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National Casemix and Classification Centre

About NCCC

Established in 2010, the National Casemix and Classification Centre (NCCC) has the expertise in supporting the ongoing development and use of casemix classifications in health services research, evaluation and management and providing services in relation to activity-based funding and activity-based management. The NCCC undertakes projects with health industry partners and government to review activity, cost and performance, and to develop systems for improved management of resources and delivery of health services.

As a centre within the Australian Health Services Research Institute (AHSRI), the NCCC often undertakes projects in partnership with other AHSRI centres and programs. This provides access to the wide range of expertise available across AHSRI to meet the varied requirements of projects.

The NCCC contributes to AHSRI’s strong national and international reputation, based on 25 years of health services research and development. In addition to producing robust academic output, the products of the NCCC and AHSRI include practical and expert advice to a variety of federal and state and territory government departments, non-government agencies, peak bodies and interest groups.

The NCCC has an established track record in:

  • supporting change within the Australian health system;
  • developing casemix classification systems;
  • evaluating new service models and options for the redesign of services; and
  • developing funding models for clinical services.

 

Learn more about NCCC

About casemix

Casemix classifications provide the health care industry with a consistent method of classifying types of patients, their treatment and associated costs. In popular usage, casemix refers to the mix of types of patients treated by a hospital or other health care facility (Eagar and Hindle 1994).

Casemix classifications are useful because they help to explain the relationship between health care activity and costs. They make use of data about patients that are clinically meaningful and that explain variation in resource use.

The AR-DRG Classification System is used to classify acute admitted patients, with other casemix classifications being used to classify other patient care. All patients who are admitted to hospital have their disease/s and any procedure/s undertaken during the admission coded using ICD-10-AM/ACHI/ACS. This coding is undertaken by specialist clinical coding staff. This coded information along with some patient demographic data (such as age, sex, patient’s length of stay) is used to allocate acute patient admissions to an AR-DRG  class. DRG assignment is either performed by the clinical coder (if they are using coding and grouping software), or by the hospital and/or relevant state health authority.

Allocation of patient hospital episode using ICD-10-AM/ACHI, then AR-DRG

A hospital’s AR-DRG profile reflects the mix of acute care patients treated by the hospital. Cost weights are developed for each AR-DRG class that can be used for funding purposes in an Activity Based Funding or casemix funding model.

Apart from activity-based funding, casemix information is used in a number of data collections by organisations such as state health departments, the Australian Institute of Health and Welfare and the Australian Government Department of Health.

Activity-Based Funding (ABF)

Casemix analysis is pivotal to the Australian Government’s proposal for reform of the Australian health system called ‘A National Health and Hospitals Network for Australia’s Future’. A key feature of this reform proposal is the national introduction of Activity Based Funding (ABF) with the AR-DRG classification being used to define and count hospital ‘activity’ in relation to the treatment of acute admitted patients. Other casemix classifications are required to classify the other patient care that hospitals provide.

The CHSD has produced a series of short papers on ABF. This education and information series is designed to explain some of the key issues surrounding the Australian current hospital reform plan.

Australian Government Department of Health

  • Resource Utilisation and Classification Study (RUCS), 2019
  • Alternative aged care assessment, classification and funding models, 2017
  • Review of Activity Based Funding data, 2017
  • Predicting demand for rehabilitation or GEM care from acute care data (Download the ABF Conference presentation), 2016
  • Predicting demand for subacute services in Tasmania, 2015

Illawarra Shoalhaven Local Health District (ISLHD)

  • ABF capacity building projects, 2017
  • Ambulatory Case Initiative Phase 1: Strategy development for specialist outpatient services, 2016
  • Casemix and performance analysis for health service transformation (short course), 2015

NSW Ministry of Health ABF Taskforce

  • Review of costing data, 2017
  • Costing radiotherapy services, 2016 
  • Development of a small hospitals funding model for NSW, 2015
  • Developing an alternative funding model for small and regional hospitals (Download the PCSI Conference presentation), 2015
  • Development of NSW 2013 AR-DRG Relative Value Units for prostheses, 2013

South Eastern Sydney Local Health District (SESLHD)

  • A review of clinical costing methodologies at SESLHD, 2015
  • Overhead charges for mental health services in SESLHD, 2016
  • Length of stay and cost impact of hospital-acquired diagnoses – a manipulative model for SESLHD (Download the ABF Conference presentation), 2014
  • Budget evaluation (qualitative review), 2014

Silver Chain Health

  • Casemix capacity development, 2018

EnableNSW

  • Pilot methodology - casemix-based payment system for Prosthetic Limb Services, 2016

Australian Commission on Safety and Quality in Health Care (ACSQHC)

  • Environmental scan: Use of coded hospital administrative data for reviewing, reporting and improving the safety and quality of health care, 2014

Health Insurance Review and Assessment Service (HIRA), South Korea  

  • Casemix development program, 2013, 2014, 2015
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