The Victorian Admitted Episodes Dataset VAED whats it for

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The Victorian Admitted Episodes Dataset (VAED)
whats it for?
Andrew Brown Manager Health Data Standards
Systems DHS Victoria Information Management
Community of Practice Open Forum 2008-06-19
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The Data Black Hole
Black Hole at centre of Virgo Cluster (Hubble)
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Overview
Using the VAED to demonstrate that DHS is not
really a data black hole.

• What is the VAED?
• History, context, background.
• Uses of the VAED.
• The future of the VAED.

Housekeeping Its OK to ask questions as we go.
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What is the VAED?

• The Victorian Admitted Episodes Dataset (VAED) is
  an administrative data collection used to record
  and report on all admitted patient activity in
  Victoria.

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

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Terminology

• VAED
• The Victorian Admitted Episodes Dataset is the
  name of the data collection.
• PRS/2
• The Patient Reporting System (version 2) is the
  software processing system and interface through
  which the VAED is collected by DHS.

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Exciting VAED trivia!

• Scope
• All public and private acute hospitals, including
  acute facilities in rehabilitation and extended
  care institutions and day procedure centres, are
  required to report the relevant minimum data set
  of admitted patient activity.

Public 147Private 152
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More exciting VAED trivia!!

• Enabling Legislation
• Data is collected under the authority of Section
  9 of the Victorian Health Act 1958.

9 Data collection The Secretary
must (a) establish a comprehensive information
system which includes information on (i) the
causes, effects and nature of illness among
Victorians and groups of Victorians
and (ii) the determinants of good health and ill
health and (iii) the utilisation of health
services in Victoria and (b) analyse and
disseminate this information widely to members of
the public.
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More exciting VAED trivia!!

• Enabling Legislation
• Data is collected under the authority of Section
  9 of the Victorian Health Act 1958.

9 Data collection The Secretary
must (a) establish a comprehensive information
system which includes information on (i) the
causes, effects and nature of illness among
Victorians and groups of Victorians
and (ii) the determinants of good health and ill
health and (iii) the utilisation of health
services in Victoria and (b) analyse and
disseminate this information widely to members of
the public.
(b) analyse and disseminate this information
widely to members of the public.
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More exciting VAED trivia!!!

• Enabling Legislation (Privates)
• ...and under the authority of Section 47 of the
  Victorian Health Services (Private Hospitals and
  Day Procedure Centres) Regulations 2002.

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

The green highlights show the data elements
specified in the Health Services (Private
Hospitals and Day Procedure Centres) Regulations
2002.
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Even more exciting VAED trivia!!!!

• How old is the VAED?
• 1979-80 Started as Victorian Inpatient Minimum
  Database (VIMD) 50 hospitals
• 1987-88 Electronic data available
• 1992-03 Episodes of care
• 1995-96 Newborn reporting (publics)
• 1999-00 Name change to VAED

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Exciting VAED trivia with big numbers!!!!!

• How big is the VAED?
• 79 data elements x
• 299 reporting units x
• Approx. 2,000,000 separations pa
• 47 billion pieces of data each year

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Not quite so exciting HDSS trivia but related to
the VAED none the less

• Who looks after the VAED?
• Operated by the Health Data Standards and
  Systems (HDSS) Unit
• PRS/2 is hosted by a FM company (The Pay
  Office) at an off-site location
• 2 staff for collection management and operations
• 1 IT support contractor
• 1 P/T staff member 1 P/T contractor dedicated
  to the Victorian ICD Coding Committee (VICC)
• 1 P/T staff member for VAED audit
• 1 P/T staff member for VAED education

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The 409kg Gorilla of data collections
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Whats it for?

• Casemix Funding
• Casemix funding was introduced in Victoria in
  1993-94.
• The VAED supports Casemix funding through its
  diagnosis and procedure codes, and other
  administrative items.

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Casemix funding in 2 minutes...
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Casemix funding
ICD-10-AM codes
Length of Stay
Grouper module
DRG
WIES module
PRS/2
WIES value ()
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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

The orange data elements are used to support
funding.
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Whats it for?

• Casemix Funding (II)
• 3.0 bn is paid to acute hospitals in the form
  of WIES payments.

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Whats it for?

• Other Acute Funding
• 400m is paid for acute services in other grants
  most of which are apportioned in some way by
  use of data wholly or partly from the VAED
• Training and Development and Research grants
• Complexity, Early graduates, Workforce
  priorities, Research
• Access, performance and incentive grants
• elective surgery access bonus funding, Trauma,
  transplants, NETS, PETS, Maternity services,
  Integrated Cancer Services, Maintenance dialysis,
  Long stay older patients, vulnerable children,
  medical displan, neonatal hearing screening,
  quality and safety and workforce and service
  planning
• Specified grants
• Includes complexity, contracts and formula,
  awards, adjustments, incl critical and neonatal
  care, and other hospital-specific grants

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

The orange data elements are used to support
funding.
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Whats it for?

• Subacute Admitted Funding
• Approximately 400m is paid for subacute admitted
  services either VAED funded or VAED data
  assisted in calculation of grants.
• VicRehab sub-acute rehabilitation patients in
  designated units
• CRAFT casemix system for rehabilitation
• Geriatric Evaluation and Management (GEM)
• Palliative care
• Transition care
• Interim care
• NHT days
• Post acute care

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

The orange data elements are used to support
funding.
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Whats it for?

• Reconciliation for Third-Party payers
• Department of Veterans Affairs (DVA)
• Transport Accident Commission (TAC)
• WorkSafe Victoria (VWA)
• Cross-border agreements with other states
• Reciprocal health care arrangements with other
  countries

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

The orange data elements are used to support
funding.
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Whats it for?

• DHS also has reporting obligations
• Requirement to report to Commonwealth Government
  under the Australian Health Care Agreements
  (AHCA)

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Australian Hospital Statistics
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Whats it for?

• DHS also has reporting obligations
• Requirement to report to Victorian Treasury
  under ERC requirements
• Performance targets
• Health Care for diverse populations and
  Indicators of Cultural and Language Diversity
• Your Hospitals Report

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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

Pink data elements that support DHS reporting
obligations.
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Whats it for?

• The VAED is a collection of hospital morbidity
  and health service activity.

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Whats it for?

• The data collection is used extensively within
  DHS to support programs, it
• Monitors effectiveness
• Helps advise on policy decisions
• Helps set funding priorities and develop funding
  models

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Whos it for?

• Examples of program users
• Mental Health Branch
• Integrated Cancer Services
• Palliative Care
• Aged Care
• Quality and Safety
• Maternity Services

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Whats it for?

• VAED is used to monitor health sector
  performance
• Hospital finance performance
• Metro Health finance branch
• Rural Regional Health Aged Care
• KPI measurement
• Private hospitals
• Capital planning

35
The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

Purple data elements that have been included to
assist program monitoring. (Note only one
black one left!)
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Whats it for?

• ...information on... (i) the causes, effects
  and nature of illness among Victorians and groups
  of Victorians and (ii) the determinants of
  good health and ill health
• Hundreds of ad hoc requests for VAED information
  are processed each year from other government
  departments, for ministerial briefings, the
  private sector, researchers and the media.

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Data Linkage

• Increased interest in data linkage of VAED
  linking it with itself and with other
  collections
• VAED for continuity of care
• VEMD for NAESG
• ACAS data set allowed removal of Hospital Bed
  Census collection and reduced data collection
  burden
• ESIS for Elective Surgery blitz initiative

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The future of the VAED
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The future of the VAED

• PRS/2 effectively 1980s technology (PRS) with a
  1990s upgrade (PRS/2).
• Problems with the structure of the data
  collection, such as limits on numbers of
  reportable instances of various items, limited
  numbers of changes per day.
• Plans for revision
• 1. Internal work to identify problems, solutions
  and changes.
• 2. Internal DHS consultation to explore impacts
  and feedback from data users.
• 3. Develop straw man proposal for change.
• 4. Consult with Data Providers and their Software
  Vendors.
• 5. Examine impacts on output reporting.
• 6. Synthesise into proposal specification for
  change.
• 7. Consultation.
• 8. Release final spec for implementation mid
  2009.
• 9. Implementation...

NB This slide was not part of the original
presentation but was added for web publication.
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The VAED Data Elements
Indigenous Status Intended Duration of
Stay Intention to Re-Admit Interpreter
Required Leave With Permission Days Leave
Without Permission Days Level of
Insurance Locality Marital Status Medicare
Number Medicare Suffix Mental Health Legal
Status Mental Health Statewide Patient
Identifier Onset Date Palliative Care Patient
Days Patient Days Patient Identifier Postcode Pre
ferred Language Procedure Codes Qualification
Status RUG ADL Separation Date Separation
Mode Separation Referral Separation
Time Sex Source of Referral to Palliative
Care Surname TAC Claim Number Transfer
Destination Transfer Source Unique Key

• ACAS Status
• Accommodation Type
• Account Class
• Admission Date
• Admission/Re-Admission to Rehabilitation
• Admission Source
• Admission Time
• Admission Type
• Admission Weight
• Barthel Index Score
• Campus Code
• Carer Availability
• Care Type
• Clinical Sub-Program
• Contract Leave Days
• Contract Role
• Contract/Spoke Identifier
• Contract Type
• Country of Birth

This makes it go!
Whats Unique Key for? It makes the VAED go!
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