Department of Health

Sub-acute admitted care is care provided to patients who have undergone a formal admission process, where the clinical intent or treatment goal is the provision of sub-acute care.

For more information on admitted services, refer to the Victorian Hospital Admission Policy and the Victorian Admitted Episodes Dataset (VAED) criteria for reporting.

Scope

Eligible facilities in scope for activity based funding in the acute admitted care stream are all current health services that report to the VAED, except those health services listed at Appendix A of the IHACPA’s National Efficient Cost Determination.

The funding policy for admitted sub-acute is based on:

  • AN-SNAP v4 classification.
  • L1.5 H1.5 +/- 4 day additive boundary policy  for multi-day episodes.
  • Episode-based funding approach for rehabilitation, GEM, and maintenance care.
  • Phase of care funding approach for palliative care.

Classification

The Australian National Subacute and Non Acute Patient (AN-SNAP) classification system Version 4 is  used to classify sub-acute admitted care. 

The sub-acute model uses 94 of the classification system's admitted classes across four care types (rehabilitation, GEM, palliative care and maintenance care). Each AN-SNAP class is allocated a price weight to determine the level of funding.  

Psychogeriatric Care AN-SNAP classes should not be reported in Victoria and do not attract NWAU in Victoria in 2021-22.
Price weights expressed as national weighted activity unit are set out in the annual National Efficient Price Determination.

Counting

All sub-acute admitted care data are collected at the patient level and reported through the VAED. 

The unit of count for Activity Based Funding (ABF) sub-acute admitted care is ‘inpatient separation’. It includes stays for patients who are treated and go home, and patients who are subsequently admitted to hospital or transferred to another facility for further care. 

Costing

Cost data for ABF sub-acute admitted care is collected at the patient level. All Victorian health services are required to submit annual patient-level cost data to the Victorian Cost Data Collection (VCDC). VCDC data is then submitted to the National Health Cost Data Collection (NHCDC) via the Independent Health and Aged Care Pricing Authority (IHACPA).

Key differences between model operating from 2021-22 and the Sub-acute Weighted Inlier Separation (SWIES)

Component Difference
Data sources

SWIES: Victorian activity and cost data.

National: National activity and cost data.

Boundary Policy

SWIES: Inlier period based on +/- 4 days from ALoS for most multiday AN-SNAP classes.

National: Inlier period based on L1.5 H1.5 from ALoS for all multiday AN-SNAP classes.

Patients requiring dialysis or radiotherapy during their admitted episode

SWIES: Not accounted for in SWIES.

National: Adjustments apply. Dialysis Adjustment = 28 per cent and Radiotherapy (RT) Adjustment = 40 per cent in NEP 21. Dialysis or RT therefore needs to be coded within the admitted sub-acute episode in the VAED.

Use of per diem payments

SWIES: Maintenance Care (MC)/Non-acute AN-SNAP classes based on per diems.

National: No per diem rates for multiday episodes or phases. All multiday MC and Palliative Care AN-SNAP classes use episode or phase based weights and boundary policy.

Private Patient adjustment

SWIES: Single price discount for private patients.

National: Private patient service adjustment differs by Care Type. Private patient accommodation adjustment differs for each state.

Other Patient adjustment 

SWIES: No adjustments other than indigenous adjustment.

National: Patient residential remoteness (outer regional, remote area, and very remote area).

 

Reviewed 07 October 2022

Health.vic

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