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  • Private Mental Health Alliance Centralised Data Management Service (PMHA CDMS)

    The PMHA's CDMS was launched in Australia in 2001 to support private hospitals with psychiatric beds to routinely collect and report on a nationally agreed suite of clinical measures and related data for the purposes of monitoring, evaluating and improving the quality of and effectiveness of care. The CDMS works closely with private hospitals, health insurers and other funders (e.g. Department of Veterans' Affairs) to provide a detailed quarterly statistical reporting service on participating hospitals' service provision and patient outcomes. Hospitals and health insurers use the information to monitor and evaluate service provision. To support private hospitals in maintaining these reporting requirements, the CDMS also maintains training resources for hospitals and a database application which enables hospitals to submit de-identified data to the CDMS. The CDMS produces an annual statistical report. In 2014–15, the CDMS accounted for 98% of all private psychiatric beds in Australia.

    Up until 30 June 2016, the CDMS was managed by the PMHA operated by the Australian Medical Association under an Agreement for Services, with funding from participating private hospitals, private health insurance funds and the Australian Government. From 1 July 2016, the CDMS entered into an interim governance arrangement with the AMA and the Australian Government pending re-negotiation of funding and governance arrangements.

    The classification of diagnostic groups used by the CDMS is based on the ICD-10 principal diagnosis assigned to the episode of care at discharge. There are 8 clinical groupings of the ICD-10 diagnoses relating to mental and behavioural disorders, they are as follows:

    • Schizophrenia, Schizoaffective and Other Psychotic Disorders. This group includes ICD-10 diagnoses of: Psychotic disorders due to psychoactive substance us (F1x.5 and F1x.7), Schizophrenia (F20), Schizotypal disorders (F21), Delusional disorders (F22 and F24), Acute and transient psychotic disorders (F23), Schizoaffective disorders (F25), and Other nonorganic psychotic disorders (F28 and F29).
    • Major Affective and Other Mood Disorders. This group includes ICD-10 diagnoses of Manic episodes and bipolar affective disorders with current episode manic (F30, F31.0, F31.1 and F31.2), Depressive episodes, bipolar disorders with current episode depressed or mixed, and recurrent depressive disorders (F31.3, F31.4, F31.5, F31.6, F31.7, F31.8, F31.9, F32 and F33), and Persistent mood disorders including cyclothymia and dysthymia, and other mood disorders (F34, F38 and F39).
    • Post Traumatic and Other Stress-related Disorders. This group includes ICD-10 diagnoses of Reactions to severe stress including acute stress reactions (F43.0, F43.8 and F43.9), Adjustment disorders with brief depressive reactions (F43.20), Adjustment disorders with prolonged depressive reactions (F43.21), Other adjustment disorders (F43.22 and F43.28) and Posttraumatic stress disorders (F43.1).
    • Anxiety Disorders. This group includes ICD-10 diagnoses of Anxiety disorders including phobic anxiety, panic disorder, generalised anxiety disorder and other neurotic disorders (F40, F41 and F48), and Dissociative disorders (F44). It does not include Obsessive Compulsive Disorders (F42) or Somatoform Disorders (F45) which are classified elsewhere.
    • Alcohol and Other Substance Use Disorders. This group includes ICD-10 diagnoses of Alcohol and Other psychoactive substance intoxication, harmful, use, dependence and withdrawal (F1x.0, F1x.1, F1x.2, F1x.3, F1x.4, F1x.8 and F1x.9).
    • Eating Disorders. This group includes ICD-10 diagnoses of Anorexia nervosa and atypical anorexia nervosa (F50.0 and F50.1), and Eating disorders other than anorexia nervosa (F50.2, F50.3, F50.4- and F50.9).
    • Personality Disorders. This group includes ICD-10 diagnoses of Paranoid and schizoid personality disorders (F60.0 and F60.1), Dissocial personality disorders including antisocial personality disorder (F60.2), Emotionally unstable personality disorders (includes borderline and impulsive) (F60.3), Histrionic, anankastic (obsessive-compulsive), anxious, and dependent personality disorders (F60.4, F60.5, F60.6 and F60.7), and Other personality disorders (F60.8, F60.9, F61.0, F61.1, F62, F63, F68 and F69).
    • Other Disorders, Not Elsewhere Classified. This group includes all remaining psychiatric and other diagnoses including: Organic Disorders (F00 through F09 and F1x.6); Obsessive Compulsive Disorders (F42); Somatoform disorders (F45); Behavioural Syndromes Associated with Physiological Disturbances and Physical Factors (F51, F53, F54, and F59); Sexual Disorders (F52, F64, F65 and F66); Mental Retardation (F70, F71, F72, F73, F78 and F79); Disorders of Psychological Development (F80, F81, F82, F83, F84, F88 and F89); Disorders of Childhood and Adolescence (F90, F91, F92, F93, F94, F95 and F98.0); Other Disorders, including ICD-10 diagnoses of Mental disorders, not otherwise specified (F99) and all other valid non-psychiatric diagnoses (i.e., diagnoses not grouped under either MDC 19 or MDC 20 in AR-DRG 4).

    The classification of patients into urban versus non-urban groups was based on the ASGC Remoteness classification of the Postcode of their Area of usual residence. Patients, whose Area of usual residence was in ASGC group Major cities were classified as "Urban", whilst those in the remaining groups (Inner regional, Outer regional, Remote and Very remote) were classified as "Non-urban".

    Statistics for States and Territories were aggregated in accordance with CDMS policy which, in order to ensure the privacy and confidentiality of both patients and providers, prohibits individual State or Territory statistics being reported in cases where the number of Hospitals is less than 5. As a consequence, statistics for the Australian Capital Territory are aggregated with those for New South Wales; whilst those for South Australia, Western Australia, Tasmania and Northern Territory are also aggregated.

    Key concepts

    Ambulatory-equivalent mental health-related admitted patient care—private hospitals

    Key concept Description

    An episode is classified as ambulatory for this report if the episode was a same day separation (that is, admission and separation occurred on the same day).

    The terms ambulatory and ambulatory-equivalent are used synonymously in this section.

    Diagnostic group The classification of diagnostic groups is based on the ICD-10 principal diagnosis assigned to the episode of care at discharge. There are 8 clinical groupings of the ICD-10 diagnoses relating to mental and behavioural disorders. For further details of these diagnostic groups, see the data source section.
    Episode An episode of care involves a period of care from admission to separation. Counts of episodes include only clinically substantive episodes of care. Episodes that are of brief duration (1 or 2 contacts only) and episodes during which contacts were sparse (average interval between contacts 6 weeks or greater) are excluded from the count. Consequently, the count of episodes can in some cases be less than the count of unique patients.

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