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This document provides the technical specifications for how the Independent Hospital Pricing Authority (IHPA) developed the Activity Based Funding (ABF) models for the service streams to be funded for the National Efficient Price (NEP) and the National Efficient Cost (NEC) Determinations for 2016-17.
The Independent Hospital Pricing Authority is committed to providing the Australian health care industry with a nationally consistent method of classifying all types of patients, their treatment and associated costs. Consequently, resources continue to be devoted to the ongoing development of a Diagnosis Related Groups (DRG) classification system based on local clinical practice.
ICD-10-AM/ACHI/ACS Ninth Edition was implemented between 1 July 2015 and 30 June 2017 for classifying episodes of admitted patient care across Australian hospital services.
The ICD-10-AM/ACHI/ACS classification system is comprised of the following classifications:
The Australian Refined Diagnosis Related Group (AR-DRG) Version 8.0 was implemented from July 1, 2016 and is the Australian Diagnosis Related Group (DRG) patient classification system that provides a clinically meaningful way of relating the types of patients treated in the hospital to the resources required by the hospital. AR-DRGs incorporate the ICD-10-AM/ACHI/ACS.
The AR-DRG Version 8.0 is published as a set of three Definition Manuals described below.
This document provide the technical specifications for how the Independent Hospital Pricing Authority (IHPA) developed the Activity Based Funding (ABF) models for the service streams to be funded for the National Efficient Price (NEP) and the National Efficient Cost (NEC) Determinations for 2015-16.
This document was produced as an accompaniment to the NEP13 and NEC13 Determinations. It provides the technical specifications for how IHPA developed the ABF models for the service streams to be funded on this basis from 1 July 2012, and provides guidance to hospitals, Local Health Networks (LHN) and state and territory health authorities on how to apply these to hospital activity.