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Data Element Detail

Patient-hospital insurance status (QHAPDC)
Identifying and Definitional Attributes
QH 040020 v3
Data Element
Derived Data Element
Draft
23-Apr-2013		Current
09-Jul-2013
Standard
01-Jul-2013
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 (QHAPDC)
Representational Attributes
Numeric
Code
N
1
1
Permissible Values

Permissible_values

CodeDescription
7Hospital insurance
8No hospital insurance
Supplementary Values

Supplemenary_values

CodeDescription
9Not stated/unknown
Collection and Usage Attributes
Persons covered by insurance for benefits of ancillary services only are included in code 8 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 7 Hospital insurance
The patient has health insurance that covers hospital accommodation.

Code 8 No hospital insurance
The patient does not have health insurance that covers hospital accommodation.

Code 9 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.
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Must not be null.
Validated against a list of Hospital Insurance codes.
For national reporting of the Patient-hospital insurance status data element the following mapping occurs:
Code 7 Hospital insurance is mapped to code 1 Hospital insurance.
Code 8 No hospital insurance is mapped to code 2 No hospital insurance.
Code 9 Not stated/unknown is mapped to code 9 Unknown.

Queensland Hospital Admitted Patient Data Collection (QHAPDC):
This data item is used to record whether patients have hospital level health insurance, irrespective of their chargeable status for this admission. That is, they may not elect to be admitted as private patients on this occasion, but the fact that they have hospital insurance should be recorded.

For example:
- A patient may have hospital insurance, but elects to be admitted as a public patient on this occasion.
- An uninsured patient may elect to be treated privately on this occasion, and meet the hospital and clinician charges himself/herself.
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 - 15
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementDerived Data ElementHospital insurance (patient)QH 040020 Version 2Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 17Current
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 16Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 15Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 14Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 13Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 12Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 11Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 10Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 9Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 8Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 18Current
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 17Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 16Superseded
Is a qualifier ofData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 15Superseded
Implementation in Metadata Sets

Implemented

  • 1 - 15
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 2MandatoryCurrent01-Jul-2019
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1MandatorySuperseded01-Jul-201330-Jun-2019
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2016-2017QH 020315 Version 1MandatorySuperseded01-Jul-201630-Jun-2017
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2017-2018QH 020501 Version 1MandatorySuperseded01-Jul-201730-Jun-2018
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2018-2019QH 020503 Version 1MandatorySuperseded01-Jul-201830-Jun-2019
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2019-2020QH 020581 Version 1MandatorySuperseded01-Jul-201930-Jun-2020
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2020-2021QH 020692 Version 1MandatorySuperseded01-Jul-202030-Jun-2021
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2021-2022QH 020780 Version 1MandatorySuperseded01-Jul-202130-Jun-2022
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2022-2023QH 0139401 Version 1MandatoryCurrent01-Jul-202230-Jun-2023
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2016-2017QH 020314 Version 1MandatorySuperseded01-Jul-201630-Jun-2017
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2017-2018QH 020329 Version 1MandatorySuperseded01-Jul-201730-Jun-2018
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2018-2019QH 020504 Version 1MandatorySuperseded01-Jul-201830-Jun-2019
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2019-2020QH 020582 Version 1MandatorySuperseded01-Jul-201930-Jun-2020
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2020-2021QH 020693 Version 1MandatorySuperseded01-Jul-202030-Jun-2021
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2021-2022QH 020781 Version 1MandatorySuperseded01-Jul-202130-Jun-2022
Source and Reference Attributes
Australian Institute of Health and Welfare
METeOR data elements:
Patient-hospital insurance status, code N, identifier 270253, Health standard 01/03/2005 https://meteor.aihw.gov.au/content/index.phtml/itemId/270253/meteorItemView/long
Patient-hospital insurance status, code N, identifier 647326, Health standard 15/10/2016 https://meteor.aihw.gov.au/content/index.phtml/itemId/647326/meteorItemView/long
CRDI; CRDI QHAPDC;