIFA 2011, and the change from SLA to SA2 to be series breaks when applied to data supplied for this indicator.  Therefore, SEIFA data for 2010–11 and previous years are not directly comparable with SEIFA data for 2011–12, and SEIFA data for 2011–12 and previous years are not directly comparable with SEIFA data for 2012–13 and subsequent years.

Patient days are reported by jurisdiction of hospitalisation, regardless of the jurisdiction of residence. Hence, rates represent the number of patient days for patients living in each remoteness area or SEIFA population group (regardless of their jurisdiction of usual residence) divided by the total number of patient days for patients living in that remoteness area or SEIFA population group hospitalised in the reporting jurisdiction. This is relevant if significant numbers of one jurisdiction’s residents are treated in another jurisdiction (for example, the Australian Capital Territory).

'Other Australians' includes separations for non-Indigenous people and those for whom Indigenous status was not stated.

Accuracy:Help on this term

For 2015–16, almost all public hospitals provided data for the NHMD, with the exception of all separations for a mothercraft hospital in the Australian Capital Territory.

The majority of private hospitals provided data, with the exception of the private day hospital facilities in the Australian Capital Territory and the Northern Territory.

States and territories are primarily responsible for the quality of the data they provide. However, the AIHW undertakes extensive validation on receipt of data. Data are checked for valid values, logical consistency and historical consistency. Where possible, data in individual data sets are checked against data from other data sets. Potential errors are queried with jurisdictions, and corrections and resubmissions may be made in response to these queries. The AIHW does not adjust data to account for possible data errors or missing or incorrect values.

There is some variation among jurisdictions in the assignment of care type categories, this may in part reflect measurement and definitional differences across jurisdictions.

The NHMD does not include data on ACAT assessments.

The AIHW report Indigenous identification in hospital separations data: quality report (AIHW 2013) found that nationally, about 88% of Indigenous Australians were identified correctly in hospital admissions data in the 2011–12 study period, and the ‘true’ number of separations for Indigenous Australians was about 9% higher than reported. The report recommended that the data for all jurisdictions are used in analysis of Indigenous hospitalisation rates, for hospitalisations in total in national analyses of Indigenous admitted patient care. However, these data should be interpreted with caution as there is variation among jurisdictions in the quality of the Indigenous status data.

Cells have been suppressed to protect confidentiality where the presentation could identify a patient or a service provider or where rates are likely to be highly volatile, for example, where the denominator is very small. The following rules were applied:

  • counts less than 3 were suppressed
  • rates were suppressed where the numerator was less than 5 and/or the denominator was less than 1,000
  • rates which appear misleading (for example, because of cross border flows) were also suppressed
  • consequential suppression was applied where appropriate to protect confidentiality.
Coherence:Help on this term

The information presented for this indicator is calculated using the same methodology as data published in Admitted patient care 2015–16: Australian hospital statistics (AIHW 2017).

The data can be meaningfully compared across reference periods for all jurisdictions except Tasmania. Data for Tasmania for 2008–09 does not include 2 private hospitals that were included in 2007–08 and 2009–10 data reported in National Healthcare Agreement reports.

Methodological variations also exist in the application of SEIFA to various data sets and performance indicators. Any comparisons of the SEIFA analysis for this indicator with other related SEIFA analysis should be undertaken with careful consideration of the methods used, in particular the SEIFA Census year, the SEIFA index used and the approach taken to derive quintiles and deciles.

National level data disaggregated by Indigenous status for 2007–08 included data from New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. National level data disaggregated by Indigenous status for 2008–09, 2009–10 and 2010–11 included data from New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory. National level data disaggregated by Indigenous status for 2011–12 and subsequent years includes data from all eight states and territories. Therefore, data disaggregated by Indigenous status from 2007–08 is not comparable to 2008–09, 2009–10 and 2010–11, and data for 2011–12 and subsequent years are not comparable with data for 2010–11 and prior years.   

In 2011, the ABS updated the standard geography used in Australia for most data collections from the Australian Standard Geographical Classification to the Australian Statistical Geography Standard. Also updated at this time were remoteness areas and the Socio-Economic Indices for Areas (SEIFA), based on the 2011 ABS Census of Population and Housing. The new remoteness areas will be referred to as RA 2011, and the previous remoteness areas as RA 2006. The new SEIFA will be referred to as SEIFA 2011, and the previous SEIFA as SEIFA 2006.

Data for 2007–08 through to 2011–12 reported by remoteness are reported for RA 2006.  Data for 2012–13, 2013–14, 2014–15 and 2015–16 are reported for RA 2011.  The AIHW considers the change from RA 2006 to RA 2011 to be a series break when applied to data supplied for this indicator, therefore remoteness data for 2011–12 and previous years are not directly comparable to remoteness data for 2012–13 and subsequent years.

Source and reference attributes

Reference documents:Help on this term

Australian Institute of Health and Welfare (AIHW) 2013. Indigenous identification in hospital separations data: quality report. Cat. no. IHW 90. Canberra: AIHW. Viewed 26 July 2017, http://www.aihw.gov.au/publication-detail/?id=60129543215.

AIHW 2017. Admitted patient care 2015–16: Australian hospital statistics. Cat. no. HSE 185. Canberra: AIHW. Viewed 8 November 2017, https://www.aihw.gov.au/reports/hospitals/ahs-2015-16-admitted-patient-care/contents/table-of-contents.

Relational attributes

Related metadata references:Help on this term

Supersedes National Healthcare Agreement: PI 27-Number of hospital patient days used by those eligible and waiting for residential aged care, 2017 QS Health, Standard 31/01/2017

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