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Data Element Detail

Episode of admitted patient care-chargeable status
Identifying and Definitional Attributes
QH 040050 v3
Data Element
Derived Data Element
Draft
19-Sep-2018		Current
16-Jul-2019
Standard
Information Management Strategic Governance Committee (IMSGC), Queensland Health
01-Jul-2018
Accommodation chargeable status elected by a patient on admission.
Admitted patient care
Chargeable status (QHAPDC)
Admitting accommodation (HBCIS); Public/Private/Shared (HBCIS)
Representational Attributes
Numeric
Code
N
1
1
Permissible Values

Permissible_values

CodeDescription
1Public
2Private shared
3Private single
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
Upon admission to hospital a patient must elect to be either a public patient or private patient.

A public patient is a patient who:
- elects to be treated as a public patient, and so cannot choose the doctor who treats them, or
- is receiving treatment in a private hospital under a contract arrangement with a public hospital or health authority.

A public patient who is allocated single room accommodation due to clinical need is still a public patient.

A private patient is a patient who elects to be treated by a doctor of their choice.

Their chargeable status is shared, unless they request and are accommodated in a single room in which case their chargeable status is 'private single'.

A private patient allocated single-room accommodation due to clinical need, rather than by choice, is still a private shared patient rather than a private single patient.
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Validated against a list of chargeable status codes.
Must not be null.
For national reporting of the Episode of admitted patient care-patient election status (NHDD) data element the following mapping occurs:
Code 1 Public is mapped to code 1 Public.
Code 2 Private shared is mapped to code 2 Private.
Code 3 Private single is mapped to code 2 Private.

Hospital Based Corporate Information System (HBCIS):
This data element is derived from the second digit of the Episode of admitted patient care-account class data element:
P is code 1 (Public)
R is code 2 (Private single)
S is code 3 (Private shared)

Ineligible for Medicare
A patient who is ineligible for Medicare does not have access to hospital treatment 'free of charge'.
Queensland public hospitals are to provide Medicare ineligible patients with a choice to be treated as a public or private patient. Different fees apply depending on the option chosen. Refer to the Queensland Health Fees and Charges Register, see https://www.health.qld.gov.au/directives/html/a#f.

Compensable
A patient who is compensable (e.g. entitled to receive compensation for their hospital treatment) does not have access to hospital treatment 'free of charge'. However, they do have the right to elect to be treated either by a hospital nominated doctor ("public") or by a doctor of their choice ("private").

Compensable patient charges will be raised on behalf of the patient either directly or indirectly through bulk-funding arrangements for their public hospital care, regardless of public or private chargeable status.
If a compensable patient has elected to be treated privately they will be responsible for all charges if the compensation claim is rejected or the insurer does not provide prior approval of the private status.

Department of Veterans' Affairs (DVA)
A patient who holds a Gold or White Repatriation Health Care Card can choose to use or not to use the benefits of their entitlement card. All eligible DVA patients who elect to have the DVA fund their hospitalisation, will also need to decide on whether they wish to have a public or private doctor manage their treatment. It is recognised that not all public hospitals have access to private doctors, hence account class codes are available that recognise a veteran's choice of doctor.

Reciprocal Health Care Agreements (RHCA)
The Australian Government has signed RHCA with the governments of the United Kingdom, Republic of Ireland, New Zealand, Sweden, the Netherlands, Belgium, Finland, Norway, Slovenia, Malta and Italy which entitles the patient to public hospital services 'free of charge' for 'essential' medical treatment while visiting Australia. A patient relying on a RHCA to cover the cost of their hospital stay must elect to be a public patient. Conditions such as period of cover vary between the different Agreements. For more information see the Department of Human Services website.

If a patient from a country with a RHCA with Australia, elects to be treated by a doctor of their choice i.e. a private patient, then they are ineligible for Medicare and do not have a right to access hospital care 'free of charge'. They will be coded as private ineligible patient regardless of whether the treatment was for 'essential' medical treatment or not.

Refugees
Is a person whose asylum claim has been successful and who has received a refugee protection visa. Refugees are Medicare eligible and as such may choose to be treated as a public patient. If the person chooses to be treated as a private patient they will be charged as a medicare eligible patient for admitted and/or outpatient services.

For more details refer to:
- Refugees, asylum seekers and detainees information sheet, see https://www.health.qld.gov.au/__data/assets/pdf_file/0033/676518/refugees-asylumseekers-infosheet.pdf.

Asylum Seekers
On 29 July 2017 the Queensland Government announced Medicare ineligible Asylum seekers would be provided with access to public health services at no charge.

Some Medicare ineligible asylum seekers may also qualify for funding to cover healthcare costs under the Status Resolution Support Service (SRSS). No costs should be directly charged to the Medicare ineligible asylum seeker however costs can be indirectly recovered from a third party such as the International Health and Medical Services (IHMS) or a SRSS provider. For full details refer to:
- Fees and Charges for Health Care Services, Health Service Directive, see https://www.health.qld.gov.au/__data/assets/pdf_file/0021/150717/qh-hsd-045.pdf; and
- Refugees, asylum seekers and detainees information sheet, see https://www.health.qld.gov.au/__data/assets/pdf_file/0033/676518/refugees-asylumseekers-infosheet.pdf.

Detainees
Detainees are not eligible for Medicare although International Health and Medical Services IHMS is contracted by the Department of Border Protection to facilitate and pay for a specific range of health services, not all health services are covered. For further details refer to:
- Refugees, asylum seekers and detainees information sheet, see https://www.health.qld.gov.au/__data/assets/pdf_file/0033/676518/refugees-asylumseekers-infosheet.pdf.

Torres Strait Treaty Zone
Papua New Guinea (PNG) nationals are considered Medicare Ineligible. Under the 'Project Agreement on Healthcare and Disease Prevention in the Torres Strait Islands' the Commonwealth Government agrees to provide a funding contribution to Queensland Health for the provision of healthcare to patients designated in the Torres Strait Treaty. Therefore, those PNG nationals designated under the Treaty are funded and should not have any fees raised against them.

PNG nationals not covered by the Treaty are to have fees raised for their healthcare as a Medicare ineligible patient.
For more details refer to:
- Torres Strait Treaty Guidelines, see https://dfat.gov.au/geo/torres-strait/Documents/torres-strait-guidelines.pdf.

Newborns
A newborn with a qualification status of unqualified will generally have the same chargeable status as their mother.

The chargeable status of a newborn with a qualification status of acute will depend on the election made by their mother on its behalf.
On admission to a public hospital, the patient must elect to be treated as either a public patient; a private patient in single accommodation; or a private patient in shared accommodation. This item is independent of the patient's hospital insurance status.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 3
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementDerived Data ElementEpisode of admitted patient care-chargeable statusQH 040050 Version 2Superseded
Is derived fromData ElementData ElementEpisode of admitted patient care-account classQH 040165 Version 2Current
Relates toData ElementData Element ConceptEpisode of admitted patient careQH 041604 Version 1Current
Implementation in Metadata Sets

Implemented

  • 1 - 9
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-201830-Jun-2019
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) 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
Source and Reference Attributes
Australian Institute of Health and Welfare
METeOR data element: Episode of admitted patient care- patient election status, code N, Identifier 326619, Health standard 23/10/2006 https://meteor.aihw.gov.au/content/index.phtml/itemId/326619/meteorItemView/long
Accommodation status; Accommodation type; Chargeable status;