Mental health servicesin Australia
This section provides a list of codes used to define mental health-related general practice encounters from the Bettering the Evaluation and Care of Health (BEACH) database (as used in the general practice section) and ‘mental health-related’ hospital separations from the National Hospital Morbidity Database (as used in the Ambulatory-equivalent and Admitted patient sections).
For the purpose of this report, mental health-related general practice encounters are defined as those encounters where a mental health-related problem was managed. Mental health-related problems are those that are classified in the psychological chapter (that is, the ‘P’ chapter) of the International Classification of Primary Care, 2nd edition (ICPC-2). In the great majority of cases the codes appearing in the diagnosis or problem fields of the BEACH survey form those listed here under the ‘Problems managed’ heading. Occasionally a code more relevant to treatments or referrals has appeared. These cases (accounting for 3% of all mental health-related problems managed in BEACH in 2011–12) are still counted as ‘mental health-related’ general practice encounters for the purpose of the report, in particular the estimates in Table Class Code 1 below.
For treatments and referrals, codes that are classified in the psychological chapter of the ICPC-2 PLUS have been used as these enable greater specificity in coding.
For medications, Anatomical Therapeutic Chemical (ATC) classification codes (WHO 2011) have been used, where the medication falls into one of four groups.
The following table presents a list of the ICPC–2, ICPC–2 PLUS and ATC codes classed as ‘psychological’ for problems managed, treatments, referrals and medications.
Source: ICPC-2 International Classification of Primary Care, 2nd edition
Data from the National Hospital Morbidity Database (NHMD) is the source for the Ambulatory-equivalent and Admitted patient sections of this online report. The definition of the scope of each section is provided in the section’s introduction or data source. Key elements of these definitions depend on the ICD–10–AM diagnosis codes and the Australian Classification of Health Interventions (ACHI) procedure codes. The codes in-scope are listed below.
During the preparation of Mental health services in Australia 1999–00 (AIHW 2002), attention was given to ensuring that, for data on hospital separations from the NHMD, the definition of a ‘mental health-related diagnosis’ included all codes that were either clinically or statistically relevant to mental health. This definition was revised for Mental health services in Australia 2000–01 (AIHW 2003) to increase the accuracy of the data. More specifically, for the analyses of the 2000–01 National Hospital Morbidity data, a diagnosis was considered clinically relevant to mental health if:
A diagnosis was defined as being statistically relevant to mental health if:
This method was developed in consultation with the National Mental Health Working Group Information Strategy Committee (now called the Mental Health Information Strategy Standing Committee) and the Clinical Casemix Committee of Australia.
Certain codes were statistically relevant during 1999–00 but not in 2000–01; these were examined and included if over 50% of total separations over the 2 years included specialised psychiatric care.
For Mental health services in Australia, the same codes used for the analysis of the 2000–01 data have been used to define ‘mental health-related’ hospital separations in the Ambulatory-equivalent and Admitted patient care sections. However, updates have been made to incorporate changes in codes that have occurred as new editions of ICD-10-AM have been released.
The full list of codes used to define mental health-related hospital separations is shown in the following table.
.. not applicable Y code used (a) Excluding F52.5.(b) Excluding F84.2.(c) Excluding F98.5 and F98.6.
The full list of ACHI codes as part of the definition of ambulatory-equivalent mental health-related hospital separations is shown in the following table. If there is no procedure recorded, or only procedure(s) in this list, and other criteria as outlined in Section 5 are met, then the separation will be categorised as ambulatory-equivalent.
AIHW 2002. Mental health services in Australia 1999–00. Mental health series no. 3. Cat. no. HSE 19. Canberra: AIHW.
AIHW 2003. Mental health services in Australia 2000–01. Mental health series no. 4. Cat. no. HSE 24. Canberra: AIHW.
World Health Organization (WHO) 2011. ATC: Structure and principles. Oslo: WHO Collaborating Centre for Drug Statistics Methodology. Viewed June 2012. http://www.whocc.no/atc/structure_and_princples/