Glossary
Key term | Definition |
|---|---|
Additional diagnosis
| The diagnosis of a condition or recording of a complaint that requires provision of care. In this report, additional diagnoses are from episodes of admitted patient care (hospitalisation) and either coexists with the principal diagnosis or arises during the episode of care. Multiple diagnoses may be recorded. |
Admission | An admission to hospital. The term hospitalisation is used to describe an episode of hospital care that starts with the formal admission process and ends with the formal separation process. |
Acute care | Care provided to patients admitted to hospital that is intended to cure illness, alleviate symptoms of illness or manage childbirth. |
Allied health | A range of services provided by university qualified health practitioners with specialised expertise in preventing, diagnosing and treating a range of conditions and illnesses. The practitioners have autonomy of practice, a defined scope of practice, a regulatory mechanism and a national organisation with clearly defined entrance criteria. Examples include psychologists, optometrists and physiotherapists. The current report includes Medicare-subsidised allied health services. |
Alzheimer’s disease
| A degenerative brain disease caused by nerve cell death resulting in shrinkage of the brain. A common form of dementia. |
Anatomical Therapeutic Chemical (ATC) classification
| Anatomical Therapeutic Chemical (ATC) codes are used to classify medicines. The ATC classification of medicines is recommended by the World Health Organization, and is the Australian standard for presenting and comparing drug usage data. The ATC classification groups medicines according to the body organ or system on which they act, and their therapeutic and chemical characteristics. More information on the ATC classification system can be found at structure and principles. |
Associated cause(s) of death | A cause(s) listed on the medical certificate of cause of death, other than the underlying cause of death. They include the immediate cause, any intervening causes, and conditions that contributed to the death but were not related to the disease or condition causing death. See also cause(s) of death. |
Australian Refined Diagnosis Related Groups (AR-DRGs) | An Australian system of diagnosis related groups (DRGs). DRGs provide a clinically meaningful way of relating the number and type of patients treated in a hospital (that is, its casemix) to the resources required by the hospital. Each AR-DRG represents a class of patients with similar clinical conditions requiring similar hospital services. |
Average length of stay | The average number of bed days for admitted patient episodes (referred to as hospitalisations in this report). Patients who have an admission and a separation on the same date are allocated a length of stay of 1 day. |
Behaviours and psychological symptoms of dementia (BPSD) | Refer to a range of non-cognitive symptoms common among people with dementia. These include – agitation, anxiety, apathy, depression, hallucinations or delusions, insomnia, risky behaviour, resistive behaviour, verbal aggression and wandering. |
Bed days | The total number of days for patients who were admitted for an episode of care and who separated during a specified reference period. A patient who is admitted and separated on the same day is allocated one bed day. |
Carer | Carer refers to people who provide any informal assistance (help or supervision) to people with disability or older people. People who provide formal assistance (on a regular paid basis, usually associated with an organisation) are not considered to be a carer for the purpose of this report. |
Care type | The care type defines the overall nature of a clinical service provided to an admitted patient during an episode of care (admitted care), or the type of service provided by the hospital for boarders or posthumous organ procurement (care other than admitted care). Admitted patient care consists of the following categories: acute care, rehabilitation care, palliative care, geriatric evaluation and management, psychogeriatric care, maintenance care, newborn care, mental health care and other admitted patient care – where the principal clinical intent does not meet the criteria for any of the other care types. Care other than admitted care includes: posthumous organ procurement and hospital boarder. |
Cause(s) of death
| All diseases, morbid conditions or injuries that either resulted in or contributed to death – and the circumstances of the accident or violence that produced any such injuries – that are entered on the medical certificate of cause of death. Causes of death are commonly reported by the underlying cause of death or associated cause(s) of death. |
Cholinesterase inhibitor | A class of anti-dementia medication that prevents the breakdown of acetylcholine, an important component in cognitive pathways in the brain. Levels of acetylcholine decrease in people with Alzheimer disease and some other dementias. By increasing the availability of acetylcholine in the brain these medications are thought to improve or stabilise cognitive function in people with dementia. Examples of these medications include Donepezil, Galantamine and Rivastigamine. |
Community-based aged care
| Support services that assist older people to continue to live independently at home. This may include healthcare and nursing services, home modifications and assistance with daily activities. Due to data limitations this report does not report on any community-based aged care services. |
Community-based health care | Also known as primary health care. These are services delivered in many community settings, such as general practices, community health centres, Aboriginal health services and allied health practices (for example, physiotherapy, dietetic and chiropractic practices) and come under numerous funding arrangements. This report includes use of specific community-based healthcare services that were subsidised through Medicare. |
Comorbidities/ co-existing health conditions
| Defined in relation to an index disease/condition, a comorbidity or co-existing health condition includes any additional disease that is experienced by a person while they have the index disease (in this instance, dementia). |
Culturally and linguistically diverse (CALD)
| There are a number of ways to define culturally and linguistically diverse people. Generally, people who were born overseas, have a parent born overseas and/or who speak a variety of languages are considered to be in the CALD population. In this report, information on people with dementia from CALD backgrounds is presented for available measures (i.e. people who were born in non-English speaking countries) rather than as a group (i.e. people from CALD backgrounds). |
Data linkage/linked data
| Bringing together (linking) information from two or more data sources believed to relate to the same entity, such as the same individual or the same institution. The resulting data set is called linked data. This report uses NIHSI data, which brings together information from hospitals, aged care, Medicare, prescription medication and mortality datasets |
Dementia
| A term used to describe a group of similar conditions characterised by the gradual impairment of brain function. It is commonly associated with memory loss, but can affect speech, cognition (thought), behaviour and mobility. An individual’s personality may also change, and health and functional ability decline as the condition progresses. Dementia is a fatal condition. |
Dementia-specific medications | Prescription medications specifically used to treat the symptoms of dementia. There are 4 dementia-specific medications – Donepezil, Galantamine, Rivastigmine and Memantine – currently subsidised under the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme. These medications can be prescribed to patients with a confirmed diagnosis of Alzheimer’s disease made by (or in consultation with) a specialist or consultant physician under specific clinical criteria. In order to continue treatment, patients must demonstrate a clinically meaningful response to the treatment. This may include improvements in the patients’ quality of life, cognitive function and/ or behavioural symptoms. |
Discharge | See separation. |
Donepezil | A dementia-specific medication approved in Australia for the treatment of mild to moderate Alzheimer’s disease. It is an acetylcholinesterase inhibitor and works by blocking the actions of the enzyme acetylcholinesterase, which destroys acetylcholine – a major neurotransmitter for memory. The use of this medicine may lead to increased communication between nerve cells and slow dementia progression |
Episode of care | The period of admitted patient care between a formal or statistical admission and a formal or statistical separation, characterised by only one care type (see care type and separation). |
First hospitalisation | This report includes hospital admissions that resulted in discharge or death in 2017. For people who had more than one hospitalisation ending in 2017, the first hospitalisation is the one that occurred earliest in the year. |
First Nations people
| A person of Aboriginal and/or Torres Strait Islander descent who identifies as an Aboriginal and/or Torres Strait Islander. |
Frontotemporal dementia | A type of dementia caused by progressive damage to the frontal and/or temporal lobes of the brain. Frontotemporal dementia is more commonly seen in people with younger onset dementia. |
Galantamine | A dementia-specific medication approved in Australia for the treatment of mild to moderate Alzheimer’s disease. It is an acetylcholinesterase inhibitor and works by blocking the actions of the enzyme acetylcholinesterase, which destroys acetylcholine – a major neurotransmitter for memory. The use of this medicine may lead to increased communication between nerve cells and slow dementia progression. |
Hospitalisation | A person-centred approach to hospitalisation data that is used in linked data analysis. Adjoining hospital episodes of care are combined into a single hospitalisation. The hospitalisation represents a person’s time in hospital, regardless of any changes to care type or hospital facility. |
Impairment | Any loss or abnormality of psychological, physiological or anatomical structure or function. |
International Classification of Diseases (ICD) and Related Health Problems | The World Health Organization’s internationally accepted classification of death and disease. The Tenth Revision (ICD-10) is currently in use. The ICD-10-AM is the Australian Modification of the ICD-10; it is used for diagnoses and procedures recorded for patients admitted to hospitals. |
Lewy body dementia/ dementia with Lewy bodies | A type of dementia caused by the degeneration and death of nerve cells in the brain due to the presence of abnormal spherical structures, called Lewy bodies, which develop inside nerve cells. |
Mean/average | The expected value of a particular variable if you were to select an observation at random from a population. Calculated by adding together the values of a variable across the total population and dividing the result by the number of observations in the population. |
Median | The midpoint of a list of observations that have been ranked from the smallest to the largest. |
Medicare | A national, government-funded scheme that subsidises the cost of personal medical services for all Australians and aims to help them afford medical care. The Medicare Benefits Schedule (MBS) is the listing of the Medicare services subsidised by the Australian Government. The schedule is part of the wider Medicare Benefits Scheme (Medicare). |
Mixed dementia | Multiple types of dementia affecting the same person. Mixed dementia is common in the population. The most common combination is Alzheimer’s disease and vascular dementia. |
Memantine | A dementia-specific medication approved in Australia for the treatment of moderately severe to severe Alzheimer’s disease. It works by blocking the neurotransmitter glutamate, which causes damage to brain cells and is present in high levels in people with Alzheimer’s disease. |
Modifiable risk factors | Risk factors that can be modified or reduced (such as tobacco smoking). |
Mortality | Number or proportion of people who died during a given time period. This report includes mortality during people’s first hospitalisation or within 7-days of discharge, within 3-months of discharge or within 12-months of discharge. |
N-methyl-D-aspartate (NMDA) receptor antagonist | A type of anti-dementia medication that blocks the functioning of NMDA receptors and reduces the levels of glutamate in the brain, thereby preventing the movement of excess calcium in the brain. Increased levels of glutamate in the brain may contribute to the symptoms and progression of Alzheimer disease and other dementias. NMDA receptor antagonists are thought to improve or stabilise cognitive function in people with Alzheimer disease, with improvements seen in the function of daily activities, thinking and behaviour. Memantine is an example of an NMDA receptor antagonist. |
National Hospital Morbidity Database (NHMD) | A compilation of episode-level records from admitted patient morbidity data collection systems in Australian hospitals. The data supplied are based on the National minimum data set (NMDS) for Admitted patient care and include the Admitted Patient Care and The National Non-Admitted Patient Emergency Department Care Databases. |
National Integrated Health Services Information (NIHSI) | The NIHSI is a person-focused, de-identified analytical asset that allows for a range of research and analysis on many aspects of population health through access to standardised, integrated health administrative datasets. The NIHSI is the only enduring linked data asset that includes linked hospital data. For more information refer to the Technical note. |
Non-Indigenous | People who have not indicated that they are of Aboriginal or Torres Strait Islander descent. |
Non-modifiable risk factors | Risk factors that cannot be modified or reduced (such as aging or genetics). |
Palliative care | Care in which the clinical intent or treatment goal is primarily quality of life for a patient with an active, progressive disease with little or no prospect of cure. |
Patient days | Total patient days is the total number of days for all patients who were admitted for an episode of care and who separated during a specified reference period. A patient who is admitted and separated on the same day is allocated 1 patient day. |
Patient-centred care | An approach to health care which places the patient at the centre of the care model, with an emphasis on collaboration between the patient and health-care providers when making decisions about their health and treatment approaches. |
Pharmaceutical Benefits Scheme (PBS) | A scheme through which the Australian Government subsidises the cost of a wide range of prescription medicines. Most prescriptions for General Schedule medicines (Section 85) are dispensed through community pharmacies, but the PBS is also available through eligible public hospitals to patients on discharge, and day patients. Several drugs are also distributed under alternative arrangements where these are considered more appropriate (Section 100). |
Prescription | An authorisation issued by a medical profession for a patient to be issued a particular medication. For dementia-specific medications, typically a prescription (script) authorises a person to receive one month’s supply of medication. |
primary health care | See community-based health care. |
Principal diagnosis | The principal diagnosis is the diagnosis considered to be chiefly responsible for occasioning an episode of patient care (hospitalisation). |
procedure | A clinical intervention that is surgical in nature, carries a procedural risk, carries an anaesthetic risk, and requires specialist training and/or special facilities or equipment available only in the acute-care setting. |
Rate | One number (numerator) divided by another number (denominator). The numerator is commonly the number of events in a specified time. The denominator is the population ‘at risk’ of the event. Rates (crude, age-specific and age-standardised) are generally multiplied by a number such as 100,000 to create whole numbers. In some instances, for example with prescription volumes or expenditure amounts in magnitude, a multiplier of 100 is used to aid comprehension. |
Remoteness | Remoteness is classified according to the Australian Statistical Geography Standard 2016 Remoteness Areas structure, usually based on location of current residence. Data on the location of usual residence may be collected differently across data sources. ABS correspondences are used to assign data from one type of geographic region to another, for example, Statistical Area Level 2 (SA2) to Remoteness Areas. |
Repatriation Pharmaceutical Benefits Scheme (RPBS) | A scheme through which the Australian Government subsidises the cost of a wide range of prescription medicines for veteran (DVA) health care card holders. Like the Pharmaceutical Benefits Scheme (PBS) most prescriptions for General Schedule medicines (Section 85) are dispensed through community pharmacies, but the PBS is also available through eligible public hospitals to patients on discharge, and day patients. Several drugs are also distributed under alternative arrangements where these are considered more appropriate (Section 100). |
Residential aged care | A program that provides personal and/or nursing care to people in a residential aged care facility. As part of the service, people are also provided with meals and accommodation, including cleaning services, furniture and equipment. |
Respite care | An alternative care arrangement for dependent people living in the community, giving people – or their carers – a short break from their usual care arrangements. Friends, family or the community may also provide informal respite. This report includes respite care where it is offered through a residential aged care facility. |
Respiratory condition | A condition affecting the airways and characterised by symptoms such as wheezing, shortness of breath, chest tightness and cough. Conditions include asthma and chronic obstructive pulmonary disease (COPD) – which includes emphysema and chronic bronchitis. |
Risk factor | Any factor that represents a greater risk of a health condition or health event. This report explored risk factors that may increase length of stay in hospital. |
Rivastigmine | A dementia-specific medication approved in Australia for the treatment of mild to moderate Alzheimer’s disease. It is an acetylcholinesterase inhibitor and works by blocking the actions of the enzyme acetylcholinesterase, which destroys acetylcholine – a major neurotransmitter for memory. The use of this medicine may lead to increased communication between nerve cells and slow dementia progression. |
Separation | A separation is the formal process where a hospital records the completion of an episode of treatment and/or care for an admitted patient – in this report, described by the term hospitalisation. |
Statistical discharge | A statistical discharge is a mode of separation assigned to patients for whom the intent of care changed during their stay in hospital (for example, from acute care to palliative care). |
Underlying cause of death | The disease or injury that initiated the train of events leading directly to death, or the circumstances of the accident or violence that produced the fatal injury. See also cause(s) of death and associated cause(s) of death. |
Vascular dementia | A form of dementia mainly caused by haemodynamic (blood flow to the brain) disorders (e.g. strokes), thromboembolism (small blood clots that block small blood vessels in the brain), small blood vessel disease in the brain and bleeding into or around the brain. |