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  • Health‑related classifications have multiple purposes, including the facilitation of data collection and management in the clinical setting, the analysis of data to inform health policy, and the allocation of financial and other resources. This section provides a short description of the classification systems referenced in this report.

    Australian Classification of Health Interventions

    The Australian Classification of Health Interventions (ACHI) is the Australian national standard for procedure and intervention coding in Australian hospitals.

    The National Centre for Classification in Health (NCCH) developed the ACHI based on the Medicare Benefits Schedule (MBS). The MBS is a fee schedule for Medicare services including general practice consultations, specialist consultations, surgical procedures and other medical services, such as diagnostic investigations and optometric services. The Department of Health (DOH) updates the MBS at least twice each year and these code changes are incorporated into the ACHI or the MBS codes are mapped to existing ACHI codes.

    The ACHI classifies procedures and interventions performed in public and private Australian hospitals, day centres and ambulatory settings, as well as allied health interventions, dentistry and imaging. The structure of the ACHI is anatomically based, rather than based on the medical specialty.

    To maintain parity with disease classification, ACHI chapters resemble the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD‑10-AM chapters). The ACHI is updated biennially by the National Centre for Classification in Health (NCCH), as the lead organisation of the Australian Consortium for Classification Development (ACCD), in line with the disease section of the ICD‑10‑AM. Use of the codes is guided by the Australian Coding Standards of the ICD‑10‑AM.

    Further information on the ACHI is available from the ACCD website.

    Australian Standard Geographical Classification

    The Australian Standard Geographical Classification (ASGC) was developed by the Australian Bureau of Statistics (ABS) for the collection and dissemination of geographically classified statistics. It is an essential reference for understanding and interpreting the geographical context of Australian statistics.

    In this report the ASGC applies to the data presented by remoteness area. This is based on the Accessibility/Remoteness Index of Australia, which measures the remoteness of a point based on the physical road distance to the nearest urban centre.

    This report uses the ASGC to present data in the following categories:

    • Major cities
    • Inner regional
    • Outer regional
    • Remote
    • Very remote

    The ASGC has been replaced by the Australian Statistical Geography Standard (ASGS).

    Australian Statistical Geography Standard

    The Australian Statistical Geography Standard (ASGS) is the new geographical standard developed by the Australian Bureau of Statistics (ABS) for the collection and dissemination of geographically classified statistics. It is a common framework that enables publication of statistics that are comparable and spatially integrated and is an essential reference for understanding and interpreting the geographical context of Australian statistics.

    The majority of National Minimum Data Sets (NMDSs) transitioned from the old ASGC to the ASGS for the 2012-13 collection period. However, there are a number of data sources published in this report that still use the ASGC to derive remoteness information. Please refer to specific chapters to determine whether the ASGC or ASGS was used to derive remoteness.

    Remoteness

    In most sections of this website the ASGS applies to the data presented by remoteness area. This is based on the ASGS Remoteness Structure which is categorised into Remoteness Areas (RAs). RAs aggregate to states and territories and cover the whole of Australia without gaps or overlaps.

    This report uses the ASGS to present data in the following categories:

    • Major cities
    • Inner regional
    • Outer regional
    • Remote
    • Very remote.

    For further information on this classification system, refer to the ABS website

    Socio-economic status

    Using a broad range of social and economic aspects of the Australian population from the 2011 Census, the ABS produced four Socio Economic Indexes for Areas (SEIFA) indices, namely, Index of Relative Socio-Economic Disadvantage (IRSD), Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). Each index ranks geographic areas across Australia in terms of their relative socio-economic advantage and disadvantage. The four indicies each summarise a slightly different aspect of the socio-economic conditions in an area.

    Mental Health Services in Australiauses the IRSD, which summarises attributes of the population such as low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations.

    The IRSD scores are categorised into five groups, referred to as quintiles, which each represent one-fifth (20%) of the population (ABS 2014). Quintile 1 encompasses people living in the most disadvantaged areas (worst off) and quintile 5 encompasses those living in the least disadvantaged group (best off) (ABS 2014). A geographical area with a low SEIFA score will likely comprise of a higher proportion of people who are relatively disadvantaged and a lower proportion of people who are relatively advantaged.

    More information can be found on the ABS website

    Anatomical Therapeutic Chemical Classification System

    The Anatomical Therapeutic Chemical (ATC) Classification System, developed by the World Health Organisation (WHO), assigns therapeutic drugs to different groups according to the body organ or system on which they act, as well as their therapeutic and chemical characteristics.

    The coding of pharmaceutical products within the Schedule of Pharmaceutical Benefits is based on the ATC Classification System but with some differences as outlined in the relevant data source sections.

    For further information on this classification system, refer to the WHO website.

    English Proficiency Country Groups

    The English Proficiency Country Groups (EP groups) were developed by the then Bureau of Immigration, Multicultural and Population Research (Australia), based on the 1991 Census. It is a classification of countries of birth to enable the analysis and presentation of data on immigrants to Australia. Countries are classified to 1 of 4 groups depending on the proportion of immigrants who entered the country in the 5 years before the Census, who spoke English well or very well (the EP index).

    The latest published version of the EP groups was based on the 2001 Census (DIMIA 2003). They are:

    • EP1—all countries rating 98.5% or higher on the EP index with at least 10,000 residents in Australia
    • EP2—countries rating 84.5% or higher on the EP index, other than those in EP1
    • EP3—countries rating 57.5% to less than 84.5%
    • EP4—countries rating less than 57.5%.

    AIHW has updated the EP groups based on the 2011 Census and it is this updated classification which has been used in this report. The updated classification can be obtained by emailing mentalhealth@aihw.gov.au.

    International Classification of Diseases

    The International Classification of Diseases (ICD), which was developed by the WHO, is the international standard for coding morbidity and mortality statistics. It was designed to promote international comparability in the collection, processing, classification and presentation of these statistics. The ICD is periodically reviewed to reflect changes in clinical and research settings (WHO 2011).

    Although the ICD is primarily designed for the classification of diseases and injuries with a formal diagnosis, it also classifies a wide variety of signs, symptoms, abnormal findings, complaints and social circumstances that may stand in place of a diagnosis.

    Further information on the ICD is available from the WHO website.

    International Statistical Classification of Diseases and Related Health Problems, 9th revision, Clinical Modification

    The International Statistical Classification of Diseases and Related Health Problems, 9th revision, Clinical Modification (ICD‑9‑CM) is based on the ninth revision of the ICD (NCC 1996). The ICD‑9‑CM was the official system of assigning codes to diagnoses and procedures associated with hospital use in Australia before it was superseded by the ICD‑10‑AM.

    International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification

    The Australian Modification of ICD‑10 (called ICD‑10‑AM) is used to classify diagnoses in the health sector in Australia. It is used in public and private hospitals, and in community and residential mental health care services. The ICD‑10‑AM was developed in Australia by the NCCH with the purpose of making ICD‑10 more relevant to Australian clinical practice (NCCH 2006).

    International Classification of Primary Care, 2nd edition, and ICPC‑2 PLUS

    The International Classification of Primary Care, 2nd edition (ICPC‑2) is a classification method for primary care or general practice encounters accepted by the WHO and primarily used in Australia. It allows for the classification of three elements of a health care encounter in relation to the patient: reasons for encounter; diagnoses or problems; and process of care.

    The ICPC‑2 PLUS (which is also known as the BEACH coding system) is an extended vocabulary of terms classified according to the ICPC‑2, which enables greater specificity in coding. The ICPC‑2 PLUS is primarily used in the context of Australian general practice.

    The ICPC‑2 is currently being used in some electronic health records in clinical general practice, for research purposes (such as the BEACH project) and for coding self-reported health information in other statistical collections such as the ABS National Health Survey.

    Further information on ICPC‑2 is available from the WHO website and information on ICPC‑2 PLUS is available from the BEACH website.


    References

    Australian Bureau of Statistics (ABS) 2007. Australian standard geographical classification (ASGC), July 2007. ABS cat. No. 1216.0. Canberra: ABS.

    ABS 2014. Socio-Economic Indexes for Areas (SEIFA). Canberra: ABS. Viewed June 2015

    Australian Government Department of Immigration and Multicultural and Indigenous Affairs (DIMIA) 2003. Statistical focus: 2001 Classification of countries into English proficiency groups. Canberra: DIMIA.

    National Coding Centre (NCC) 1996. The Australian version of the international statistical classification of diseases and related health problems, 9th revision, clinical modification. Sydney: NCC.

    National Centre for Classification in Health (NCCH) 2006. The international statistical classification of diseases and related health problems, 10th revision, Australian modification. Sydney: NCCH.

    World Health Organization (WHO) 2010. ATC: International classification of diseases (ICD). Geneva: Viewed June 2012.