EXPLANATORY TEXT

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Why do we need the Australian Allied Health Classification Systems?

The current economic and political environment in the Australian health sector emphasises efficiency , competition and accountability within the context of evidence-based practice and quality improvement.

Increasingly, public sector health service providers are being asked to justify their costs in terms of the outcomes they achieve. Allied Health practitioners need to be able to respond to the challenges presented by these changes in the language of the new management paradigm.

Governments at the national and state level have moved to output based (casemix) funding as the primary funding mechanism for health care provider organisations. Existing casemix funding models do not adequately encompass the variety and complexity of Allied Health activities.

Many Allied Health departments collect a variety of workload and output data but these data are institution-specific, variously defined and rarely standardised. They, therefore, do not permit comparison between regions, states or even across like organisations.

To address these shortfalls, the NAHCC (with Department of Health and Family Services funding) developed the Australian Allied Health Classification System.

This new system is a major achievement for allied health professions, which in the first version offers:

  • a common language to communicate key aspects of the business of allied health professionsals to in-house senior management and government agencies
  • a standardised system for allied health professionals to compare their clinical practice s
  • a rich database for research into allied health activities, interventions and outcomes
  • a chance to benchmark services across organisations using Australian data .

Where does this system fit in the current Health Service Management thinking?

Health service managers are increasingly linking inputs (eg staff labour and materials) to outputs (treated patients) and outcomes (health improvement).

While many allied health professionals have comprehensive systems in place to capture the input data, little is systematically available to measure outputs.

The following diagram conceptualises the way that health service managers now view the activities within their organisations.

The inputs to outcomes continuum

INPUTS
for example

PROCESSES
for example
OUTPUTS
for example
OUTCOMES
for example
staff time interventions equipment ordering treated patient health improvement
materials staff management research increased body of knowledge
  teaching and training trained students  

This kind of analysis is being used by managers to consider the cost / benefits of allied health services.

How can you best position yourself in this environment?

To succeed, each of the following elements needs careful attention:

  • Defining and measuring AH activity
  • analysing best practice (efficiency / effectiveness)
  • conducting research
  • costing and pricing AH activities
  • Effectively competing with alternative providers in the health sector
  • Workload management / staff accountability / comparisons
  • benchmarking exercises

To be able to do these things certain systems and information must be in place.

The following table details what is needed and attempts to catalogue what is already available.

System or information required availability status Availability status
  • Description of Allied Health activities The Australian Allied Health Classification System - now available
 The Australian Allied Health Classification System - now available
  • Description of client characteristics NAHCC Allied Health Minimum Data Set - now available (work to be undertaken on Indicators for Intervention)
    • diagnostic issues
    • demography
    • referral source
    • inpatient / ambulatory split
 NAHCC Allied Health Minimum Data Set - now available (work to be undertaken on Indicators for Intervention)
  • Description of provider / setting characteristics NAHCC Allied Health Minimum Data Set
    • Provider ID - now available
    • service type
 NAHCC Allied Health Minimum Data Set  now available
  • Data collection and reporting mechanisms various systems available (but not standardised). NAHCC has a draft software requirements guide
    • user-friendly
    • manual and computerised
    • cost-effective
 various systems available (but not standardised). NAHCC has a draft software requirements guide
  • Activity Quantification Local systems exist but a national standard is not available as a time based system.
    • time based
    • frequency based
 Local systems exist but a national standard is not available as a time based system.
NAHCC hopes to address this in version 2 of the Australian AH Classification System.
  • Meaningful data utilisation The standard and availability varies across organisations.
    • clinical outputs / products
    • workload / productivity analysis
    • casemix analysis
 The standard and availability varies across organisations.
  • Professional and Industry Standards not comprehensively available for the Australian setting, although substantial work has been done on entry level competency skills
    • staffing needs
    • clinical skills
    • standards of practice
    • resource utilisation
    • productivity
    • outcome
    • reporting standards
    • clinical risk indicators
 Not comprehensively available for the Australian setting, although substantial work has been done on entry level competency skills
  • Outcome measures
little Allied Health data available.

How the Australian Allied Health Classification System - Version 1 was developed?

Ten allied health professions were involved in the process of developing a common set of activity descriptors which became the generic allied health activity classification system.

This was achieved through a series of workshops and consultations in most states/territories which involved representatives from the following professions:

  • Audiologists
  • Dietitians
  • Occupational Therapists
  • Orthoptists
  • Physiotherapists
  • Podiatrists
  • Prosthetists and Orthotists
  • Psychologists
  • Social Workers
  • Speech Pathologists

The Australian Allied Health Classification System consists of two components:-

  1. The Allied Health Activity Classification Hierarchy
  2. The Allied Health Minimum Data Set

The Allied Health Activity Classification Hierarchy has four components at the first tier level: clinical care, clinical services management, teaching and training and research

The Minimum Data Set defines twenty data items associated with patient care.

Both the Classification and the Minimum Data Set are described fully in the following section. These are described in the following sections.

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