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Potential changes to Hospital Admissions Policy

(as advised to Health Service CEOs by email on 10 September 2009)

The Department of Health (the department) has identified areas that potentially require clarification or change to the current Hospital Admissions Policy, in particular, relating to the Criteria for Admission for Type B, C and E. Recent audits of the Victorian Admitted Episodes Data Set have shown a high level of classification error (19 per cent) for these Criteria for Admission. Advice from health services has indicated that this is partly due to confusion regarding definitions of admission types.

In order to address these issues, the department is seeking to develop simplified criteria for these admission types, with the aim of introducing the new criteria from 1 July 2010.

Before any final decision is made on the criteria for admission, the department will work with health services during 2009-10 to ensure any proposed changes are simple, logical, and equitable.

The process:

During 2009-10, the department will review current admissions data against the potential changes to the Criteria for Admission.  Health services will be provided with information about which admissions would, and would not be allowed under the changes, enabling health services to understand the scope of the changes. Health services are encouraged to provide feedback to the department on the implications of the different admission criteria. In particular, the department will be seeking advice from health services on the potential financial impacts of the proposed changes on health services, and consideration of whether changes to the Type B list or Type E definition may impact clinical decision making. Comments should be provided via email to HDSS.HelpDesk@health.vic.gov.au.

Proposed changes for 2010-11 are:

Type B:
Admissions for Type B will be determined by using a single procedures list outlining what same day procedures can be admitted. The draft list is available on this page and is specified as ICD-10-AM/ACHI (Australian Classification of Health Interventions) codes for ease of use. Please contact Melissa Arduca by email at Melissa.Arduca@dhs.vic.gov.au for the password.

Type E:
It is proposed to refine the definition of Type E as:

extended treatment where it is intended that there is four or more hours continuous treatment involving: half hourly observations; OR continuous monitoring such as ECG, EEG; OR continuous IV therapy of any sort.

Type C:
There are no changes proposed to the definition of Type C.

However, health services should note that it remains the Department’s expectation that Type C admissions are those that would normally be undertaken on a non-admitted basis and therefore not normally accepted as admissions. 

Type C admissions will be closely monitored by the Department during 2009-10 and health services may be asked to explain their rationale for Type C admissions. 

Actions required:

Health services do not need to take any actions other than noting this information. These changes are currently only proposed for consultation purposes, and no change in practice is required during 2009-10.

Health services will be provided with information about how proposed changes could impact on their admissions.  Health services are welcome to provide the Department any comments and input on the impacts of the proposed changes to the Hospital Admission Policy, in anticipation of potential implementation in 2010-11.

Admission Policy - procedure code lists (ZIP File 152KB) - Updated 14 April 2010

Admission Policy Consultation Process (PDF File 34KB)