AROC Inpatient
Clinical Data Set
Background to the data collection
In developing the Version 1 AROC data set, the objective
was to include data items that are routinely collected by
a majority of providers and to conform with the National
Health Data Dictionary (NHDD) wherever possible. The Australian
Minimum Data Set for Rehabilitation, developed by the AFRM,
was used as the basis for the AROC clinical data set. The
AROC Inpatient Clinical Data Set includes information about
the rehabilitation service, the person receiving the rehabilitation,
administrative details about the period of rehabilitation
care and clinical characteristics. The majority of data items
will be collected at the beginning of an episode with some
items, such as the outcome measure, accommodation and level of support
needing to be collected at the completion of an episode as
well. The version 1 AROC Clinical Data Set was developed using
the following principles:
- Where a NHDD definition exists, and is consistent with
AROC requirements, it is incorporated in the AROC data set
exactly as it appears in the NHDD;
- Where a NHDD definition exists, but is less detailed
than AROC requires, it is incorporated in the AROC data
set using a codeset that can be mapped to the NHDD codeset;
- Where a data item is required for AROC purposes but does
not exist in the NHDD, it is incorporated in the AROC dataset
based on an agreed industry definition.
Versions of the AROC
Inpatient Clinical Data Set
AROC commenced data collection in July 2002 with Version
1 of the AROC Clinical Data Set. This version of the data
set remained in use until September 2003 when the AROC Clinical
Data Set Version 2 was implemented.
All inpatient episodes of rehabilitation discharged from a
participating rehabilitation facility up to and including
June 2007 were submitted to AROC conforming to the version
2 data specifications.
The Version 3 AROC Inpatient Clinical
Data Set was implemented in July 2007. The Version 3 data
set's implementation was in line with the implementation of
the AN-SNAP Classification Version 2,
the release of the Australian Impairment
Codes Version 1 and the release of the latest version
of SNAPshot.
Regardless of the version of the AROC data sets, facilities
submit their data directly to the AROC database via AROC
Online Services.
Impairment codes
AROC commenced data collection in July 2002 with Version
1 of the AROC Clinical Data Set. This version of the data
set used a modified version of the UDS impairment codes (modified
in that AROC did not use impairment code 17). When the AROC
Clinical Data Set changed to Version 2
in September 2003 these codes remained unchanged.
In late 2006 and early 2007 a sub-committee of the AROC Scientific
and Clinical Advisory Committee reviewed the impairment codes
to ensure clinical relevance in the Australian environment.
The result of this review is a revised set of codes, known
as the Version 1 Australian Impairment
Codes, implemented 1 July 2007 in line with the Version
3 AROC Inpatient Clinical Data Set.
A full mapping of the impairment codes
between the modified UDS version and the new Version 1 Australian
Impairment Codes is available, however, the main changes to
the impairment codes are:
- reclassification of orthopaedic impairment
group
- first level splits the category into replacement/repair,
or fracture/dislocation
- next level identifies the body part
- two additional classes in the Pain impairment
group
- headache (including migraine)
- multi-site pain
- the renaming of the Debility impairment group
to Reconditioning/Restorative and the inclusion of three
classes within this category
- post surgical management
- post medical management
- cancer rehabilitation
- additional classes under Non Traumatic Brain
Injury
- sub-arachnoid haemorrhage
- anoxic brain damage
- other non traumatic brain
- removal of a number of 'other' categories
AN-SNAP classification
The Australian National Sub-Acute and Non-Acute Patient (AN-SNAP)
classification was developed in 1996, a result of a
study conducted by the Centre
for Health Service Development. When AROC commenced data
collection in July 2002 with Version 1 of the AROC Clinical
Data Set, casemix analysis was conducted using the Version
1 AN-SNAP classification.
In 2006, after 10 years of use, it was decided that it was
time to review the AN-SNAP classification to ensure it was
still in keeping with clinical practice. NSW Health commisioned
the Centre for Health Service
Development to undertake this review. The review took
several months and involved many clinicians from around the
country. The result of the review is the Version
2 AN-SNAP classification. The Version
3 AROC Inpatient Clinical Data Set is able to use either
version for casemix classification, however, all benchmark
reports will use the Version 2 AN-SNAP
classification.
Clinical indicators
In 2007 AROC and the AFRM jointly completed a review of the
ACHS Rehabilitation Medicine Clinical Indicators. This review
has resulted in revised indicators being implemented on 1 January 2008. The six indicators that comprise the new Version 4 ACHS
Rehabilitation Medicine Clinical Indicators (available to
download below) are:
- Timely assessment of function on admission
- Assessment of function prior to patient episode end
- Timely establishment of a multi-disciplinary team rehabilitation
plan
- Discharge plan prior to patient separation
- Functional gain achieved by rehabilitation program
- Destination after discharge from a rehabilitation program
There are two new indicators in Version 4 (functional gain
achieved and discharge destination), while others have been
slightly modified. Two indicators have been deleted (mortality
and interruptions).
It is a goal of AROC's that in the near future we will be
able to assist rehabilitation facilities with sending ACHS
their Rehabilitation Medicine Clinical Indicators. As such,
the Version 3 AROC Inpatient Clinical
Data Set now contains all data items necessary for the
collection and compilitation of the ACHS Rehabilitation Medicine
Clinical Indicators.
AROC recommend that rehabilitation units collect all relevant
Hospital Wide indicators as well as the Rehabilitation Medicine
indicators.
Download the AROC Clinical
Data Set & supporting documents
- Effective for episodes ending
as of 1 July 2007:
Data Item Compliance
All items in AROC data sets are mandatory and should be collected
and submitted to AROC. It
is important that all submitted data conform to the specified
format, therefore, if a facility is unable to collect
some items in the AROC data set space for them should be included
in their data extract. Facilities submit their data directly
to the AROC database via AROC
Online Services.
Data Audit
All data submitted to AROC
undergoes a comprehensive audit process. Episodes with missing
data and definite or potential errors are notified to the
submitting facility by email for review and correction. Corrected
data should be resubmitted to AROC via AROC
Online Services (AOS). Further details about what is checked
in the AROC Data Audit process, and what the errors and crosschecks
all mean can be found in Appendix 2 of the AOS
user's guide.
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