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AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE (AIHW)


NAME OF COLLECTION

National Hospital Morbidity Database (NHMD)


OVERVIEW

The National Hospital Morbidity Database is compiled by the Institute from data supplied by state and territory health authorities. It is a collection of electronic confidentialised summary records for 'separations' (that is, episodes of care) in public and private hospitals in Australia. Almost all hospitals in Australia are included: public acute, public psychiatric hospitals, private acute and psychiatric hospitals, and private free-standing day hospital facilities.

Separations can be a total hospital stay (from admission to discharge, transfer or death), or a portion of a hospital stay beginning or ending in a change of type of care (for example, from acute to rehabilitation). A record is included for each separation, not for each patient. So patients who separate more than once have more than one record in the database.

The collection includes data for the years from 1993-94 to 2005-06.


SCOPE

The National Hospital Morbidity Database includes data from public acute and (until 1997-98) Department of Veterans' Affairs hospitals, public psychiatric hospitals, private acute and psychiatric hospitals, and private free standing day hospital facilities.

The major exceptions within the public sector are hospitals operated by the Department of Defence, correctional facilities and hospitals located in off-shore territories. There are also some exceptions within the private sector, for example data are not available for some years for a few small private hospitals and private free-standing day hospital facilities in some jurisdictions.

The scope of the data collection has also varied from year to year. Comparisons between the states and territories, reporting years and hospital sectors should be therefore made with caution. 


DATA DETAIL

The main data items include:

• Demographic data
  • Sex
  • Date of birth
  • Age, age group (in 5-year groups)
  • Country of birth (from 1996-97)
  • Indigenous status
  • State and local area of residence (Statistical Local Area, Statistical Subdivision, Statistical Division, from 1997-98)
  • Rural, Remote and Metropolitan Areas of patient's residence (from 1995-96)
  • Remoteness Area of patient's residence (from 2000-01)

• Establishment data
  • State or territory of the hospital
  • Sector (public, private)
  • Rural, Remote and Metropolitan Areas and other characteristics of the hospital (from 1995-96, and only for public hospitals)
  • ARIA (Accessibility/Remoteness Index of Australia) of the hospital (from 1998-99, and only for some jurisdictions)
  • Remoteness Area of the hospital (from 2000-01)

• Administrative data
  • Funding source data elements including Admitted patient election status, Funding source for hospital patient, Department of Veterans' Affairs patient and Medicare eligibility status
  • Urgency of admission

• Length of stay data
  • Admission and separation dates
  • Leave days
  • Same day flag (to indicate separation/discharge on the same day as admission)

• Clinical and related data
  • Principal diagnosis (the diagnosis established after study to be chiefly responsible for occasioning the patient's episode of care in hospital)
  • Additional diagnoses (include coexisting conditions and/or complications)
  • Procedures (surgical and non-surgical)
  • Major Diagnostic Category (MDC) and Australian Refined Diagnosis Related Group (AR-DRG)
  • Estimated average cost for the AR-DRG (for the public and private sectors)
  • Care type (for example acute, rehabilitation, palliative, newborn) (from 1995-96 for some jurisdictions; the newborn category was introduced in 1998-99)
  • Admission mode (source from which the person was transferred/referred)
  • Separation mode (status at separation: discharge/transfer/death and place to which person is released)
  • Intended length of stay (same day or overnight)
  • External causes of injury or poisoning
  • Places of occurrence of external cause
  • Activity when injured (from 1998-99)

• Diagnoses, procedures and external causes of injury are recorded using the International Classification of Diseases (ICD)

• State/territory
• Statistical Division, Statistical Subdivision, Statistical Local Area
• Rural, Remote and Metropolitan Areas
• Remoteness Areas