Private Mental Health Alliance (PMHA) Update
2016 represents significant a milestone for the PMHA. Since 1996, the Australian Medical Association (AMA), Private Healthcare Australia (PHA) representing private health insurers, the Australian Private Hospitals Association (APHA), representing private hospitals with psychiatric beds (Hospitals), and the Australian Government have been strongly committed to supporting a PMHA for the private mental health sector.
Established by the AMA in 1996, the PMHA brings together providers, payers and consumers and carers on a regular and structured basis to work on difficult and complex issues related to funding, classification, quality of care, outcome measurement, and consumer and carer participation. The level of trust and cooperation that has developed over time between the stakeholders enabled the Alliance to establish a unique national PMHA Centralised Data Management Service (CDMS) to improve the quality of information and enable benchmarking within the private hospital sector.
The PMHA’s CDMS was established by the AMA in 2001 to support the implementation of a National Model for the Collection and Analysis of a Minimum Data Set with Outcome Measures for Private Hospital–based Psychiatric Services. The National Model has been implemented in all private facilities with psychiatric beds (Hospitals) across Australia and currently 100% participate in the service provided by the CDMS. Under the National Model, these participating Hospitals collect two measures of a patient’s clinical status at key occasions during the provision of care. Those occasions are:
- At Admission and Discharge from episodes of Overnight inpatient care;
- At Admission and Discharge from episodes of Ambulatory care, for example Day Programs; and
- Where episodes of care are extended over longer periods, at Review every three months.
The two measures of clinical status are:
- A twelve item clinician–completed rating scale, developed by the Royal College of Psychiatrists in the UK and known as the Health of the Nation Outcome Scale, or the HoNOS; and
- A fourteen item patient–completed questionnaire, which for our convenience is known as the MHQ– 14.
This clinical data is recorded and then linked with data collected under the Hospital Casemix Protocol (HCP) using the CDMS’s Hospitals Standardised Measures database (HSMdb), which is provided to participating Hospitals by the CDMS. The two sets of linked data are then submitted, in a de-identified format, to the CDMS by participating Hospitals. The data submitted by all Hospitals forms the basis for the Standard Quarterly Reports (SQRs) that are prepared and distributed to Hospitals and private health insurers by the CDMS. As well as providing participating Hospitals with a database application, the CDMS provides detailed training materials and considerable active support in the implementation of the data collection process. Hospitals, therefore, have a more comprehensive and clinically accessible method, of describing the severity and complexity of the problems treated and a common language for discussing and comparing the outcomes of the care they provide. Clinical review and reporting functions within HSMdb enables Hospitals to select a set of records for review and statistical analysis on the basis of a very wide range of administrative, clinical and service-related attributes. Our most recent run of CDMS SQRs has demonstrated that all private hospitals across Australia with psychiatric beds are now able to routinely submit data in respect of outcomes of care they provide with completion rates that are probably the best you would currently see in mental health services anywhere in the world. This is an outstanding achievement and we extend our ongoing thanks to all our participating facilities, which are listed below.
CDMS Annual Statistical Reports
The CDMS continues to produce Annual Statistical Reports (ASR) on Private Hospital-based Psychiatric Services based on data submitted by private hospitals listed above. These Reports are produced each year, as part of the PMHA’s ongoing commitment toward improving the quality, reliability, and use of information on private sector mental health services. The ASRs set out useful summary statistics that include the following.
- Number of patients admitted to private hospitals for psychiatric care.
- Demographic and diagnostic profiles of those patients.
- Comparison of patients reported mental health, social and role functioning at Admission and on Discharge against that of the general population.
- Comparisons of the demographic and diagnostic profiles to indicate that generally different groups of people are receiving mental health care in each sector.
A copy of the most recent ASR for the 2014-15 financial year is available at: https://pmha.com.au/PublicationsResources/Statistics.aspx
Provision of support to existing and newly enrolled Hospitals
On the 17th September 2015 the CDMS Director, Mr Allen Morris-Yates, participated in a national workshop organised by the APHA to support Hospitals in their collection and use of the data required under the PMHA’s National Model. A second national workshop will be held in Melbourne on 26 February 2016. In addition, state level workshops are also being conducted; the first having been held in Brisbane on 12 February, with further such workshops planned for Sydney, Melbourne and Adelaide this year.
Townsville Private Clinic, a member of the Healthe Care group, has completed its enrolment in the PMHA and its CDMS. The CDMS Director visited the hospital on 15th December 2015 to provide training.
One other new psychiatric unit within an established private general Hospital, Berkeley Vale Private Hospital on the central coast of NSW, has enrolled in the PMHA and its’ CDMS. The new unit opened in February 2016 and the CDMS Director will visit the facility to provide training in March 2016.
Provision of support to Payers
Under the auspices of Private Healthcare Australia, the CDMS Director provided two workshops for Payers in Sydney and Melbourne on 26th and 27th of November respectively.
Each workshop covered the following topics:
A brief introduction to the PMHA and its CDMS. In this first part of the workshop participants were given a brief introduction to the PMHA and its CDMS followed by an overview of the development of the National Model that provides the framework within which Hospitals collect data on patient outcomes.
Understanding your Standard Quarterly Reports (SQRs). In this part of the workshop participants were taken through the two key outcome measures reported in the SQRs. They were given an opportunity to use both the patient self-assessment measure (the MHQ-14) and the clinician-completed rating scale (the HoNOS) to gain an understanding of how a typical patient suffering a depressive illness would be represented in the data.
Using the SQR Viewer to explore the statistics contained in the SQRs. In this final part of the workshop, the Director of the CDMS used a representative but de-identified dataset to demonstrate how the SQR Viewer software could be used to quickly obtain a detailed understanding of where a Hospital sits in relation to its peers.
Published: 13 Apr 2016