department of human services the victorian admitted episodes dataset (vaed) – what’s it for?...
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Department of Human Services
The Victorian Admitted Episodes The Victorian Admitted Episodes Dataset (VAED) – what’s it for?Dataset (VAED) – what’s it for?
Andrew BrownManager Health Data Standards & SystemsDHS Victoria
Information Management Community of Practice Open Forum 2008-06-19
The Data Black HoleThe Data Black Hole
Black Hole at centre of Virgo Cluster (Hubble)
OverviewOverview
• What is the VAED?
• History, context, background.
• Uses of the VAED.
• The future of the VAED.
“Using the VAED to demonstrate that DHS is not really a data black hole.”
Housekeeping: It’s OK to ask questions as we go.
What is the VAED?What is the VAED?
The Victorian Admitted Episodes Dataset (VAED) is an administrative data collection used to record and report on all admitted patient activity in Victoria.
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave Days Contract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date on Separation (b)Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
TerminologyTerminology
VAED
The Victorian Admitted Episodes Dataset is the name of the data collection.
PRS/2
The Patient Reporting System (version 2) is the software processing system and interface through which the VAED is collected by DHS.
Exciting VAED trivia!Exciting VAED trivia!
Scope:
All public and private acute hospitals, including acute facilities in rehabilitation and extended care institutions and day procedure centres, are required to report the relevant minimum data set of admitted patient activity.
Public: 147Private: 152
More exciting VAED trivia!!More exciting VAED trivia!!
Enabling Legislation:
Data is collected under the authority of Section 9 of the Victorian Health Act 1958.9 Data collection
The Secretary must—
(a) establish a comprehensive information system which includes information on—
(i) the causes, effects and nature of illness among Victorians and groups of Victorians; and
(ii) the determinants of good health and ill health; and
(iii) the utilisation of health services in Victoria; and
(b) analyse and disseminate this information widely to members of the public.
More exciting VAED trivia!!More exciting VAED trivia!!
Enabling Legislation:
Data is collected under the authority of Section 9 of the Victorian Health Act 1958.9 Data collection
The Secretary must—
(a) establish a comprehensive information system which includes information on—
(i) the causes, effects and nature of illness among Victorians and groups of Victorians; and
(ii) the determinants of good health and ill health; and
(iii) the utilisation of health services in Victoria; and
(b) analyse and disseminate this information widely to members of the public.
(b) analyse and disseminate this information widely to members of the public.
More exciting VAED trivia!!!More exciting VAED trivia!!!Enabling Legislation (Privates):
...and under the authority of Section 47 of the Victorian Health Services (Private Hospitals and Day Procedure Centres) Regulations 2002.
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
The green highlights show the data elements specified in the Health Services (Private Hospitals and Day Procedure Centres) Regulations 2002.
Even more exciting VAED trivia!!!!Even more exciting VAED trivia!!!!
How old is the VAED?
• 1979-80: Started as Victorian Inpatient Minimum Database (VIMD) – 50 hospitals
• 1987-88: Electronic data available
• 1992-03: Episodes of care
• 1995-96: Newborn reporting (publics)
• 1999-00: Name change to VAED
Exciting VAED trivia with big Exciting VAED trivia with big numbers!!!!!numbers!!!!!
How big is the VAED?
• 79 data elements x
• 299 reporting units x
• Approx. 2,000,000 separations pa =
• 47 billion pieces of data each year
Not quite so exciting HDSS trivia but Not quite so exciting HDSS trivia but related to the VAED none the lessrelated to the VAED none the lessWho looks after the VAED?
• Operated by the Health Data Standards and Systems (HDSS) Unit
• PRS/2 is hosted by a FM company (The Pay Office) at an off-site location
• 2 staff for collection management and operations
• 1 IT support contractor
• 1 P/T staff member + 1 P/T contractor dedicated to the Victorian ICD Coding Committee (VICC)
• 1 P/T staff member for VAED audit
• 1 P/T staff member for VAED education
The 409kg Gorilla of data The 409kg Gorilla of data collectionscollections
What’s it for?What’s it for?
Casemix Funding
• Casemix funding was introduced in Victoria in 1993-94.
• The VAED supports Casemix funding through its diagnosis and procedure codes, and other administrative items.
Casemix funding in 2 minutes...Casemix funding in 2 minutes...
Casemix fundingCasemix funding
ICD-10-AM codes
Grouper module
WIES module
DRG
Length of Stay
WIES value ($)
PRS/2
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
The orange data elements are used to support funding.
What’s it for?What’s it for?
Casemix Funding (II)
• $3.0 bn is paid to acute hospitals in the form of WIES payments.
What’s it for?What’s it for?Other Acute Funding
$400m is paid for acute services in other grants – most of which are apportioned in some way by use of data wholly or partly from the VAED:
• Training and Development and Research grants – Complexity, Early graduates, Workforce priorities, Research
• Access, performance and incentive grants– elective surgery access bonus funding, Trauma, transplants, NETS,
PETS, Maternity services, Integrated Cancer Services, Maintenance dialysis, Long stay older patients, vulnerable children, medical displan, neonatal hearing screening, quality and safety and workforce and service planning
• Specified grants– Includes complexity, contracts and formula, awards, adjustments,
incl critical and neonatal care, and other hospital-specific grants
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
The orange data elements are used to support funding.
What’s it for?What’s it for?Subacute Admitted Funding
Approximately $400m is paid for subacute admitted services – either VAED funded or VAED data assisted in calculation of grants. • VicRehab: sub-acute rehabilitation patients in designated units
– CRAFT casemix system for rehabilitation• Geriatric Evaluation and Management (GEM)• Palliative care • Transition care• Interim care• NHT days• Post acute care
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
The orange data elements are used to support funding.
What’s it for?What’s it for?
Reconciliation for Third-Party payers• Department of Veterans’ Affairs (DVA)• Transport Accident Commission (TAC)• WorkSafe Victoria (VWA)• Cross-border agreements with other states• Reciprocal health care arrangements with other countries
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
The orange data elements are used to support funding.
What’s it for?What’s it for?
DHS also has reporting obligations• Requirement to report to Commonwealth Government under the Australian Health Care Agreements (AHCA)
Australian Hospital StatisticsAustralian Hospital Statistics
What’s it for?What’s it for?
DHS also has reporting obligations• Requirement to report to Victorian Treasury under ERC requirements
– Performance targets– Health Care for diverse populations and
Indicators of Cultural and Language Diversity
– Your Hospitals Report
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
Pink data elements that support DHS’ reporting obligations.
What’s it for?What’s it for?
The VAED is a collection of hospital morbidity and health service activity.
What’s it for?What’s it for?
• The data collection is used extensively within DHS to support programs, it:
– Monitors effectiveness
– Helps advise on policy decisions
– Helps set funding priorities and develop funding models
Who’s it for?Who’s it for?
Examples of program users:– Mental Health Branch
– Integrated Cancer Services
– Palliative Care
– Aged Care
– Quality and Safety
– Maternity Services
What’s it for?What’s it for?
• VAED is used to monitor health sector performance:
– Hospital finance performance
– Metro Health finance branch
– Rural & Regional Health & Aged Care
– KPI measurement
– Private hospitals
– Capital planning
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
Purple data elements that have been included to assist program monitoring. (Note – only one black one left!)
What’s it for?What’s it for? “...information on...
(i) the causes, effects and nature of illness among Victorians and groups of Victorians; and
(ii) the determinants of good health and ill health”
Hundreds of ad hoc requests for VAED information are processed each year from
other government departments, for ministerial briefings, the private sector,
researchers and the media.
Data LinkageData Linkage
Increased interest in data linkage of VAED – linking it with itself and with other collections:
– VAED for continuity of care
– VEMD for NAESG
– ACAS data set allowed removal of Hospital Bed Census collection and reduced data collection burden
– ESIS for Elective Surgery blitz initiative
The future of the VAEDThe future of the VAED
The future of the VAEDThe future of the VAED•PRS/2 – effectively 1980s technology (PRS) with a 1990’s upgrade (PRS/2).•Problems with the structure of the data collection, such as limits on numbers of reportable instances of various items, limited numbers of changes per day.Plans for revision:1. Internal work to identify problems, solutions and changes.2. Internal DHS consultation to explore impacts and feedback from data users.3. Develop ‘straw man’ proposal for change.4. Consult with Data Providers and their Software Vendors.5. Examine impacts on output reporting.6. Synthesise into proposal specification for change.7. Consultation.8. Release final spec for implementation mid 2009.9. Implementation...
NB: This slide was not part of the original presentation but was added for web publication.
The VAED Data ElementsThe VAED Data ElementsACAS StatusAccommodation Type Account ClassAdmission DateAdmission/Re‑Admission to RehabilitationAdmission SourceAdmission TimeAdmission TypeAdmission WeightBarthel Index ScoreCampus CodeCarer AvailabilityCare TypeClinical Sub-ProgramContract Leave DaysContract RoleContract/Spoke IdentifierContract TypeCountry of BirthCriterion For AdmissionDate of AccidentDate of BirthDiagnosis CodesDuration of Mechanical Ventilation in ICUDuration of Non-invasive Ventilation (NIV)Duration of Stay in Cardiac/Coronary Care UnitDuration of Stay in Intensive Care UnitDVA IDFunctional Assessment Date Funding ArrangementGiven Name(s)Health Insurance FundHospital Generated DRG
Indigenous StatusIntended Duration of StayIntention to Re‑AdmitInterpreter RequiredLeave With Permission Days Leave Without Permission Days Level of InsuranceLocalityMarital StatusMedicare NumberMedicare SuffixMental Health Legal StatusMental Health Statewide Patient IdentifierOnset DatePalliative Care Patient DaysPatient Days Patient IdentifierPostcodePreferred LanguageProcedure CodesQualification StatusRUG ADLSeparation DateSeparation ModeSeparation ReferralSeparation TimeSexSource of Referral to Palliative CareSurnameTAC Claim NumberTransfer DestinationTransfer SourceUnique Key
This makes it go!
What’s Unique Key for? It makes the VAED go!
