[WWW - 2023.07.31]

Data Element Detail

Expected principal source of funds for the episode
Identifying and Definitional Attributes
QH 040624 v2
Data Element
Data Element
Current
29-Nov-2006		Superseded
01-Nov-2012
Standard
01-Jul-2006
30-Jun-2012
Expected principal funding source for an admitted or non admitted patient care episode
Admitted and non admitted patient care
Funding source for hospital patient
Representational Attributes
Numeric Character
Code
N(2)
2
2
Permissible Values

Permissible_values

CodeDescription
01Australian Health Care Agreements
02Private Health Insurance
03Self-Funded includes, funded by the patient, patient's family of firned or other beneficiaries.
04Worker's Compensation
05Motor Vehicle Third Party Personal Claim
06Other Compensation (e.g. public liability, common law, medical negligence)
07Department of Veterans' Affairs
08Department of Defence
09Correctional Facility
10Other Hospital or Public Authority (Contracted Care).
11Reciprocal Health Care Arrangements (with other countries).
12Other
13No charge raised
Supplementary Values

Supplemenary_values

CodeDescription
99Not stated/unknown
Collection and Usage Attributes
The final payment class should be used

Code 01 Australian Health Care Agreements
Australian Health Care Agreements should be recorded as the funding source for Medicare eligible admitted patients who elect to be treated as public patients and Medicare eligible emergency department patients and Medicare eligible patients presenting at a public hospital outpatient department for whom there is not a third party arrangement.
Excludes: Inter-hospital contracted patients and overseas visitors who are covered by Reciprocal health care agreements and elect to be treated as public admitted patients.

Code 02 Private health insurance
Excludes: overseas visitors for whom travel insurance is the major funding source.

Code 03 Self funded includes, funded by the patient, patients family or friends or other beneficiaries

Code 10 Other hospital or public authority is used for contracted care

Code 11 Reciprocal health care agreements (with other countries)
Australia has Reciprocal Health Care Agreements with the United Kingdom, the Netherlands, Italy, Malta, Sweden, Finland, Norway, New Zealand and Ireland. The Agreements provide for free accommodation and treatment as public hospital services, but do not cover treatment as a private patient in any kind of hospital.

The Agreements with Finland, Italy, Malta, the Netherlands, Norway, Sweden and the United Kingdom provide free care as a public patient in public hospitals, subsidised out-of-hospital medical treatment under Medicare, and subsidised medicines under the Pharmaceutical Benefits Scheme.

The Agreements with New Zealand and Ireland provide free care as a public patient in public hospitals and subsidised medicines under the Pharmaceutical Benefits Scheme, but do not cover out-of-hospital medical treatment.

Visitors from Italy and Malta are covered for a period of six months from the date of arrival in Australia only.
Excludes: Overseas visitors who elect to be treated as private patients.
12 Other should be used for overseas visitors who have travel insurance as the major funding source

Code 13 No charge
Includes: Admitted patients who are Medicare ineligible and receive public hospital services free of charge at the discretion of the hospital or the state/territory. Also includes patients who receive private hospital services for whom no accommodation or facility charge is raised (for example, when the only charges are for medical services bulk-billed to Medicare), and patients for whom a charge is raised but is subsequently waived.
Excludes: Admitted public patients (Medicare eligible) whose funding source should be recorded as Australian Health Care Agreements or Reciprocal Health Care Agreements. Also excludes Medicare eligible non-admitted patients, presenting to a public hospital emergency department and Medicare eligible patients (for whom there is not a third party payment arrangement) presenting at a public hospital outpatient department, whose funding source should be recorded as Australian Health Care Agreements.
Also excludes patients presenting to an outpatient department who have chosen to be treated as a private patient and have been referred to a named medical specialist who is exercising a right of private practice. These patients are not considered to be patients of the hospital (see Guide for use).
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 3
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementExpected principal source of funds for the episodeQH 040624 Version 1Superseded
Has been superseded byData ElementData ElementEpisode of care-expected principal source of patient fundingQH 040624 Version 3Superseded
Relates toData ElementData ElementCompensable status (QHAPDC)QH 040051 Version 4Superseded
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1MandatorySuperseded01-Jul-200630-Jun-2012
Source and Reference Attributes
CRDI; CRDI QHAPDC; CRDI QHNAPDC; Funding source; Principal funding source;