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The goal of the Consultation and review of the AR-DRG and ICD-10-AM/ACHI/ACS Classification Systems report was to review the end-to-end development processes, implementation arrangements and user needs in developing and implementing updates to the following classifications, now and into the future:
IHPA is responsible for relevant data collections to enable activity based funding. IHPA’s Data Access and Release Policy outlines the principles and processes adopted by IHPA in the discretionary access and release of data collected under the National Health Reform Act 2011. The Policy provides guidance as to how IHPA will determine whether to release data.
Each year, IHPA publishes the General List of In-Scope Public Hospital Services (the General List) as part of the National Efficient Price Determination.
The General List defines public hospital services eligible for Commonwealth funding, except where funding is otherwise agreed between the Commonwealth and a state or territory.
The purpose of the Policy is to outline the processes by which IHPA adjusts for instability in the year-on-year price weights and adjustments.
The purpose of the Assessing Materiality of Changes Proposed to the National Pricing Model document is to outline the process IHPA follows when assessing the materiality of proposed changes to the national pricing models such as the introduction of new adjustments or alternative pricing policy approaches.
The Public Interest Disclosure Act 2013 (the Act) regulates the internal reporting of suspected wrongdoing or disclosable conduct within public sector agencies. It provides a framework and protections for public officials who make eligible disclosures under the Act.
The IHPA Data Access and Release Policy (formerly Information Release Policy) outlines the principles and processes adopted by IHPA in the discretionary access and release of data under the National Health Reform Agreement and the National Health Reform Act 2011.
The ICD-10-AM/ACHI/ACS classification system is comprised of the following classifications:
- International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM)
- Australian Classification of Health Interventions (ACHI)
- Australian Coding Standards (ACS)
ICD-10-AM/ACHI/ACS Eleventh Edition is published as a set of five volumes which contain the following products:
The National Health Reform Act 2011 (the Act), section 131(1)(f), provides that IHPA will determine the public hospital functions that are to be funded in the states and territories by the Commonwealth, except where otherwise agreed between the Commonwealth and a state or territory.
The Back-casting Policy outlines the process IHPA follows when back-casting the NEP or the NEC for the purpose of the calculation of the Commonwealth’s funding, as set out in the NHRA (clause A40).
AR-DRG Version 9.0 Final Report
AR-DRG Version 9.0 was approved by the Pricing Authority in November 2016. Development of Version 9.0 was finalised following clinical and statistical analysis and in consultation with clinicians, jurisdictions and other health sector stakeholders. It has been used to price admitted acute episodes of care from 1 July 2018.
The AR-DRG Version 9.0 final report details the changes and rationale for the refinement process.
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.
This report presents the results of phase one of the project to develop Australian Refined Diagnosis Related Groups (AR-DRG)1 Version (V) 8.0. This phase focuses on the case complexity component of the classification that has not been reviewed for many years