NEW ZEALAND HEALTH INFORMATION SERVICE
Home > technical documentation
Appendix B: Glossary
[A (PDF, 94 KB) of this Glossary is also available.]
Introduction
Included in this glossary are terms defined by the National Data Policy Group. Some of these terms may not be currently used in the national statistical collections. Some definitions may differ from those used in specific current collections.
Admission
The documentation process, which may include entry to the NHI, by which a person becomes resident in a healthcare facility. For the purposes of the national collections, healthcare users who attend for more than three hours should be admitted.
Healthcare users who receive treatment for more than three hours or who have a general anaesthetic are to be admitted. This also applies to health care users of emergency departments.
When calculating the three hours, exclude waiting time in a waiting room, exclude triage and use only the duration of treatment. If part of the treatment is observation, then this time contributes to the 3 hours. ‘Treatment’ is clinical treatment from a nurse or doctor or other health professional.
Acute admission
An unplanned admission on the day of presentation at the admitting healthcare facility. Admission may have been from the Emergency or Outpatient Departments of the healthcare facility. If the patient is admitted from A&E, then the time of admission should include the time spent in A&E. Treatment carried out in A&E is to be coded on the inpatient event.
Additional diagnosis
A condition or complaint either co-existing with the principal diagnosis or arising during the episode of care or attendance at a healthcare facility.
For coding purposes, additional diagnoses should be interpreted as conditions that affect patient management in terms of requiring any of the following:
– therapeutic treatment
– diagnostic procedures
– increased nursing care and/or monitoring.
AHB
Area Health Board. AHBs were health funding bodies until 1 July 1993. They were replaced with four Regional Health Authorities.
Arranged admission
A planned admission where:
– the admission date is less than seven days after the date the decision was made by the specialist that this admission was necessary, or
– the admission relates to normal obstetric cases, 36 to 42 weeks gestation, delivered during the event. These patients will have been booked into the admitting facility. The health specialty code will always be within P10 Delivery Services (Mothers).
Attendance
An encounter where the healthcare user goes to the healthcare provider.
Bed equivalent
The term ‘bed equivalent’ includes the categories beds, cots/bassinets, incubators, and special day-patient chairs that can accommodate a patient after admission to a healthcare facility.
Boarder
A boarder is a person who is receiving food and/or accommodation but for whom the hospital does not accept the responsibility for treatment and/or care. However, a hospital may register a boarder. This excludes all babies born in hospital. Boarders are not required to be reported to the NMDS.
CHE
Crown Health Enterprise. This term was used to refer to hospitals from 1 July 1993 to 31 December 1997,first under Regional Health Authorities, and then under the Transitional Health Authority (THA).
Community client
A person receiving healthcare assistance from outside of a healthcare facility.
Community patient
A healthcare user who receives treatment, therapy, advice or diagnostic services outside of a healthcare facility, eg, those in the care of a community mental health team.
Community support
A community client not resident in a healthcare facility who receives assistance only with the normal activities of daily living, or visits for monitoring purposes only where there is no active treatment or clinical intervention, eg, those receiving:
– nappy/linen service
– meals on wheels
– home care
– attendant care
– home help
– hygiene and dressing assistance
– visits from a DHB well elderly visitor
– accredited visitors
– befriending schemes.
Community support clients are healthcare non-users.
Day patient
A patient admitted for healthcare with a length of stay less than one day, regardless of intent. See also ‘Admission’ and ‘Intended day case’.
DHB
District Health Board. The 21 DHBs are the current health funding bodies, introduced on 1 January 2001.
‘Did Not Attend Outpatient Clinic Appointment’ (DNA)
A patient is classified as DNA if they did not attend the outpatient clinic appointment and there was no communication before the appointment. If there was communication, this is deemed to be a cancellation.
Discharge
The process of documentation that changes the status of an admitted healthcare user.
Domiciliary service
A domiciliary service is aimed at the treatment of healthcare users in the community in their home. This sub-categorisation of community service is no longer in common usage.
Elective admission
A booked admission on a date more than seven days after a specialist decision to admit or a patient who was placed on a waiting list without a specific date being given.
First specialist assessment
The first assessment by a registered medical practitioner or nurse practitioner for a particular referral (or, with a self-referral, for a discrete episode). The healthcare user receives treatment, therapy, advice, diagnostic or investigatory procedures at a health care facility and leaves within 3 hours of the start of the consultation. Service is provided in ward and/or at designated outpatient clinic. Excludes Emergency Department attendances and outpatient attendance for pre-admission assessment/screening.
Follow-up attendances
Healthcare user sees a registered medical practitioner or nurse practitioner for services, following the first specialist assessment for a particular referral. The healthcare user receives treatment, therapy, advice, diagnostic or investigatory procedures at a health care facility and leaves within 3 hours of the start of the consultation. Includes post-discharge follow-up, including new clinic attendance. Service is provided in ward and/or at designated outpatient clinic. Excludes Emergency Department attendances and attendances specified as separate purchase units.
Forensic psychiatry
Forensic psychiatry is that branch of psychiatry which requires special knowledge and training in the law as it relates to the mental state of the offender (or alleged offender), and training in the assessment, treatment and care of persons who have offended or who are alleged to have offended or appear likely to do so because of their psychiatric condition.
Health agency facility
A place that may be permanent, temporary or mobile (excluding supervised hostels, halfway houses and staff residences), which people attend or are resident in, for the primary purpose of receiving healthcare or disability support services (ie, would not be resident if no need for healthcare).
Healthcare user (HCU)
A person booked to receive or receiving healthcare resulting from direct contact with a healthcare provider where the healthcare results in the use of resources associated with observation, assessment, diagnosis, consultation, rehabilitation or treatment.
Healthcare non-user
A person in contact with the health service but not booked to receive or receiving healthcare.
HFA
Health Funding Authority. The HFA was the health funding body from 1 January 1998 to 12 December 2000. It was replaced with the District Health Boards.
HHS
Hospitals and Health Services. This term was used to refer to hospitals from 1 January 1998 to 12 December 2000, under Health Funding Authorities.
Intended day case
A patient where the intention at admission is that the event will be a day case event.
Inpatient
A patient admitted for healthcare, where the intention at admission was that this would not be a day case event. Includes patients who are transferred from another healthcare facility, but not interdepartmental transfers within the same hospital.
Inpatient length of stay
The time in days between admission to hospital ‘X’ and discharge, death or transfer from hospital ‘X’, minus leave days from hospital ‘X’.
Leave
The planned absence of an inpatient from the healthcare facility to which they were most recently admitted. Leave is counted only where that patient is absent at midnight and has a planned return within three nights of going on leave, for the continuation of their treatment or care. If after three days for non-psychiatric hospital inpatients or 14 days for informal mental health inpatients the patient has not returned to care, discharge is effective on the date of leaving hospital. Where there is more than one period of leave during an episode, accumulated leave days should be reported. NZHIS will be notified when formal or sectioned patients have been on leave for 14 days.
This definition does not cover sectioned Mental Health Service patients whose leave definitions are included in the Mental Health (Compulsory Assessment and Treatment) Act 1992.
Leave days
The number of days an inpatient on leave is absent from the hospital at midnight, up to a maximum of three days (midnights) for non-psychiatric hospital inpatients and 14 days (midnights) for informal psychiatric patients. If after three days for non-psychiatric hospital inpatients or 14 days for informal psychiatric inpatients the patient has not returned to care, discharge is effective on the date of leaving hospital. This period of leave is not to be reported in the event leave days field. Where there is more than one period of leave during an episode, accumulated leave days should be reported. NZHIS will be notified when formal or sectioned patients have been on leave for 14 days.
Longstay
A healthcare user who has received continuous inpatient care, regardless of periods of leave and location, for a period as specified by the requirement of the service or data user.
Mass contacts
Healthcare non-users whose only contact with the health service is through health promotion or screening campaigns.
Measures
These are cumulative stays that are incremented at midnight:
(a) Unoccupied bed equivalent days per period
(b) Occupied bed equivalent days per period
(c) Resourced bed equivalent days per period.
Percentage occupancy = (occupied bed days per period / resourced bed days per period) x 100.
Turnover rate = (admissions / number of days in period) / resourced bed days per period.
Turnover interval = unoccupied bed days per period / (admissions x number of days in period).
Five-day wards need to be handled carefully. They have five resourced bed days per week but only four bed-equivalent days, as they are counted at midnight. The denominator used should be four resourced bed days rather than five; otherwise 100 percent occupancy would not be possible.
Mental health first admissions
A patient admitted for the first time with a mental illness diagnosis.
Mental health readmissions
A patient admitted for subsequent treatment of a mental illness.
NCCH
National Centre for Classification in Health, Sydney University, Australia. See http://www2.fhs.usyd.edu.au/ncch/.
NDPG
National Data Policy Group. A sectorwide consultation and decision-making group set up by NZHIS.
New Zealand Health Information Services (NZHIS)
New Zealand Health Information Service is a group within the Ministry of Health responsible for the collection and dissemination of health-related data.
Occupied bed equivalent
A resourced bed equivalent that is assigned to an admitted patient who is not on leave.
Old longstay
A client who has achieved old longstay status as at July 1991. This status results from continuous residence in a psychiatric hospital since 1 April 1975, except for periods of absence of less than one year.
Outpatient
An outpatient is a patient who receives a pre-admission assessment, or a diagnostic procedure or treatment at a healthcare facility, and who is not admitted, and the specialist’s intent is that they will leave that facility within 3 hours from the start of the consultation.
When patients receive a general anaesthetic they are deemed not to be outpatients. See ‘Follow-up attendance’.
Outpatient clinic
A scheduled administrative arrangement enabling outpatients to receive the attention of a healthcare provider. The holding of a clinic provides the opportunity for consultation, investigation and minor treatment, and patients normally attend by prior arrangement. The clinic may be held on or off the hospital site. See ‘Follow-up attendance’.
Patient
This term is synonymous with ‘healthcare user’.
PMS
A facility’s local patient management system.
Principal diagnosis
The diagnosis established after study to be chiefly responsible for causing the patient’s episode of care in hospital (or attendance at the healthcare facility).
The phrase “after study” in the definition means evaluation of findings to establish the condition that was chiefly responsible for the episode of care. Findings evaluated may include information gained from the history of illness, any mental status evaluation, specialist consultations, physical examination, diagnostic tests or procedures, any surgical procedures, and any pathological or radiological examination.
The condition established after study may or may not confirm the admitting diagnosis.
Procedure
A discrete therapeutic or diagnostic intervention.
Recurrent-care patient
A patient who attends as a day patient but where the intention is for recurring day therapy, eg, renal dialysis, chemotherapy, geriatric, paediatric care.
Recurrent-care psychiatry
A patient who attends at a day/recurrent-care facility, staffed by a mental health service (excluding substance abuse and forensic services), for a period of more than 3 hours and less than one day, including treatment/education/promotion services.
Referral
Referral is a request for the shifting of responsibility. The actual transfer of responsibility is recorded by (usually) a change from one status to another, or a change of responsible clinician. The request may precede the assumption of responsibility by some time, the difference being the waiting time.
Rehabilitation
Intensive therapy and skill retraining required, after an acute treatment period, to permit an independent or semi-independent existence outside the hospital environment.
Resourced bed equivalent
A bed equivalent that is resourced to accommodate an admitted patient. Resources must include staff, linen, etc. The old term ‘commissioned bed’ corresponds with the term ’resourced bed’.
Respite/crisis care
A short-term admission, usually in order to give a carer respite from the provision of care.
RHA
Regional Health Authority. The four RHAs were the health funding bodies from 1 July 1993 to 1 July 1997. They were replaced with a single Transitional Health Authority.
THA
Transitional Health Authority. The THA was the single health funding body from 1 July 1997 to 31 December 1997. It was replaced with the Health Funding Authority.
Total attendances
The sum of first and follow-up attendances.
Transfer
The physical movement of a healthcare user within a healthcare facility not involving a change of healthcare status. The transfer of responsibility is signalled when a referral is accepted.
Unoccupied bed equivalent
A resourced bed equivalent that is not an occupied bed equivalent. The old term ‘commissioned bed’ corresponds with the term ‘resourced bed’.
Visit
An encounter where the healthcare provider goes to the healthcare user.