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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 is prepared in accordance with the Requirements for Annual Reports, as issued by the Department of the Prime Minister and Cabinet and approved by the Joint Committee of Public Accountants Audit under sub sections 63(2) and 70(2) of the Public Service Act 1999. The report is a formal accountability document that details the activities of the Independent Hospital Pricing Authority (IHPA) from 1 July 2014 – 30 June 2015.
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.
The 2015-16 Pricing Framework builds on the three previous Pricing Frameworks (2012-13 Pricing Framework, 2013-14 Pricing Framework and 2014-15 Pricing Framework). For simplicity, where IHPA has reaffirmed a previous principle, the supporting argument has not been restated in this year’s paper. IHPA issued the Pricing Framework prior to releasing the NEP and NEC Determinations, which were made publicly available in March 2015.
This Discussion Paper develops the elements of a Draft Pricing Framework for use by the Independent Hospital Pricing Authority in the national implementation of activity based funding (ABF) for Australian public hospitals.