OVERVIEW

Between 1 July 2013 to 30 June 2017, ACCD was under contract by the Independent Hospital Pricing Authority (IHPA) to develop and refine the AR-DRG Classification System which consisted of two components, namely:

  • ICD-10-AM/ACHI/ACS and
  • AR-DRGs

During this period, ACCD delivered to IHPA:

  • Ninth and Tenth Edition of ICD-10-AM/ACHI/ACS and
  • AR-DRG Version 8.0 and 9.0

In 2016, IHPA made a strategic decision to retain the development of the AR DRG classification within the agency for the development of AR DRG V10.0 and continued to contract ICD 10 AM/ACHI/ACS Eleventh Edition development to the ACCD.IHPA and ACCD will work together to ensure there is continued integration between ICD-10-AM/ACHI/ACS and AR-DRG development.

The complex and significant work program for the continued maintenance and development of ICD-10-AM/ACHI/ACS supports IHPA in the development of Activity Based Funding classifications.

The consortium partners have the following responsibilities:

  • The University of Sydney has overall responsibility and provides leadership for the ACCD. The University, with its associated experts, takes responsibility for the work on ICD-10-AM/ACHI/ACS maintenance and development which underpins the AR-DRG classification as part of the AR-DRG Classification System, and for communication with stakeholders, education and publishing.
  • Western Sydney University (WSU) is responsible for IT systems maintenance and development, including the user interface for submissions and queries, and the (internal) IT platform to manage the processing of proposals.

Both IHPA and ACCD recognise the risk in orienting the refinement of the ICD-10-AM/ACHI/ACS purely towards AR-DRG classification development. Both components need to be cross-referenced, but not be purely driven, limited and determined by each other.

Ensuring Objectivity in AR-DRG Classification System Changes

Separate development of ICD-10-AM/ACHI/ACS and AR-DRGs minimises the likelihood that changes in the former are designed to produce a specific grouper outcome. The primary consideration should always be clinical and statistical appropriateness. It remains essential for operating procedures and governance to separate clearly the reasons for changes to ICD-10-AM/ACHI/ACS and AR-DRGs, so that the purposes of each are clear, transparent; and that the financial impacts of grouper changes are also clear to all parties involved.

Providing for Multiple Uses of ICD-10-AM/ACHI/ACS

ACCD recognises that ICD-10-AM/ACHI/ACS has many uses other than providing a classification base for AR-DRGs. Other important uses in the Australian health system include safety and quality of health care, evaluation of primary care (through analysis of potentially preventable hospitalisation) and population health (determinants of health). Proposals for governance and expert input take into account these varied uses. ACCD have a good understanding of all these uses of ICD-10-AM/ACHI/ACS.

ACCD aims to achieve the objectives in the maintenance and development of ICD-10-AM/ACHI/ACS through:

  • Stakeholder engagement through our Governance model, public submission and queries process and pro-active communication strategy.
  • Enhancement of the refinement processes by increased stakeholder consultation, and migration and incorporation of methods and information technology (IT) systems for refinement of the ICD-10-AM/ACHI/ACS classifications.
  • Transparency of classification inputs and outputs and key stakeholder management that will be fostered through an agreed project and communications plan.
  • Accountability of classification outputs through agreed timelines for project deliverables as well as specific process performance measures.

ACCD incorporates diverse skill sets and operates under this best practice approach.