Activity based funding: Non-admitted patient NBEDS 2018-19
Identifying and definitional attributes
|Metadata item type:||Data Set Specification|
|Registration status:||Independent Hospital Pricing Authority, Standard 17/07/2018|
|DSS type:||Data Set Specification (DSS)|
The scope of the Activity based funding: Non-admitted patient National Best Endeavours Data Set (ABF NAP NBEDS) is non-admitted patient service events involving non-admitted patients provided by:
This also includes all in-scope services contracted by a public hospital, Local Hospital Network or jurisdiction regardless of the physical location of the contracting public hospital, Local Hospital Network or jurisdiction, or the location where the services are delivered. The ABF NAP NBEDS is intended to capture instances of service provision from the point of view of the patient.
The scope of the ABF NAP NBEDS includes all arrangements made to deliver non-admitted patient service events (not covered by the national minimum data sets listed below) to non-admitted patients:
Excluded from the scope of the ABF NAP NBEDS are all services covered by:
For the purpose of this ABF NAP NBEDS, a non-admitted service is a specialty unit or organisational arrangement under which a jurisdictional health authority, Local Hospital Network or public hospital provides non-admitted services.
Local Hospital Networks are defined as those entities recognised as such by the relevant state or territory health authority.
Collection and usage attributes
|Guide for use:|
A non-admitted patient service event is defined as an interaction between one or more health-care provider(s) with one non-admitted patient, which must contain therapeutic/clinical content and result in a dated entry in the patient's medical record.
1. All non-admitted services that meet the criteria of a non-admitted patient service event should be counted, and be counted only once regardless of the number of health-care providers present. The multiple health-care provider indicator can be used to identify service events with three or more health-care providers.
2. Patients can be counted as having multiple non-admitted patient service events in one day, provided that every visit meets each of the criteria in the definition of a non-admitted patient service event.
3. Patient education services can be counted as non-admitted patient service events, provided that they meet the criteria included in the definition of a non-admitted patient service event.
4. Each patient attending a group session is counted as a non-admitted patient service event, providing that the session included the provision of therapeutic/clinical advice for each patient and that this was recorded using a dated entry in each patient’s medical record. A data element identifying a group session is included to record this type of service event.
5. Consultations delivered by information and communication technology (ICT), including but not limited to telehealth and where the patient is participating via a video link consultations can be counted as service events if they substitute for a face-to-face consultation, provided that they meet all the criteria included in the definition of a non-admitted patient service event. A telephone consultation is only counted as one non-admitted patient service event, irrespective of the number of health professionals or locations participating in the consultation. A telehealth consultation has service events counted at the location of the healthcare provider and the location of the patient.
6. Services provided to inpatients (including services provided by staff working in non-admitted services who visit admitted patients in wards, or other types of consultation and liaison services involving inpatients) are not counted as non-admitted patient service events.
7. Travel by a health professional is not counted as a non-admitted patient service event.
8. All non-admitted services that meet the criteria in the definition of non-admitted patient service events must be counted, irrespective of funding source (including Medicare Benefits Schedule) for the non-admitted service.
9. For activity based funding purposes, diagnostic services are not counted as non-admitted patient service events; these are an integral part of the requesting clinic's non-admitted patient service event.
10. Renal dialysis, total parenteral nutrition, home enteral nutrition and home ventilation performed by the patient in their own home without the presence of a health-care provider may be counted as a non-admitted patient service event, provided there is documentation of the procedures in the patient's medical record. For activity based funding purposes, all non-admitted patient sessions performed per month are to be bundled and counted as one non-admitted patient service event per patient per calendar month regardless of the number of sessions.
11. Multidisciplinary case conferences without the patient present whilst not meeting the definition of a non-admitted patient service event, are reported through this data set for activity based funding purposes, provided there is documentation of the conference and associated outcomes in the patient's medical record.
The ABF NAP NBEDS is intended to capture instances of healthcare provision from the point of view of the patient. This may be for assessment, examination, consultation, treatment and/or education.
One service event is recorded for each interaction, regardless of the number of healthcare providers present.
Events broken in time:
The period of interaction can be broken but still regarded as one service event if it was intended to be unbroken in time. This covers those circumstances in which treatment during a service event is temporarily interrupted for unexpected reasons, for example, a healthcare provider is called to assess another patient who requires more urgent care. Where a healthcare provider is unable to complete the interaction, it is considered to be a service event only if the definition of service event (above) is met.
Service events can occur in an outpatient clinic or other setting.
Service events delivered via Information and Communication Technology (ICT) (including but not limited to telephone and where the patient is participating via a video link) are included if:
If a patient is accompanied by a carer/relative, or the carer/relative acts on behalf of the patient with or without the patient present (e.g. the mother of a two-year-old patient, or the carer for an incapacitated patient), only the patient’s service event is recorded unless the carer/relative interaction meets the definition of a service event (above).
Note: carer refers to an informal carer only.
Service events delivered in groups:
Care provided to two or more patients by the same service provider(s) at the same time can also be referred to as a group session.
One service event is recorded for each patient who attends a group session regardless of the number of healthcare providers present, where the definition of a service event (above) is met.
A service event is the result of a service request (including formal referral and self-referral or attendance at a walk-in clinic).
Activities which do not meet the definition of a service event include:
Classification of care type depends on an assessment of the overall nature of care provided, based on other service event characteristics collected at the jurisdiction level such as clinic type, provider type and/or referral details. The method used to derive the care type should be submitted with the dataset.
|Implementation start date:||01/07/2018|
|Implementation end date:||30/06/2019|
Glossary terms that are relevant to this NBEDS are listed below.
Source and reference attributes
Independent Hospital Pricing Authority
|Steward:||Independent Hospital Pricing Authority|
IHPA (Independent Hospital Pricing Authority) 2017. Tier 2 Non-Admitted Service Compendium. Sydney: IHPA, accessed online 17 July 2018 https://www.ihpa.gov.au/publications/tier-2-non-admitted-services-compendium-2018-19
IHPA 2017. Tier 2 Non-Admitted Services Definitions Manual. Sydney:IHPA. accessed online 17 July 2018 https://www.ihpa.gov.au/publications/tier-2-non-admitted-services-definitions-manual-2018-19
|Related metadata references:|
See also Activity based funding: Mental health care NBEDS 2018-19 Health, Standard 25/01/2018, Independent Hospital Pricing Authority, Proposed 03/07/2017
See also Activity based funding: Non-admitted patient care aggregate NBEDS 2018-19 Independent Hospital Pricing Authority, Standard 17/07/2018
See also Non-admitted patient care Local Hospital Network aggregate NBEDS 2018-19 Health, Standard 25/01/2018
See also Non-admitted patient care hospital aggregate NMDS 2018-19 Health, Standard 25/01/2018, ACT Health, Final 08/08/2018
See also Statistical Area Level 1 of usual residence NBEDS 2018-19 Health, Superseded 17/10/2018