You are here
The Pricing Framework for Australian public hospital services 2019-20 builds on the seven Pricing Frameworks from previous years. The Pricing Framework is the key strategic document underpinning the National Efficient Price (NEP) and National Efficient Cost (NEC) Determinations for the financial year 2019-20.
This document provides background to the development of the new classification, explains the data elements and collection protocols, reporting requirements, and how the data is grouped.
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.
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.