National Casemix and Classification Centre (NCCC)

The NCCC has been formed following the successful bid by the University of Wollongong (UoW) to develop the Australian Refined Diagnosis Related Group (AR-DRG) Classification System. The NCCC is part of the UoW Centre for Health Service Development (CHSD) Sydney Business School.

The Australian Department of Health and Ageing (DoHA) has contracted the University of Wollongong (UoW) to refine the AR-DRG Classification System which includes:

• The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), the Australian Classification of Health Interventions (ACHI), the Australian Coding Standards (ACS), and
• The Australian Refined Diagnosis Related Group (AR-DRG) classification.

The ICD-10-AM/ACHI/ACS was previously managed under a DoHA contract by the National Centre for Classification in Health (NCCH), University of Sydney. AR-DRG classification development was previously managed by the DoHA in Canberra.

The NCCC will develop the 2012 versions of  ICD-10-AM/ACHI/ACS and AR-DRG, with a planned national implementation date of 1 July 2013 for both classification systems.  The NCCC will also provide user support services for ICD-10-AM/ACHI/ACS Seventh Edition and AR-DRG versions which will continue to be used in Australia until 30 June 2013.

AR-DRG Classification System

The two classification components, ICD-10-AM/ACHI/ACS and AR-DRG, are now collectively known as the AR-DRG Classification System. These two classifications will continue to be used to code and group inpatient episodes of care in Australian hospitals for statistical reporting and funding purposes. Together, the coding (using ICD-10-AM/ACHI/ACS), then grouping (using AR-DRG) of health data enable analysis of a hospital’s casemix. 

Casemix is an information tool involving the use of scientific methods to build and make use of classifications of patient care episodes. Casemix is about the relationship between hospital’s activity and costs, and makes use of data about classifications that are clinically meaningful and explain variation in resource use. Casemix analysis will be pivotal to the Australian Government’s current health reform plan; the health reform plan is largely based on activity based funding, and casemix as described by the AR-DRG Classification System reflects hospital inpatient activity. Please refer here for more.

Staff and expertise

The NCCC engages CHSD specialists in classification and casemix. There is also opportunity to recruit additional experts and to build capacity in this important area of health information.  The CHSD currently employs staff who have been intimately involved in the development of ICD-10-AM/ACHI/ACS from inception through to the seventh edition. Other CHSD staff have considerable experience with casemix system development and its use in the evaluation of programs and the analysis of outcomes. For staff profiles see here.

In addition, CHSD staff are actively involved in ICD-11 development and maintenance, working closely with the World Health Organisation (WHO) and international colleagues, particularly with regard to morbidity classification matters, through the role of Chair of the Morbidity Reference Group of WHO-Family of International Classifications Network (WHO-FIC).

The establishment of the NCCC builds on the research that CHSD has been undertaking for over a decade. The NCCC complements the other CHSD centres:

• The Australian Health Outcome Centre (AHOC)
• The Australasian Rehabilitation Outcome Centre (AROC)
• The Palliative Care Outcomes Collaboration (PCOC)
• The Australian Occupational Science Centre (AOSC)
• The Australian Centre for Clinical Terminology and Information (ACCTI)

The CHSD is a research centre of UoW’s Sydney Business School and the NCCC operates out of both the Sydney Business School headquarters in 1 Macquarie Place Circular Quay, Sydney and the main centre at the UoW campus. 

AR-DRG System Governance

A new national governance system is being established to guide future AR-DRG System development. A diagrammatic representation is here.