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National Outcomes and Casemix Collection

The National Outcomes and Casemix Collection (NOCC) will enable the further development of outcomes and casemix concepts in mental health.

The regular assessment of outcomes has been an aim of the National Mental Health Strategy since it was first agreed by all Australian health ministers in 1992. Two objectives of the strategy related specifically to outcomes:

• to institute regular reviews of outcomes of services provided to persons with serious mental health problems and mental disorders as a central component of mental health service delivery and
• to encourage the development of national outcome standards for mental health services, and systems for assessing whether services are meeting these standards.

Instruments for measuring consumer outcomes were not available when the National Mental Health Strategy commenced. In response to this need, a major research and development program was initiated under the first National Mental Health Plan (1993-98) to identify and field trial consumer outcome measures that would serve two needs. Firstly, the outcome measures had to be useful in routine clinical practice to allow monitoring of the health and wellbeing of the individual consumer. Secondly, the measures had to be suitable for monitoring outcomes at the broader service level. In a related national project, funded to develop casemix classification for mental health services, significant experience was gained in the use of standardised scales for the measurement of 'clinical severity' in mental health services that could serve as the basis for the further development of casemix concepts in mental health. An understanding of variations in casemix is essential to interpreting outcome data. Current AR-DRG casemix models are widely agreed to be unsatisfactory for understanding variation in case complexity in mental health.

Under the Australian Health Care Agreements, all states and territories have entered into agreements with the Commonwealth that provide funds to support the workforce training and information system development needed to enable collection of an agreed 'outcomes and casemix' dataset. The scope of the initiative covers all specialised mental health services funded in the public sector.

A key aspect of the initiative is the agreement by states and territories to provide data to the Australian Government on an annual basis. The national data collected under this arrangement will be the focus of extensive research and development over future years, designed to further develop the application of outcomes and casemix concepts in mental health.

Page last reviewed: 5 March 2013