Appendix B: National collections glossary
Terms used by National collections. Some terms may not be currently in use.
A
Under the contract of the Independent Health and Aged Care Pricing Authority (IHACPA), the ACCD was responsible for the development of the:
- ICD-10-AM/ACHI/ACS Ninth Edition, Tenth Edition and Eleventh Edition
- AR-DRG v8.0, v9.0 and v10.0.
The Australian Classification of Health Interventions (ACHI) is the national standard for intervention clinical coding. ACHI is used classify interventions performed in public and private hospitals.
The procedure codes in ACHI are numeric only. ACHI contains codes for:
- surgical procedures
- medical procedures
- allied health interventions
- dental services
- other interventions performed outside the operating theatre.
An acute admission is an unplanned inpatient admission on the day of presentation at the admitting healthcare facility. Admission may be to:
- an Emergency Department (ED)
- an Acute Assessment (AAU)
- a Short Stay Unit (SSU).
Admission may be from emergency or outpatient departments of the healthcare facility, or a transfer from another healthcare facility.
If a patient is admitted to ED, AAU, SSU or is admitted from ED to an inpatient ward, the event start datetime will be the datetime assessment or treatment commenced in ED, AAU, or SSU. In the NNPAC national collection this is datetime of first contact. Procedures carried out in ED meeting the criteria for clinical coding are to be coded as part of the episode of admitted patient care (inpatient event).
A condition or complaint either coexisting with the principal diagnosis or arising during the episode of admitted patient care, episode of residential care or attendance at a healthcare facility, as represented by a code.
The process where the healthcare facility accepts responsibility for the patient's care or treatment and the person becomes a resident in a healthcare facility.
For the purposes of the national collections, event records are to be reported to the National Minimum Dataset (NMDS) if the healthcare user:
- received assessment or treatment for 3 hours or more
- had a general anaesthetic.
This also applies to healthcare users of Emergency Departments (ED). When calculating the 3 hours, exclude waiting time in a waiting room, exclude triage and use only the duration of assessment or treatment. If part of the assessment or treatment includes observation, then this time contributes to the 3 hours. ‘Assessment or treatment’ is clinical assessment, treatment, therapy, advice, diagnostic or investigatory procedure from a:
- nurse, excluding triage nurse
- nurse practitioner
- clinician
- other health professional.
Start time for an inpatient admission should be the same as the NNPAC datetime of first contact in ED.
A person who undergoes a hospital’s admission process to receive treatment or care.
Admission follows a clinical decision based upon specified criteria that a patient requires sameday, overnight, multiday care or treatment and becomes a resident in a healthcare facility.
AHBs were health funding bodies until 1 July 1993. They were replaced with 4 Regional Health Authorities (RHA).
An arranged admission is a planned admission where either the admission:
- date is less than 7 days after the date the decision was made by the specialist that the admission was necessary
- relates to normal maternity cases of 37 to 42 weeks gestation delivered during the event — these maternity patients will have been booked into the admitting facility.
An encounter where the healthcare user goes to a healthcare provider or facility and leaves within 3 hours of the start of the consultation.
B
'Bed equivalent' includes the categories that can accommodate a patient after admission to a healthcare facility, such as:
- beds
- cots or bassinets
- incubators
- special day patient chairs.
A boarder is a person who is receiving food or accommodation but for who the hospital does not accept the responsibility for care or treatment. This excludes all pēpi born in hospital.
A healthcare facility may register and admit a boarder but there is no requirement for the event to be reported to the NMDS.
C
Casemix is the mix of cases treated within a healthcare facility or other healthcare service. A casemix classification categorises patient episodes of care into clinically meaningful groups, based on patient attributes that best explain the cost of care.
This term was used to refer to hospitals from 1 July 1993 to 31 December 1997, first under Regional Health Authorities, and then under the Transitional Health Authority (THA).
The Codefinder software is an application that assists in the clinical coding process. The software replaces the task of searching for ICD-10-AM/ACHI codes in the hard copy coding books with computerised prompts that aid in the decision-making process. The Codefinder software contains the same information used in the hard copy coding books to make sure that terminology, rules and codes are applied consistently. The software does not identify the relevant information in the patient’s clinical record. This is the responsibility of a clinical coder. The Codefinder software also contains diagnosis related grouping, editing and data quality functions.
A person receiving healthcare assistance outside of a healthcare facility.
A healthcare user who receives treatment, therapy, advice or diagnostic services outside of a healthcare facility. For example, those in the care of a community mental health team.
A community client, not a resident in a healthcare facility, who either:
- receives assistance only with the normal activities of daily living
- visits for monitoring purposes only where there is no active treatment or clinical intervention.
For example, those receiving:
- nappy or linen service
- meals on wheels
- home care
- attendant care
- home help
- hygiene and dressing assistance
- visits from a district well elderly visitor
- accredited visitors
- befriending schemes.
Community support clients are healthcare non-users.
D
A person admitted to a healthcare facility with a length of stay 3 hours or more but less than one day, as in not overnight, regardless of intent.
Day case (same day) event records will have the same event start and end date. See also 'Admission' and 'Intended day case'. This term is synonymous with 'same day patient' and 'short stay event'.
Previously there were 21 DHB health funding bodies, which were introduced 1 January 2001.
From 1 May 2010 there were 20 DHBs, as Otago and Southland DHBs merged and were known as Southern DHB.
DHBs were disestablished under the Health Reform with their functions merged into Health New Zealand | Te Whatu Ora (HNZ) 1 July 2022.
A person is classified as DNA if they did not attend a scheduled outpatient clinic appointment and there was no communication before the appointment. If there was communication, this is deemed to be a cancellation.
Did not wait is used in ED where the person is triaged but did not wait for treatment.
It is also used for outpatient services where the person arrives but does not wait to receive service.
A healthcare user physically leaves a healthcare facility, such as discharged, transferred or died, or the process of documentation that changes the status or service provided to the healthcare user during an admitted episode of care, for example statistical discharge.
Also refer to NMDS event end datetime, event end type code and NMDS event end type definitions.
A domiciliary service is aimed at the treatment of healthcare users in the community in their home. This sub-categorisation of community service is no longer in common usage.
E
A planned, booked, admission where the event start date is 7 or more days after the date the decision was made by the specialist that the admission was necessary.
A phase of treatment defined according to the acuity of the healthcare user:
- acute
- non-acute — arranged or elective.
Healthcare users may have more than one admitted episode of care in the period from admission to discharge. For example, in one hospitalisation there may have been an acute episode of care for a fractured neck or femur, followed by a rehabilitation episode of care.
This term is synonymous with ‘event’.
F
The FSA by a:
- registered medical practitioner of registrar level or above
- registered nurse practitioner for a particular referral — or, with a self-referral, for a discrete episode.
The healthcare user receives treatment, therapy, advice, diagnostic or investigatory procedures within 3 hours of the start of the consultation. The service is provided in a ward or designated outpatient clinic or by telehealth. Excludes emergency department and outpatient attendances for preadmission assessment or screening.
A follow up attendance is a subsequent patient consultation with a registered medical practitioner of registrar level or above, or a registered nurse practitioner, for the same condition in the same specialty.
The specialist’s intent is that they will finish the consultation within 3 hours, and the patient is not admitted, is not administered a general anaesthetic, and receives:
- treatment
- therapy
- advice
- diagnostic
- investigatory procedures.
Forensic psychiatry is a branch of psychiatry which requires special knowledge and training in the:
- law as it relates to the mental state of the offender, or alleged offender
- assessment, treatment and care of persons who have offended or who are alleged to have offended or appear likely to do so because of their psychiatric condition.
G
The grouper is a specially designed computer software that assigns patient admitted episodes of care to DRGs using diagnosis (ICD-10-AM) and procedure (ACHI) codes and other specific attributes such as:
- age
- sex
- length of stay
- event end type.
External cause codes are not used by the grouper. The grouper uses up to 30 diagnoses and up to 30 procedures in its calculations.
It is recommended that hospitals prioritise diagnoses and procedure codes within the current coding standards and guidelines in order to present the grouper with the most serious diagnoses and procedures.
H
A place that may be permanent, temporary or mobile, which people attend or are resident in, for the primary purpose of receiving healthcare or disability support services — as in would not be resident if no need for healthcare.
Excluded from the term are:
- supervised hostels
- halfway houses
- staff residences.
A person booked to receive or receiving healthcare resulting from direct contact with a healthcare provider where the healthcare results in the use of resources associated with:
- observation
- assessment
- diagnosis
- consultation
- rehabilitation
- treatment.
This term is synonymous with ‘patient’.
A person in contact with a health service but not booked to receive or receiving healthcare.
The HFA was the health funding body from 1 January 1998 to 12 December 2000. It was replaced with the District Health Boards (DHBs).
HHS was used to refer to hospitals from 1 January 1998 to 12 December 2000, under Health Funding Authority (HFA).
I
The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) is based on the World Health Organization (WHO) disease publication ICD-10.
ICD-10-AM enables the translation of diagnoses, injuries and other health related problems from clinical concepts into an alphanumeric code. This permits easy storage, retrieval and analysis of data.
IHACPA's primary function is to enable activity-based funding for Australian public hospital services. IHACPA is also responsible for developing national classifications for healthcare and other services delivered by public hospitals.
National classifications developed include:
- ICD-10-AM
- ACHI
- AR-DRG.
They also help resolve disputes on cost-shifting and cross-border issues as required.
An admission where the intent of the admitted episode of care will be a same day event, such as event start and end date are the same.
Intended day case events were identified by the event type ID. The event type ID was retired for all event records reported with an event end date on or after 1 July 2013, as it was no longer used by the DRG grouper software logic.
A healthcare user admitted for healthcare. Includes same day events. Includes inpatients who are transferred from another healthcare facility or inter-departmental transfers, statistical discharge between specific health specialities, within the same facility.
For event records reported to NMDS with an event end date before 1 July 2013 the definition of ‘inpatient’ included ‘where the intention at admission was that it would not be a same day event’.
The time in days between admission to hospital ‘X’ and discharge, death or transfer from healthcare facility ‘X’, minus leave days from hospital ‘X’. Counts are at midnight.
L
The planned absence of an inpatient from the healthcare facility to which they were most recently admitted.
Leave is counted only where that inpatient is absent at midnight and has a planned return within 3 nights of going on leave, for the continuation of their treatment or care. If after 3 days for non-psychiatric hospital inpatients or 14 days for informal mental health inpatients the patient has not returned to care, discharge is effective on the date of leaving hospital.
Where there is more than one period of leave during an admitted episode of care, accumulated leave days should be reported.
This definition does not cover sectioned mental health service patients whose leave definitions are included in the Mental Health (Compulsory Assessment and Treatment) Act 1992.
The number of days an inpatient on leave is absent from the healthcare facility at midnight, up to a maximum of:
- 3 days, midnights, for non-psychiatric hospital inpatients
- 14 days, midnights, for informal psychiatric patients.
If after 3 days for non-psychiatric hospital inpatients or 14 days for informal psychiatric inpatients the patient has not returned to care, discharge is effective on the date of leaving hospital. This period of leave is not to be reported in the event leave day’s field.
Where there is more than one period of leave during an admitted episode of care, accumulated leave days should be reported.
For formal patients the duration of their leave is variable and is determined by the legislation they are under.
A healthcare user who has received continuous inpatient care, regardless of periods of leave and location, for a period as specified by the requirement of the service or data user.
M
Healthcare non-users whose only contact with the health service is through health promotion or screening campaigns.
These are cumulative stays that are incremented at midnight.
- Unoccupied bed equivalent days per period.
- Occupied bed equivalent days per period.
- Resourced bed equivalent days per period.
Percentage occupancy = (occupied bed nights per period / resourced bed nights per period) x 100.
Turnover rate = (admissions or number of days in period) / resourced bed nights per period.
Turnover interval = unoccupied bed nights per period / (admissions x number of days in period).
Five-day wards need to be handled carefully. They have 5 resourced bed nights per week but only 4 bed-equivalent days, as they are counted at midnight. The denominator used should be 4 resourced bed nights rather than 5 — otherwise 100% occupancy would not be possible.
A person admitted for the first time with a mental illness.
A person admitted for subsequent treatment of a mental illness.
N
The NBRS is a national collection that contains information by health speciality and booking status on how:
- many patients are waiting for elective surgery
- long they have had to wait for before receiving treatment.
The NCAMP is an annual project in order for Health NZ to meet its statutory obligation of delivering information from the national collections. NCAMP requires public healthcare facilities to initiate changes to their patient management systems (PMSs).
The NCCC was responsible for the development of the Australian refined diagnosis related group (AR-DRG) classification system that consists of:
- International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Eighth Edition
- Australian Classification of Health Interventions (ACHI), Eighth Edition
- Australian Coding Standards (ACS), Eighth Edition
- Australian Refined Diagnosis Related Groups (AR-DRG) AR-DRG v7.0.
NCCH was the service provider for the ICD-9-CM-A and ICD-10-AM classifications (1st to 7th Editions) up until 30 June 2010. The NCCH was responsible for the development of the Australian refined diagnosis related groups (AR-DRG) classification systems from 1 July 2013 to 2018.
The NC group manage the national collections, reporting systems and provide access to information and coded clinical data.
National Collections and Reporting (NCR) was changed to National collections as part the Health NZ — Data and digital restructure in 2023.
NZHIS was a group within the Ministry of Health responsible for the collection and dissemination of health-related data. NZHIS was disestablished in 2008.
The NHI is a unique number that is assigned to each person who receives healthcare in New Zealand. The NHI is an index of identity information associated with that unique number. The Health Information Privacy Code places restrictions on the creation and use of unique identifiers such as the NHI number.
The NMDS is a national collection of public and private hospital discharge information, including clinical information for inpatient and sameday patients. It also includes aged care and hospice records along with those for maternity services.
The NMDS is used for policy formation, performance monitoring, research and review. It provides statistical information, reports, and analyses about the trends in the delivery of hospital inpatient and day patient health services, both nationally and on a provider basis.
The NNPAC is a national collection of non-admitted, outpatient and emergency department (ED), activity, which was introduced 1 July 2006. NNPAC information includes event-based purchase units that relate to medical and surgical outpatient and ED attendances. From July 2020 clinical information has been reported for ED attendances. From July 2023 procedure information has been reported for 5 purchase unit codes.
O
A resourced bed equivalent that is assigned to an admitted inpatient who is not on leave.
A client who has achieved old long stay status as at July 1991. This status results from continuous residence in a psychiatric hospital since 1 April 1975, except for periods of absence of less than one year.
An OP is a person:
- who receives a preadmission assessment, a diagnostic procedure, treatment, therapy, advice at a healthcare facility or through telehealth
- who is not admitted
- where the specialist’s intent is that they will leave that facility within 3 hours from the start of the consultation.
When a person receives a general anaesthetic they are deemed not to be an outpatient. Refer to 'Follow-up attendance'.
A scheduled administrative arrangement enabling an outpatient, person, to receive the attention of a healthcare provider. The holding of a clinic provides the opportunity for consultation, investigation and minor treatment with a person attending in person or virtually by prior arrangement. The clinic may be held on or off the hospital site. Refer to 'Follow-up attendance'.
P
This term is synonymous with ‘healthcare user’.
A facility's local patient administration system (PAS) or patient management system (PMS).
The PRIMHD creates a single national mental health information collection of service activity and outcomes data from across Aotearoa New Zealand’s mental health sector. Public hospitals and non-governmental organisations (NGOs) electronically report their activity and outcomes data to national collections.
The diagnosis established after study to be chiefly responsible for:
- occasioning an episode of admitted patient care in hospital
- attendance at the healthcare facility.
The phrase 'after study' in the definition means evaluation of findings to establish the condition that was chiefly responsible for occasioning the episode of care.
Findings evaluated may include information gained from:
- the history of illness
- any mental status evaluation
- specialist consultations
- physical examination
- diagnostic tests or procedures
- any surgical procedures
- any pathological or radiological examination.
The condition established after study may or may not confirm the admitting diagnosis.
Reference: Australian Coding Standards (ACS), Twelfth Edition, IHACPA 2022.
Procedures are those aspects of clinical care carried out on patients undergoing treatment:
- for the prevention, diagnosis, care or relief of disease
- for the correction of deformity or deficit, including those performed for cosmetic reasons
- associated with pregnancy, childbirth or contraceptive or procreative management.
A procedure is defined as a clinical intervention represented by a code that:
- is surgical in nature
- carries a procedural risk
- carries an anaesthetic risk
- requires specialist training
- requires special facilities or equipment only available in an admitted patient care setting.
R
A person who attends as a same day patient but where the intention is for recurring day therapy. For example:
- renal dialysis
- chemotherapy
- geriatric
- paediatric care.
A person who attends at a same day or recurrent care facility, staffed by a mental health service, excluding substance abuse and forensic services, for a period of more than 3 hours and less than 1 day, including treatment, education and promotion services.
Referral is a request for the shifting of clinical responsibility. The actual transfer of responsibility is recorded by, usually, either a change:
- from one status to another
- of responsible clinician.
The request may precede the assumption of responsibility by some time, the difference being the waiting time.
Intensive therapy and skill retraining required, after an acute treatment period, to permit an independent or semi-independent existence outside the hospital environment.
A bed equivalent that is resourced to accommodate an admitted patient. Resources must include staff, linen, and the like. The old term 'commissioned bed' corresponds with the term 'resourced bed'.
A short term admitted episode of care, usually to give a carer respite from the provision of care.
The 4 RHAs were the health funding bodies from 1 July 1993 to 1 July 1997. They were replaced with a single Transitional Health Authority (THA).
S
A person admitted for healthcare where a length of stay will be 3 hours or more but less than 1 day, overnight, regardless of intent.
Short stay events will have the same event start and end date. Refer to 'Admission' and 'Intended day case'.
This term is synonymous with 'day case patient' or 'same day event'.
T
The THA was the single health funding body from 1 July 1997 to 31 December 1997. It was replaced with the Health Funding Authority (HFA).
The sum of first and follow-up attendances.
The physical movement of a healthcare user either from:
- one healthcare facility to another
- within a healthcare facility not involving a change of healthcare status.
The transfer of responsibility is signalled when a referral is accepted.
U
The underlying cause of death is defined by the World Health Organization (WHO) as either the:
- disease or injury which initiated the train of morbid events leading directly to death
- circumstances of the accident or violence which produced the fatal injury.
A resourced bed equivalent that is not an occupied bed equivalent. The old term 'commissioned bed' corresponds with the term 'resourced bed'.
V
An encounter where the healthcare provider goes to the healthcare user.