Fourth national mental health plan: measurement strategy

NMHP PI 16 Rates of post-discharge community care

Page last updated: May 2011

  • Strategic issue - Service Access, Coordination and Continuity of Care.
  • Rationale - Transition in care from hospital to the community is identified as a critical time in the treatment continuum. Evidence suggests that immediately following discharge is a period of increased vulnerability, and that timely follow-up mitigates the risk of relapse. A responsive community support system for persons who have experienced an acute psychiatric episode requiring hospitalisation is essential to maintain clinical and functional stability and to minimise the need for hospital readmission.
  • Endorsement status - Endorsed by AHMAC Mental Health Standing Committee, February 2011.
  • Date last updated - January 2011.
Indicator details
National Mental Health Performance Framework
Data collection details

Indicator details

  • Description - Percentage of separations from the mental health service organisation's acute psychiatric inpatient unit(s) for which a community ambulatory service contact was recorded in the seven days immediately following that separation.
  • Numerator - Number of in-scope separations from the mental health service organisation's acute psychiatric inpatient unit(s) for which a community ambulatory service contact in which the consumer participated, was recorded in the seven days immediately following that separation.
  • Denominator - Number of in-scope separations for the mental health service organisation's acute psychiatric inpatient unit(s).
  • Computation - (Numerator Denominator) x 100.Calculated separately for public, private and MBS-funded services.
  • Calculation conditions
    • Coverage/Scope - All public mental health service organisations acute psychiatric inpatient units.
      • The following separations are excluded:
        • Same day separations.
        • Statistical and change of care type separations.
        • Separations that end by transfer to another acute or psychiatric inpatient hospital.
        • Separations that end by death, left against medical advice/discharge at own risk.
      • The following community ambulatory service contacts are excluded from the calculation:
        • Community ambulatory service contacts occurring on the day of separation.
    • Methodology
      • Implementation of this indicator requires the capacity to track service use across inpatient and community boundaries and is dependent on the capacity to link patient identifiers.
      • Where a mental health service organisation has more than one unit of a particular service type for the purpose of this indicator those units should be combined. Top of page
  • Definitions
    • Same day separations are defined as inpatient episodes where the admission and separation dates are the same.
    • An community ambulatory service contact is the provision of a clinically significant service by a specialised mental health service provider(s) for patients/clients, other than those patients/clients admitted to psychiatric hospitals or designated psychiatric units in acute care hospitals, and those resident in 24 hour staffed specialised residential mental health services, where the nature of the service would normally warrant a dated entry in the clinical record of the patient/client in question.
  • Presentation - Percentage.
  • Disaggregation - State/Territory and age.
  • Notes
    • The reliability of cross-jurisdictional comparisons on this indicator is dependent on the implementation of statewide unique patient identifiers as the community services may not necessarily be delivered by the same mental health service organisation that admits the patient.
    • This measure does not consider variations in intensity or frequency of service contacts following discharge from hospital.
    • This measure does not distinguish qualitative differences between phone and face-to-face community contacts.
  • Is specification interim or long-term? - Long-term.
  • Reported in:
    • COAG National Action Plan Progress Report.
    • Report on Government Services. Top of page

National Mental Health Performance Framework

  • Tier - Tier III - Health System Performance.
  • Primary domain - Continuous.
  • Secondary domain(s) - Accessible and safe.
  • Mental health sub-domain - Cross-setting continuity.
  • Type of measure - Process.
  • Level at which indicator can be useful for benchmarking
    • Service Unit.
    • Regional group of services.
    • Mental Health Service Organisation.
    • State/Territory.
  • Related performance indicators and performance benchmarks
    • 28 day readmission rate.
    • Average length of acute inpatient stay.
    • Post-discharge community care. Top of page

Data collection details

  • Data source(s)
    • Numerator - State/territory admitted patient and community mental health care data.
    • Denominator - State/territory admitted patient mental health care data.
  • Data source(s) type
    • Numerator - Administrative by-product.
    • Denominator - Administrative by-product.
  • Frequency of data source(s) collection
    • Numerator - Annually.
    • Denominator - Annually.
  • Data development
    • Short-term - Nil.
    • Medium-term - Nil.
    • Long-term - Full implementation of this measure requires unique statewide patient identifiers not currently available in all jurisdictions.