8. Unit of reporting

8.1. Basic unit of reporting – the Collection Occasion

8.1.1. For the purposes of NOCC reporting requirements, the unit of reporting is the Collection Occasion. A specified data set is to be reported for three defined collection occasions (Admission, Review, and Discharge).

8.1.2. It is important to distinguish the unit of reporting from the unit of analysis. The units of reporting serve as the building blocks to assemble higher level ‘units of care’ which will be the subject of analysis. For this there needs to be both:

• a capacity to link discrete collection occasion events, using as a primary key the data elements Mental Health Service Organisation, Patient Identifier and Episode of Mental Health Care Identifier; and
• a conceptual framework to guide the bundling of those events into coherent units for analysis.

8.2. Reporting context — Episode of Mental Health Care Identifier

8.2.1. The Episode of Mental Health Care Identifier links together Collection Occasions which arise from the same Episode of Mental Health Care. As such, a single Admission occasion, any number of Review occasions, and a single Discharge occasion collected in respect of a given Episode of Mental Health Care should share the same value on this identifier.

8.2.2. For each uniquely identified patient or client the Episode of Mental Health Care Identifier must uniquely identify each episode. That is, the union of Patient Identifier with Episode of Mental Health Care Identifier must itself be unique within the broader scope of the Mental Health Service Organisation, however the Episode of Mental Health Care Identifier on its own need not be unique within that broader scope. This will ensure that Episodes of Mental Health Care are uniquely identified within the scope at which they themselves are defined.

8.2.3. As with Patient Identifiers, the Episode of Mental Health Care Identifier used to refer to supply NOCC data should be stable over time – that is, it should allow Collection Occasion components of the episode to be linked even when those components are spread across multiple reporting years.

8.3. Reporting context — Reason for Collection

8.3.1. Application of the reporting protocol requires that the defined Collection Occasions be mapped to a range of key events (i.e., admission to hospital, registration by community services, clinical review, transfer, discharge etc) which may occur within the context of an Episode of Mental Health Care.

8.3.2. Understanding the nature of the events triggering admission, discharge or review is necessary for subsequent informed analysis. For example, it will be desirable to separately analyse the differential outcomes of new consumers admitted to ambulatory care from those who commence an ambulatory episode following discharge from hospital.

8.3.3. In addition, to promote consistency in the development of guidelines for the regular review and closure of cases under ongoing Ambulatory care use of a concept of ‘active care’ has been found necessary. For this purpose, States and Territories have been moving to progressively implement the following business rule, or some variation that closely approximates the rule:

A person is defined as being under ‘active care’ at any point in time when:

• they have not been discharged from care; AND
• some services (either direct to or on behalf of the consumer) have been provided over the previous 3 months; AND
• plans have been made to provide further services to the person within the next 3 months.

Thus, where no future services are planned in the next 3 months, the person is not considered to be under ‘active care’.

8.3.4. These considerations are captured within the data element Reason for Collection. The domain of the Reason for Collection item is shown in Table 8.1 below. [1]

Individual States and Territories have the option of specifying the domain in greater detail and are encouraged to do. However, where the domain is further specified, States and Territories should ensure a capacity to map to the national definitions. These represent the mandatory national conditions for collection of data at Admission, Review and Discharge.

Table 8.1 Domain and data definitions for Reason for Collection

Collection Occasion	Reason for Collection	Definition
Admission to mental health care episode	01. New referral	Admission to a new inpatient, community residential or ambulatory episode of care of a consumer not currently under the active care of the Mental Health Service Organisation.
	02. Transfer from other treatment setting	Transfer of care between an inpatient, community residential and ambulatory setting of a consumer currently under the active care of the same Mental Health Service Organisation. Where a consumer’s care is “transferred from” another Mental Health Service Organisation, the Reason for Collection should be recorded as “01 - New Referral”.
	03. Admission – Other	Admission to a new inpatient, community residential or ambulatory episode of care for any reason other than defined above
Review of mental health care episode	04. 3-month review	Standard review conducted at 3 months (91 days) following admission to the current episode of care or 91 days subsequent to the preceding Review
	05. Review – Other	Standard review conducted for reasons other than the above.
Discharge from mental health care episode	06. No further care	Discharge from an inpatient, community residential or ambulatory episode of care of a consumer for whom no further care is planned to be provided by the Mental Health Service Organisation.
	07. Transfer to change of treatment setting	Transfer of care between an inpatient, community residential and ambulatory setting of a consumer currently under the care of the same Mental Health Service Organisation. Where a consumer’s care is “transferred to” another Mental Health Service Organisation, the Reason for Collection should be recorded as “06 - No Further Care”.
	08. Death	Completion of an episode of care following the death of the consumer.
	09. Discharge - Other	Discharge from an inpatient, community residential or ambulatory setting for any reason other than defined above.

8.4. Collection Occasion Date

8.4.1. The Collection Occasion Date is the reference date for all data collected at any given Collection Occasion.

8.4.2. For data collected at the beginning of an Episode of Mental Health Care the Collection Occasion Date is referred to as the Admission Date. For data collected at end of an Episode of Mental Health Care, the Collection Occasion Date is referred to as Discharge Date. For data collected at Review during an ongoing Episode of Mental Health Care, the Collection Occasion Date is referred to as the Review Date.

8.4.3. The Collection Occasion Date should be distinguished from the actual date of completion of individual measures that are required at the specific occasion. In practice, the various measures may be completed by clinicians and consumers over several days. For example, at Review during ambulatory care, the client’s case manager might complete the HoNOS and LSP during the clinical case review on the scheduled date, but in order to include their client’s responses to the consumer self-report measure, they would most likely have asked the client to complete the measure at their last contact with them. For national reporting and statistical purposes, a single date is required which ties all the standardised measures and other data items together in a single Collection Occasion. [2] The actual collection dates of the individual data items and standard measures may be collected locally but is not required in the national reporting extract.

8.4.4. A special requirement applies in the case of inpatient episodes to facilitate record matching with corresponding records collected under the NMDS – Admitted Patient Mental Health Care. For Admission to inpatient episodes, the Collection Occasion Date should be the date of admission as recorded in the NMDS data set. For Discharge from inpatient episodes, the Collection Occasion Date should be the date of separation as recorded in the NMDS data set. [3]

[1]

It is noted that the Reasons for Collection item has some conceptual similarities to the National Health Data Dictionary data elements Mode of Admission, Mode of Separation and Reason for Cessation of Treatment. However, the items have different domains and purposes. The Reasons for Collection domain incorporates two concepts: ‘Why is the information being collected now?’ And ‘where is the patient coming from/going to’ in terms of the next step in their sequence of care.

[2]

The implication is that each data item and standardised measure needs to ‘belong’ to a specific Collection Occasion and assumes the date properties of the Collection Occasion. Technical solutions are needed within local information systems to group all relevant data items and standardised measures collected as part of the NOCC dataset and attach them to a specific, dated Collection Occasion.

[3]	This requirement is workable for the vast majority of inpatient episodes but may not be appropriate for those episodes that include extended periods of leave. See Section 7.3 for proposed approach for dealing with such cases.