PHI 47/23 Release of 2021-22 HCP and PHDB Annual Reports and Reporting Requirements for Hospital-in-the-Home Care

This circular announces the release of the updated Hospital Casemix Protocol (HCP) and Private Hospital Data Bureau (PHDB) 2021–22 annual reports and also reminds hospitals and insurers of their hospital-in-the-home care reporting requirements.

Date published:
PHI circular type:
PHI announcement
Audience:
Health sector

HCP Annual Report

The Hospital Casemix Protocol (HCP) 2021-22 Annual Report has been released on the Department of Health and Aged Care website.  The report updates the preliminary report released in January 2023. For the majority of tables, statistics are presented for the time period 2010-11 to 2021-22. The reports are available in Excel format and contain summarised data collected from private health insurers through HCP1.

Tables include statistics related to Care Type, Completeness, Charge Components, Patient Age Groups, Medical services and Australian Refined - Diagnosis Related Groups (available for 2021-22 only) for privately insured separations in public and private hospitals.

New to this report (and the preliminary version), the Department revised its methodology for calculating overall statistics following a review of HCP1 separations without a medical (i.e. MBS) component. These separations were previously included in the analysis however, findings from a review showed it was more appropriate to exclude these separations when calculating overall statistics to avoid understating the medical component contribution to the overall charges, benefits and out-of-pocket amounts.  The review found many separations without a medical component contained other information that indicated a medical component was likely to have occurred, such as the separation:

  • had a principal or additional MBS item(s) in the HCP1 Episode Record,
  • was assigned a diagnosis related group within the surgical partition,
  • had one or more Australian Classification of Health Intervention codes,
  • had medical charges and/or benefits data supplied in the HCP1 Episode Record, or
  • had at least one record in the separation’s corresponding HCP1 Medical Record, albeit with missing data.

The Hospital Casemix Protocol (HCP) 2021-22 Annual Report includes both the revised and previous methodologies for Table 1.

See the 2021-22 HCP Annual Report

PHDB Annual Report

The Private Hospital Data Bureau (PHDB) 2021-22 Annual Report has been released on the Department of Health and Aged Care website. The report updates the preliminary report released in January 2023. For the majority of tables, statistics are presented for the time period 2010-11 to 2021-22. The reports are available in Excel format and contain summarised data collected from private hospitals through PHDB.

Tables include statistics related to Care Type, Completeness, Charge Components, Funding source, Patient Age Groups and Australian Refined - Diagnosis Related Groups (available for 2021-22 only) for private hospital separations.

See the 2021-22 PHDB Annual Report

To enable greater consistency between HCP and PHDB Annual Report statistics and figures published in the Australian Institute of Health and Welfare’s (AIHW) Australian Hospital Statistics annual reports, the hospital type (i.e. public or private) has been adjusted in a small number of cases. Further information is available in each Annual Report’s Explanatory notes section.

In addition to the methodology change mentioned, further minor adjustments to the methodology used to calculate statistics presented in the HCP and PHDB Annual Reports may result in differences when compared to previously published Annual Reports.

The Department also notes the under-reporting of dialysis related separations in HCP1 and PHDB which primarily impacts AR-DRGs (version 9.0): L61Z (Haemodialysis) and L67C (Other Kidney and Urinary Tract Disorders, Minor Complexity) and the over-reporting of rehabilitation separations in HCP1 which primarily impacts AR-DRG (version 9.0): Z60B Rehabilitation, Minor Complexity.

Although improvements have been made, the Department notes there is an ongoing issue in the HCP (hospital to insurer), HCP1 (insurer to Department) and PHDB data involving the supply of non-admitted service data, in particular, these relate to the AR-DRGs (version 9.0): U60Z (Mental Health Treatment W/O ECT, Sameday) and V62B (Alcohol Use and Dependence, Minor Complexity). A relatively small number of these additional non-admitted records are currently included in both the HCP and PHDB Annual Reports as there is insufficient information available to enable the Department to exclude them.

The Department also notes the under-reporting of dialysis related separations in HCP1 and PHDB which primarily impacts AR-DRGs (version 9.0): L61Z (Haemodialysis) and L67C (Other Kidney and Urinary Tract Disorders, Minor Complexity) and the over-reporting of rehabilitation separations in HCP1 which primarily impacts AR-DRG (version 9.0): Z60B Rehabilitation, Minor Complexity.

Any queries regarding these matters should be emailed to casemix.queries@health.gov.au.

Hospital-in-the-home reporting requirements

As outlined in the relevant data specifications, HCP, HCP1 and PHDB data should only contain admitted patient care episodes.

Hospital-in-the-home is defined as the provision of care to hospital admitted patients in their place of residence as a substitute for hospital accommodation. Place of residence may be permanent or temporary. The criteria for inclusion as hospital-in-the-home include but are not limited to:

  • without hospital-in-the-home care being available patients would be accommodated in the hospital
  • the treatment forms all or part of an episode of care for an admitted patient (as defined in the metadata item Episode of admitted patient care)
  • the hospital medical record is maintained for the patient
  • there is adequate provision for crisis care
  • Hospital-in-the-home care does not include services delivered to non-admitted patients.

For additional information see AIHW Metadata Online Registry – Hospital-in-the-home care

For data specifications see:

If you require further information about HCP or PHDB data provided to the department’s Data Submission Portal call (02) 6289 8058 or email your enquiry to hcp@health.gov.au.