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Data Element Detail

Patient-hospital insurance status (HBCIS)
Identifying and Definitional Attributes
QH 041668 v1
Data Element
Data Element
Draft
23-Apr-2013		Current
09-Jul-2013
Standard
01-Jul-1994
Hospital insurance under one of the following categories:
- Registered insurance: hospital insurance with a health insurance fund registered under the National Health Act 1953 (Cwlth).
- General insurance: hospital insurance with a general insurance company under a guaranteed renewable policy providing benefits similar to those available under registered insurance.
- No hospital insurance or benefits coverage under the above.
Institutional health care
Hospital insurance status (HBCIS)
Representational Attributes
Alphabetic
Code
A
1
1
Permissible Values

Permissible_values

CodeDescription
NNo hospital insurance
YHospital insurance
Supplementary Values

Supplemenary_values

CodeDescription
UNot stated/unknown
Collection and Usage Attributes
Persons covered by insurance for benefits of ancillary services only are included in code N No hospital insurance.

This metadata item is to determine whether the patient has hospital insurance, not their method of payment for the episode of care.

Code Y Hospital insurance
The patient has health insurance that covers hospital accommodation.

Code N No hospital insurance
The patient does not have health insurance that covers hospital accommodation.

Code U Not stated/unknown
It is not stated or unknown whether the patient has health insurance that covers hospital accommodation. For example, a patient is unconscious and is therefore unable to provide the information, or the patient is unable to identify whether their health insurance covers hospital accommodation.
This data element is mapped to the Patient-hospital insurance status (QHAPDC) data element as follows for reporting to the Statistical Services Branch (SSB):
Code Y Hospital insurance is mapped to code 7 Hospital insurance.
Code N No hospital insurance is mapped to code 8 No hospital insurance
Code U Not stated/unknown is mapped to code 9 Not stated/unknown
Insurance status was reviewed and modified to reflect changes to new private health insurance arrangements under the Health Legislation (Private Health Insurance Reform) Amendment Act 1995.
Employee health benefits schemes became illegal with the implementation of Schedule 2 of the private health insurance reforms, effective on 1 October 1995.
Under Schedule 4 of the private health insurance reforms, on 1 July 1997, the definition of the 'basic private table' or 'basic table', and 'supplementary hospital table' and any references to these definitions was omitted from the National Health Act 1953. All hospital tables offered by registered private health insurers since 29 May 1995 have been referred to as 'Applicable Benefits Arrangements' and marketed under the insurer's own product name.
This data element assists in the analysis of utilisation and health care financing.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 4
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
Is used in the derivation ofData ElementData ElementHospital insurance (patient)QH 040020 Version 1Superseded
Is used in the derivation ofData ElementDerived Data ElementHospital insurance (patient)QH 040020 Version 2Superseded
Is used in the derivation ofData ElementDerived Data ElementPatient-hospital insurance status (QHAPDC)QH 040020 Version 3Current
Relates toData ElementData Element ConceptPatientQH 040378 Version 2Current
Implementation in Metadata Sets

Implemented

No Metadata Items
Source and Reference Attributes
Hospital insurance; Insurance;