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Subacute and non-acute care
Subacute care is defined as specialised multidisciplinary care in which the primary need for care is optimisation of the patient’s functioning and quality of life. A person’s functioning may relate to their whole body or a body part, the whole person, or the whole person in a social context, and to impairment of a body function or structure, activity limitation and/or participation restriction.
Subacute care comprises the following care types:
- Rehabilitation care
- Palliative care
- Geriatric evaluation and management (GEM) care
- Psychogeriatric care
Non-acute care comprises the following care type:
IHPA is responsible for the implementation of a nationally consistent activity based funding (ABF) system for subacute and non-acute care. The Australian National Subacute and Non-Acute Patient (AN-SNAP) classification system was selected by IHPA as the ABF classification system to be used for subacute and non-acute care.
AN-SNAP classification system
The AN-SNAP classification was developed as a casemix classification for subacute and non-acute care patients in a national study, the AN-SNAP Report of the National Subacute and Non-Acute Casemix Classification. The study was conducted by the Centre for Health Service Development, University of Wollongong in 1997. AN-SNAP classifies episodes of subacute and non-acute patient care that are provided in inpatient, outpatient and community settings. Patients are classified on the basis of setting, care type, phase of care, assessment of functional impairments, age and other measures.
The AN-SNAP classification was reviewed and updated by the Centre for Health Service Development, University of Wollongong to version 3 during 2011 and released in January 2012. IHPA has priced subacute and non-acute care services using AN-SNAP version 3 since July 2013.
In December 2013, the Centre for Health Service Development, University of Wollongong, was commissioned by IHPA to develop AN-SNAP version 4. The classification development process involved a significant level of consultation with jurisdictions, clinicians and other key stakeholders across the subacute sector throughout the project.
Five specialist clinical committees were established to support the classification development in the areas of palliative care, rehabilitation, GEM, psychogeriatrics and paediatrics and specialised statistical techniques to produce a fully revised version of the AN-SNAP classification that reflects current and evolving clinical practice. AN-SNAP version 4 was released May 2015 and will be used to price subacute and non-acute services from 2016-17.
Key AN-SNAP documents
- Standardised Mini-Mental State Examination (SMMSE)
- Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines, AIHW and IHPA
- Hospital service — care type, code N[N], AIHW
- Data set specifications
- Australian subacute and Non-acute Patient Classification fact sheet