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Data Element Detail

Episode type
Identifying and Definitional Attributes
QH 040013 v2
Data Element
Data Element
Current
01-Jul-1995		Superseded
30-Jun-1998
Standard
01-Jul-1995
30-Jun-1998
An episode type describes the phase of treatment. The episode type changes when the principal clinical intent changes.

Acute (Episode of Care)
An acute episode of care is a phase of treatment where the principal clinical intent is one or more of the following.
To:
- manage labour (obstetric);
- cure illness or provide definitive treatment for injury;
- perform surgery;
- relieve symptoms of illness or injury (excluding palliative care);
- reduce severity of illness or injury;
- protect against exacerbation and/or complication of an illness and/or injury which could threaten life or normal function; or
- perform diagnostic or therapeutic procedures.

Rehabilitation (Episode of Care)
A phase of treatment where a patient with a disability is participating in a multi-disciplinary program aimed at improving functional capacity, retraining lost skills, and/or a change in psychosocial adaptation.

Palliative (Episode of Care)
A phase of treatment where the patient's condition has progressed beyond the stage where curative treatment is effective or attainable, or where the patient chooses not to pursue curative treatment. Palliative care provides relief of suffering and enhancement of quality of life for such a patient. Interventions such as radiotherapy, chemotherapy, and surgery are considered part of the palliative episode if they are undertaken specifically to provide symptomatic relief.

Non-acute Nursing Home Type (Episode of Care)
An episode of care which applies to patients who have been classified as Nursing Home Type patients (NHTPs). Patients are classified as NHTPs after 35 days consecutive hospitalisation, unless the treating doctor has:
- completed an Acute Care Certificate under section 3B of the Health Insurance Act 1973 (Commonwealth); or
- made an order under section 3A of that Act;
which determines that the patient is in need of acute care for a specified period.

The 35 day qualifying period may accrue in more than one hospital (public, private or both), excluding extended treatment wards in public psychiatric hospitals.

Patients who go on leave or are separated from hospital, but return within seven days, may continue accruing their 35 days. Patients who leave hospital and do not enter another hospital for at least seven days will begin at day one on their next admission to hospital.

Leave days and days out of hospital do not count in accruing the 35 days.

If a patient is reclassified from nursing home type to another episode of care (eg, the patient broke their arm and requires acute care), the 35 day qualifying period begins again.

Non-acute - Respite (Episode of Care)
A phase of treatment where the patient:
- has not qualified as nursing home type but is in receipt of respite care and the sole reason for admitting the patient to a hospital is that the care that is usually provided in another environment (eg, at home or in a nursing home) is unavailable in the short term; or
Non-acute - Other (Episode of care)
A phase of treatment where the patient:
- has not qualified as nursing home type, or would normally not require hospital treatment, but there are factors in the home environment (physical, social, psychological) which make it inappropriate for the patient to be discharged in the short term; or
- is being treated in a psychiatric unit and has a stable but severe level of functional impairment, an inability to function independently without extensive care and support, and for whom the principal function is provision of care over an indefinite period.

Unqualified neonate (Episode of care)
An unqualified neonate is nine days old or less who:
- does NOT require treatment in an intensive care facility approved by the Commonwealth Minister for the purpose of the provision of special care: and
- does NOT remain in hospital without its mother; and
- is a single live birth, or the first live born infant of a multiple birth.

Other Care (Episode of Care)
A phase of treatment where the principal clinical intent does not meet the criteria for acute, rehabilitation, palliative, nursing home type, other non-acute, or unqualified neonate episodes of care.

It would be rare that a patient needs to be reported under other care.
Institutional health care: the identification of different episodes of care is required in order to appropriately classify and count the care a person received whilst in hospital. The type of care received will determine the appropriate casemix classification that shall be employed to classify the episode.
Episode type
Admission type (HBCIS)
Representational Attributes
Numeric Character
Code
N(2)
2
2
Permissible Values

Permissible_values

CodeDescription
01Acute
05Unqualified neonate
06Other care
21Rehabilitation - delivered in a designated unit
22Rehabilitation - according to a designated program
23Rehabilitation - principal clinical intent
31Palliative - delivered in a designated unit
32Palliative - according to a designated program
33Palliative - principal clinical intent
41Non-acute care - Nursing Home Type patient
42Non-acute care - Respite
43Non-acute care - Other
44Non-acute care - Nursing Home patient
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
An episode of care refers to the phase of treatment rather than to each individual patient day. There may be more than one episode of care within the one overnight stay period.

An episode of care begins on the date the person meets the criteria defined above for a particular type of care; this may be the same as the date the person was admitted to hospital or a date during the hospital stay. An episode of care ends when the principal intent of the care changes or when the patient is formally separated from the hospital.

A rehabilitation episode of care includes care provided:
- in a designated rehabilitation unit;
- in a designated rehabilitation or psychiatric rehabilitation program, as designated by the State health authority for Medicare patients in a recognised public hospital, for private patients in a public or private hospital, as approved by a registered health benefits organisation; or
- under the principal clinical management of a rehabilitation physician; or which in the opinion of the treating doctor the principal clinical intent of the care is rehabilitation.

A palliative episode of care includes care provided:
- in a designated palliative care unit;
- in a designated palliative care program; or
- under the principal clinical management of a palliative care physician; or
- which, in the opinion of the treating doctor, the principal clinical intent of the care is palliation.

Coding for rehabilitation/palliative care should be carried out in strict numerical sequence and only the first appropriate category should be coded; i.e. when a patient under the clinical management of a rehabilitation/palliative care physician is receiving care in a designated program, the episode should be coded to the option that is highest in the hierarchy (designated program).

The Nursing Home Type Patient criteria applies to all admitted patients regardless of the type of episode of care the patient is receiving. Once a patient meets this criteria they should be classified as a Nursing Home Type Patient.
QHAPDC
Code 44 (Non-acute care - Nursing Home patient) is used in HBCIS only, and not provided to DSU, as nursing homes are not part of the scope of QHAPDC.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 3
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementEpisode typeQH 040013 Version 1Superseded
Has been superseded byData ElementData ElementEpisode typeQH 040013 Version 3Superseded
Relates toData ElementData Element ConceptEpisode of care (admitted patient)QH 040019 Version 1Superseded
Implementation in Metadata Sets

Implemented

  • 1 - 2
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionMonthly Activity Collection (MAC)QH 020008 Version 1Superseded01-Jul-199530-Jun-1998
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1MandatorySuperseded01-Jul-199530-Jun-1998
Source and Reference Attributes
CRDI; CRDI QHAPDC; Care type;