Stratification Variables
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- Elinor Cannon
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1 Stratification Variables The ACHS, in collaboration with relevant medical colleges, associations and specialty societies have developed the following stratification variables to enable like organisations to be grouped for the purpose of comparison. Three levels of comparison are available: An individual organisation s data results compared to ALL organisations who submit data for a particular indicator. An individual organisation s data results compared to all other organisations submitting data within the same sector, that is, public or private. An individual organisation s data results compared to other organisations classified according to defined stratification variables as described in the section below Anaesthesia stratification variables, and by public or private sector. Anaesthesia stratification variables version 5 All organisations are stratified into public / private categories and surgical complexity as defined by number of ICU beds during the 6 month data collection period: Adult ICU Level 1 Adult ICU Level 2 Adult ICU Level 3 Paediatric ICU No ICU Free Standing Day Only Facility Day Surgery stratification variables version 4 All organisations are stratified into public / private categories and type of day procedure service: Free standing - stands alone and purpose built. General hospital - shares facilities within a hospital. Unit or centre - within a public or private hospital, with its own admission, theatre, recovery and discharge areas. Emergency Medicine stratification variables version 4 All organisations are stratified into public / private categories and role delineation for Australian Emergency Departments: Major Referral Emergency Department Urban District Emergency Department Major Regional/Rural Base Emergency Department Rural Emergency Service Primary Care/ Rural Emergency Service Gastrointestinal Endoscopy stratification variables version 1 Gynaecology stratification variables version 6 Public / Private Stratification only. Peer Group Stratification Variables Page 1 of 6
2 Hospital in the Home stratification variables version 4 Public / Private Stratification Medical Visitation (health care organisations that have medical staff visiting HITH patients in their place of residence versus health care organisations that do not have medical staff visiting HITH patients in their place of residence) Provision of Intravenous Therapy (IVT) (health care organisations that have HITH patients receiving IVT versus health care organisations that do not have HITH patients receiving IVT) Direct Admission from the Emergency Department (ED) (health care organisations that admit to HITH directly from the ED versus health care organisations that do not admit to HITH directly from the ED). Hospital-Wide stratification variables version 11.1 All organisations are stratified into public / private categories and hospital type based on Australian Institute of Health and Welfare (AIHW) public hospital peer groups. Private sector healthcare organisations should choose the most appropriate category based on the number of casemix adjusted separations, geographic location and / or clinical services as described below: Peer group Subgroup Code Definition and Specialist children s Large Medium Small acute Specialist children s Major city Regional and Group 1 Group 2 Regional A1 A2 B1 B2 C1 C2 D1 Major city with >20,000 acute casemix-adjusted separations, and Regional with >16,000 acute casemix-adjusted Specialised acute children s with >10,000 acute casemixadjusted Major city acute treating more than 10,000 acute casemix-adjusted Regional acute treating >8,000 acute casemix-adjusted separations per annum, and with >5,000 casemix-adjusted separations. Medium acute in Regional and Major city areas treating between 5,000 and 8,000 acute casemix-adjusted Medium acute in Regional and Major city areas treating between 2,000 and 5,000 acute casemix-adjusted separations per annum, and acute treating <2,000 casemixadjusted separations per annum but with >2,000 Small Regional acute (mainly small country town ), acute treating <2,000 separations per annum, and with less than 40% non-acute and outlier patient days of total patient days. Peer Group Stratification Variables Page 2 of 6
3 Sub-acute and nonacute Unpeered and other Psychiatric Small non-acute Multi-purpose services Hospices Rehabilitation Mothercraft Other non-acute D3 D2 E2 E3 E4 E5 E9 G F Small (<5,000 acute casemix-adjusted separations but not multi-purpose services and not small non-acute ). Most are <2,000 separations. Small non-acute, treating <2,000 separations per annum, and with more than 40% non-acute and outlier patient days of total patient days. For example, geriatric treatment centres combining rehabilitation and palliative care, with a small number of acute patients. Prison medical services, dental, special circumstance, Major city with <2,000 acute casemixadjusted separations, with <200 separations etc. Infection Control stratification variables version 3.1 All organisations are stratified into public / private categories and bed size: 1 49 beds beds beds beds = or > 500 beds Intensive Care stratification variables version 4 All organisations are stratified into public / private categories and intensive care unit classification, according to the College of Intensive Care Medicine of Australia and New Zealand (Refer to Appendix 3): Adult ICU Level III Adult ICU Level II Adult ICU Level I Internal Medicine stratification variables version 5 All organisations are stratified into public / private categories and hospital type based on Australian Institute of Health and Welfare (AIHW) public hospital peer groups. Private sector healthcare organisations should choose the most appropriate category based on the number of casemix adjusted separations, geographic location and / or clinical services provided as described below: Peer group Subgroup Code Definition and Specialist children s A1 Major city with >20,000 acute casemix-adjusted separations, and Regional with >16,000 acute casemix-adjusted Peer Group Stratification Variables Page 3 of 6
4 Large Medium Small acute Sub-acute and nonacute Unpeered and other Psychiatric Specialist children s Major city Regional and Group 1 Group 2 Regional Small non-acute Multi-purpose services Hospices Rehabilitation Mothercraft Other non-acute A2 B1 B2 C1 C2 D1 D3 D2 E2 E3 E4 E5 E9 G F Specialised acute children s with >10,000 acute casemixadjusted Major city acute treating more than 10,000 acute casemix-adjusted Regional acute treating >8,000 acute casemix-adjusted separations per annum, and with >5,000 casemix-adjusted separations. Medium acute in Regional and Major city areas treating between 5,000 and 8,000 acute casemix-adjusted Medium acute in Regional and Major city areas treating between 2,000 and 5,000 acute casemix-adjusted separations per annum, and acute treating <2,000 casemixadjusted separations per annum but with >2,000 Small Regional acute (mainly small country town ), acute treating <2,000 separations per annum, and with less than 40% non-acute and outlier patient days of total patient days. Small (<5,000 acute casemix-adjusted separations but not multi-purpose services and not small non-acute ). Most are <2,000 separations. Small non-acute, treating <2,000 separations per annum, and with more than 40% non-acute and outlier patient days of total patient days. For example, geriatric treatment centres combining rehabilitation and palliative care, with a small number of acute patients. Prison medical services, dental, special circumstance, Major city with <2,000 acute casemixadjusted separations, with <200 separations etc. Peer Group Stratification Variables Page 4 of 6
5 Medication Safety stratification variables version 3 Mental Health Community Based stratification variables version 2 Public and Private stratification only. Mental Health Inpatient stratification variables version 6 All organisations are stratified into public / private categories and number of psychiatry separations in the six month data collection period separations separations 1000 separations Obstetric stratification variables version 7 All organisations are stratified into public / private categories and the total number of births annually (as nominated by ) as follows: < 1000 births per year births per year and NO Neonatal Intensive Care Nursery Neonatal Intensive Care Nursery And / Or > 3000 births per year Ophthalmology stratification variables version 4 All organisations are stratified into public / private categories and number of ophthalmology separations in each six month data collection period: separations separations = or > 300 separations Oral Health stratification variables version 2.1 Paediatric stratification variables version 4 All organisations are stratified into public / private categories and the number of paediatric separations in each six month data collection period: separations separations separations separations = or > 7000 separations Pathology stratification variables version 3 All organisations are stratified into public / private categories, hours of operation and metropolitan/non-metropolitan for the pathology service as follows: 24 hour service/metropolitan 24 hour service/non-metropolitan Day service plus on-call/metropolitan Day service plus on-call/non-metropolitan Radiation Oncology stratification variables version 3 Peer Group Stratification Variables Page 5 of 6
6 Radiology stratification variables version 4 All organisations are stratified into public/private categories and type of radiology service: A1, A2, A3 B1, B2, B3 C2, C3, C4 D3, D4 Where: A Provider with > 100,000 radiology examinations per annum B Provider with 50,000 to 99,999 radiology examinations per annum C Provider with 12, 000 to 49,999 radiology examinations per annum D Provider with 1 to 11,999 radiology examinations per annum 1 Site providing on an elective and emergency basis a complete range of diagnostic radiology and also complex neuro, vascular and general interventional radiology. 2 Site providing on an elective and emergency basis a complete range of diagnostic radiology and vascular and general interventional radiology. 3 Site providing on elective and emergency basis some components of diagnostic radiology with or without general interventional radiology. 4 Site providing on elective basis some components of diagnostic radiology with or without general interventional radiology. Rehabilitation Medicine stratification variables version 4 All organisations are stratified into public / private categories and type of rehabilitation care: Category 1: Rehabilitation service provided by allied health professional under the clinical supervision of the referring medical officer. Category 2: Rehabilitation service providing rehabilitation within a particular medical speciality such as orthopaedics, geriatrics or cardiology and is under the direction of an appropriate qualified specialist. Category 3: Rehabilitation service under the direction of a Rehabilitation Medicine Specialist and providing a full range of rehabilitation services. Surgical stratification variables version 3 All organisations are stratified into public / private categories and total number of beds at this site, location or campus: 1 49 beds beds beds beds = or > 400 beds Peer Group Stratification Variables Page 6 of 6
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