- Background to the data collection
- Versions of the AROC Inpatient Clinical Data Set
- Impairment codes
- AN-SNAP classification
- Clinical indicators
- AROC Online Data Dictionary
- Guidelines for submission of AROC data
- Data Item Compliance
- Data Audit
In developing the Version 1 AROC data set, the objective was to include data items routinely collected by a majority of providers and which conform with the National Health Data Dictionary (NHDD) wherever possible. The Australian Minimum Data Set for Rehabilitation, developed by the Australasian Faculty of Rehabilitation Medicine (AFRM), formed the basis of the AROC clinical data set. The AROC Inpatient Clinical Data Set includes information about the rehabilitation service, the person receiving the rehabilitation, administrative details about the period of rehabilitation care and clinical characteristics. The majority of data items are collected at the beginning of an episode while some items, such as the outcome measure, accommodation and level of support are collected at the completion of an episode. The version 1 AROC Clinical Data Set was developed using the following principles:
- Where a NHDD definition existed, and was consistent with AROC requirements, it was incorporated in the AROC data set exactly as it appeared in the NHDD;
- Where a NHDD definition existed, but was less detailed than AROC requirements, it was incorporated in the AROC data set using a codeset that could be mapped to the NHDD codeset;
- Where a data item was required for AROC purposes but did not exist in the NHDD, it was incorporated in the AROC dataset based on an agreed industry definition.
AROC commenced data collection in July 2002 with Version 1 of the AROC Clinical Data Set. This version of the data set remained in use until September 2003 when the AROC Clinical Data Set Version 2 was implemented. All inpatient episodes of rehabilitation discharged from a participating rehabilitation facility up to and including June 2007 were submitted to AROC conforming to the version 2 data specifications.
The Version 3 AROC Inpatient Clinical Data Set was implemented in July 2007. The Version 3 data set implementation was in line with the implementation of the AN-SNAP Classification Version 2 and the release of the Australian Impairment Codes Version 1. Version 4 of the AROC data set was implemented on 1 July 2012.
AROC commenced data collection in July 2002 with Version 1 of the AROC Clinical Data Set. This version of the data set used a modified version of the UDS impairment codes (modified in that AROC did not use impairment code 17). When the AROC Clinical Data Set changed to Version 2 in September 2003 these codes remained unchanged.
In late 2006 and early 2007 a sub-committee of the AROC Scientific and Clinical Advisory Committee reviewed the impairment codes to ensure clinical relevance in the Australian environment. The result of this review is a revised set of codes, known as the Version 1 Australian Impairment Codes, implemented 1 July 2007 in line with the Version 3 AROC Inpatient Clinical Data Set.
A full mapping of the impairment codes between the modified UDS version and the new Version 1 Australian Impairment Codes is available, however, the main changes to the impairment codes are:
- reclassification of orthopaedic impairment group
- first level splits the category into replacement/repair, or fracture/dislocation
- next level identifies the body part
- two additional classes in the Pain impairment group
- headache (including migraine)
- multi-site pain
- the renaming of the Debility impairment group to Reconditioning/Restorative and the inclusion of three classes within this category
- post surgical management
- post medical management
- cancer rehabilitation
- additional classes under Non Traumatic Brain Injury
- sub-arachnoid haemorrhage
- anoxic brain damage
- other non traumatic brain
- removal of a number of 'other' categories
The Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) classification was developed in 1996, a result of a study conducted by the Centre for Health Service Development. When AROC commenced data collection in July 2002 with Version 1 of the AROC Clinical Data Set, casemix analysis was conducted using the Version 1 AN-SNAP classification.
In 2006, after 10 years of use, it was decided that it was time to review the AN-SNAP classification to ensure it was still in keeping with clinical practice. NSW Health commissioned the Centre for Health Service Development to undertake this review. The review took several months and involved many clinicians from around the country. The result of the review was the Version 2 AN-SNAP classification. The Version 3 AROC Inpatient Clinical Data Set is able to use either version for casemix classification, however, all benchmark reports used the Version 2 AN-SNAP classification.
The Centre for Health Service Development (CHSD) was engaged by the Independent Hospital Pricing Authority (IHPA) in December 2013 to develop version 4 of the AN-SNAP classification. This important development project will be undertaken between January 2014 and October 2014 and will include extensive industry consultation.
In 2007 AROC and the AFRM jointly completed a review of the ACHS Rehabilitation Medicine Clinical Indicators. This review has resulted in revised indicators being implemented on 1 January 2008. The six indicators that comprise the new Version 4 ACHS Rehabilitation Medicine Clinical Indicators (available to download below) are:
- Timely assessment of function on admission
- Assessment of function prior to patient episode end
- Timely establishment of a multi-disciplinary team rehabilitation plan
- Discharge plan prior to patient separation
- Functional gain achieved by rehabilitation program
- Destination after discharge from a rehabilitation program
There are two new indicators in Version 4 (functional gain achieved and discharge destination), while others have been slightly modified. Two indicators have been deleted (mortality and interruptions).
It is a goal of AROC's that in the near future we will be able to assist rehabilitation facilities with sending ACHS their Rehabilitation Medicine Clinical Indicators. As such, the Version 3 AROC Inpatient Clinical Data Set now contains all data items necessary for the collection and compilitation of the ACHS Rehabilitation Medicine Clinical Indicators.
AROC recommend that rehabilitation units collect all relevant Hospital Wide indicators as well as the Rehabilitation Medicine indicators.
All items in AROC data sets are mandatory and should be collected and submitted to AROC. It is important that all submitted data conform to the specified format, therefore, if a facility is unable to collect some items in the AROC data set space for them should be included in their data extract.
All data submitted to AROC undergoes a comprehensive audit process. Episodes with missing data and definite or potential errors are notified to the submitting facility by email for review and correction. Corrected data should be resubmitted to AROC. Further details about what is checked in the AROC Data Audit process, and what the errors and crosschecks all mean can be found in Appendix 2 of the AOS User Guide.
TERMINOLOGY CHANGES — RESIDENTIAL CARE (AUSTRALIA)
As at 1 July 2014 the Australian Government changed the definition of residential care resulting in “low level care” and “high level care” no longer being current terminology (more details). The AROC V4 Dataset for Australia and the Australian Data Collection Forms for pathways 2, 3, 4 & 5 still have this concept in the data items “Type of Accommodation prior to the impairment”, “Interim Accommodation post discharge” and “Final Accommodation post discharge”. The ramifications of this definitional change was discussed by the AROC Scientific Clinical Advisory Committee. It was agreed that whilst AROC can’t change the V4 code set for the three affected data items mid-stream, we can introduce a new business rule that takes account of this definitional change.
New business rule for Australian facilities: All episodes admitted from or discharged to residential care from July 2014 are to be coded to residential high level care (nursing home).
NOTE: all future analyses on Australian admissions from / discharges to residential care will combine residential low level care (hostel) and residential high level care (nursing home). When the AROC V4 dataset is revised the Accommodation data items affected by this definitional change will be adjusted to include codes identifying the 4 levels of care packages at home now available, as well as residential aged care and a code identifying referral to NDIS.
- Rehabilitation Care Plan - Anywhere Hospital
- AN-SNAP Classification Version 3 (Released January 2012, NB: Rehabilitation classes are unchanged)
- AN-SNAP Calculator (Excel 2007+)
- Inpatient Clinical Data Set
- Ambulatory Clinical Data Set
- Impairment Specific Data Items
- Australian Impairment Codes
- Guidelines for Coding Impairments
- Data submission dates
- Order of Australia Award for AROC Clinical Director